Lab Results Interpretation Help, Please

Hello everyone.

Can someone please tell me if these results are promising?

Before I started tx, my lab results from 11/14/06 were as follows:

Hep C Quantitiation 1,140,000 IU/mL

HCV log10  6.057 log10  IU/ml

(Is the first number my viral load?)

The results I got today from 1/16 bloodwork are:

Hep C Quantitation 93,200  IU/mL

HCV log10  4.969  log10  IU/mL

Thanks in advance,

Wyntre

[hepcD]

The number 1,140,000 is your starting vl
HOw long have you been on tx ?

[compulsive]

Of course -  only YOU could force me to post here!!!
(just kidding....}

I am thinking this must be your 12 week pcr result?

the relevent #'s are:

                     6.057
                       and
                     4.969

Which is a drop in your viral load, which means you ARE responding to the treatment, which is good.  

Hang in there and everyone else will tell you all the technical things you need to know - the good the bad and the luke warm!

[wyntre9]

Yes, Hep, 1,140,000 is my starting hep C quantitation (am I to assume that's also referred to as viral load?)

Gee, Comp, I'm soooo glad you did surface on this side just for me.  :)

I've been on tx for 6 weeks as of today.

My doc has me going weekly or bi-weekily for blood tests coz my wbc and platelets are a problem.

In fact, here are those results, too.

Any advice?

WBC   2.7  LOW

Platelets,  133  LOW

and Neutrophils, (Absolute)  LOW

[compulsive]

Uh... stay away from sick people and crowds?

  I'm no expert - but I know my WBC is around there and thats what my doc told me.

  You might want to post what your HGB is as well, 'cause for sure someone is gonna ask about it!

AND - While your not UND at 6 weeks - a two log drop (I believe that's what I am seeing) is a quite respectable response.  Be happy - treatment is working for you!!

[HCA]

Your 6 week pcr shows a drop of 1.09 log.
This is a rather mediocre result.
To have any realistic chance of SVR you must show at least a  log drop at 12 weeks.
The dramatic viral eradication tends to happen in the first weeks.
You are in there punching and we have to hope that the 12 week test is better for you-wishing you the best!

[HCA]

Sorry should of course read 'at least 2 log drop'

[wyntre9]

Would that include hundreds of 5-10 year old kids, as in a public school?

(Last week WBC was 2.2 and my Primary Doc did call me and tell me I shouldn't leave the house and definitely shouldn't go back to work any time soon.)

I thought he was saying that coz he's from Russia.

Terminology problems.

UND = undetectable?
HGB - Is that Hemoglobin?

One other thing.  My ALT is now 28.
The reason I was even tested for Hep C back in August was coz of slightly elevated ALT of 47.
So is this another sign the tx is working?

YAAAAHHHHHHHHH!

[wyntre9]

So since I'm only at the halfway point of this magical 12 week PCR  (what's that)
and I've got a 1 log drop,
doesn't that indicate the chances of getting another 1 log drop in the next 6 weeks are good?

Of course, I'm no mathematician.  Can you tell?

[compulsive]

I knew it was a "decent" drop in your viral load - wasn't too sure if it was one or two logs.  I shouldn't have said anything...

and yes,

UND = undetectable
HGB = Hemoglobin


It may be another good sign that your WBC crept up a bit.  That means You may escape the exciting "rescue drug" ride.  


Hang in there, there will be other folks here to tell you lot's more soon.

I just had to stick my nose in since it's you...
see ya on the "other side"



  

[HCA]

It's a tricky one!
Viral eradication is not linear.
The vast bulk of the virus tends to get wiped out in the first four weeks-thats what we want!
You are responding but not particularly quickly,and quick is best!
It's result not bad, but not great.
We have to see you at an absolute maximum of 11,400 at the 12 week point.
Just fight the good fight till the next test-could be you do better than that figure! Certainly hope so!

[wyntre9]

Thanks for the advice.

And. btw, I'm not upset or depressed or anxious or anything like that.

Just curious.

[HCA]

I have just given you stats. and you are not a statistic you are a person and your response pattern does not have to follow averages shown by other people.
You could still test undetectible at 12 weeks-there are plenty of people on this forum who have bucked trends.It's all a bit of a lottery!!

[jmjm530]

I agree with HCA. What you want is at least a 90 per cent drop in viral load per month. Depending on how agressive you want to fight this, consider asking your doctor to either increase your dosage and/or change the type of interferon. At the same time, consider weekly viral load tests until non-detectible to check your progress or lack thereof. If you're still detectible at week 12 (and non-detectible at week 24) by very sensitive vl tests, studies suggest you will need to treat for 72 weeks for a decent chance at SVR.

My personal feeling is that if you have little or no liver damage --  and are still detectible at week 12 -- better to stop treatment, cut your losses and adopt a liver healthy lifestyle to fight another day, hopefully with better drugs.

All the best,

-- Jim

[jmjm530]

But what do I know...I've been dead for five years.

[wyntre9]

OK.

So based on my interpretation ;) my VL is less than 10% at 6 weeks than it was pre TX
(93,000 = more than a 90% drop from 1,140,000)

So, I therefore (choose) to conclude that it stands to reason that in twice the time, 12 weeks vs. 6 weeks, the VL will likely drop
to 10% of it's current rate of 93,000

WHICH, will mean 9,300, well under the magic number of 11,400.

Right?  :)

OK, you don't have to answer that.  
But, seriously, I really appreciate the number crunching.  
I'd always rather KNOW than NOT.
But you still didn't tell me what PRP is.

[wyntre9]

A Ghost in the Post.  OOOOOOOoooo.

Someone better report it.  It's haunted.  :)

[HCA]

Check out Jim's post above-he is well informed and respected on treatment issues.
I think you mean PCR-stands for polymerase chain reaction,and is the lab process which analyses the quantity of RNA (the virus) which is evident in the blood sample they took from you.

[compulsive]

jmjm,
Yes, that was a pretty strange little study.  Your pretty lively for somkeone who's been dead 5 years...


wyntre,

Do you mean a PCR  - as in 12 week pcr?

a PCR is your viral load test, its the one that gives those numbers  you've been crunching...

[orphanedhawk]

Since my platelets and wbc are much, much lower than yours, I don't think you have much to worry about. I wouldn't run around wiping snotty kid's noses but as long as things stay where they are, I wouldn't worry. ( But I may not be a good one to listen to)

[jmjm530]

Wyn,

How much ribavirin are you taking, how much do you weigh and do you know what your pre-treatment hemoglobin was and what your hemoglobin is now? I ask because it's important to be on the current riba dose for your weight and more than that some suggest that if you don't have a decent enough hemoglobin drop, maybe the ribavirin isn't being absorbed into your system as effeciently as it should. Not all agree on the latter.

SF,

I don't see any disagreement except for how I'd personally handle being detectible at week 12. If you're detectible at week 12 and non-detectible by week 24, then your chance of SVR goes up if you treat for 72 weeks. But if you're still detectible at week 24, your chance of SVR is not very good. I think this is what you are saying as well?

-- Jim

[jmjm530]

OK. That means it's your week 4 viral load test which makes perfect sense. It still shows you're responding, just not a rapid responder. Might then want to ask your doctor to test you again for viral load at let's say week 6. BTW, try and get your next viral load test the day before your shot. For example, ideally your week 6 viral load test would be the day before your 7th shot.

-- Jim

[wyntre9]

"How much ribavirin are you taking, how much do you weigh and do you know what your pre-treatment hemoglobin was and what your hemoglobin is now? I ask because it's important to be on the current riba dose for your weight and more than that some suggest that if you don't have a decent enough hemoglobin drop, maybe the ribavirin isn't being absorbed into your system as effeciently as it should. Not all agree on the latter."

I know I'm gonna be demoted or unpromoted or left back.

I weigh 140.
I'm on 1000 of Ribavarin.
Hemoglobin now is 13.2
Hemoglobin before tx was
(drumroll)
14.5

[sfbaygirl]

Jim; Got ya! I know you are saying this way after the fact, but can you really say if you were in the postion of extending if you weren't totally clear at week 12, but were at week 15 you would have stopped? Of course then there weren't the studies in that there were then...

Wyn/Jim/compulisive;  From what I have read and heard (Jim has the studies) we don't have to worry about catching things when our White counts are low on tx. I have been on planes, trains and with tons of snot nosed kids at fairs and haven't caught a thing with really low platelets and WBC/ANC at 400.

[jmjm530]

That's the correct ribavirin dose for your weight. Depending again on how agressively you might want to fight this, you could ask your doctor about increasing your ribavirin to 1200 mg/day. The logic here is get your serum ribavirin levels up higher with the hope of speeding up your viral response. The downside of increasing ribavirin is that you may end up with more side effects including anemia. Certainly not a clear cut call given your numbers.  BTW do you know what stage liver damage you have from your biopsy?

-- Jim

[HCA]

Thought a three week test would have been unusual.
Now we know it's a four week result it's a little more encouraging.
I can't find relevant data on four week tests other than UND/rapid virological responders-the dream scenario.
Your doc. will probably next test at twelve weeks when all will be revealed.

[jmjm530]

SF:...I know you are saying this way after the fact, but can you really say if you were in the postion of extending if you weren't totally clear at week 12, but were at week 15 you would have stopped?
--------------------
What I said was that if you/I/anyone has *little or no liver damage* then it's very reasonable to stop at week 12 if still detectible because the odds aren't at all good unless you extend and/or boost the meds with the risk of accompanying side effects.  In my case, I was under the impression I was between stage 3 and 4 when I began treatment (significant liver damage), so no, I probably would not have stopped. In fact, I believe the original plan was to go to Infergen if detectible at week 12 and extend to 72 weeks. To be truthful, if I had little or no liver damage, I wouldn't have treated, period.
----------------------------------------

SF: we don't have to worry about catching things when our White counts are low on tx. I have been on planes, trains and with tons of snot nosed kids at fairs and haven't caught a thing...

ANC, not WBC is the important lab to look at. Many doctors don't intervene with helper drugs until ANC is below 500. My doctor let's it drop to 200. I was never told to stay away fron snot nosed kids :)

-- Jim

[jmjm530]

SF:...I know you are saying this way after the fact, but can you really say if you were in the postion of extending if you weren't totally clear at week 12, but were at week 15 you would have stopped?
--------------------
What I said was that if you/I/anyone has *little or no liver damage* then it's very reasonable to stop at week 12 if still detectible because the odds aren't at all good unless you extend and/or boost the meds with the risk of accompanying side effects.  In my case, I was under the impression I was between stage 3 and 4 when I began treatment (significant liver damage), so no, I probably would not have stopped. In fact, I believe the original plan was to go to Infergen if detectible at week 12 and extend to 72 weeks. To be truthful, if I had little or no liver damage, I wouldn't have treated, period.
----------------------------------------

SF: we don't have to worry about catching things when our White counts are low on tx. I have been on planes, trains and with tons of snot nosed kids at fairs and haven't caught a thing...

ANC, not WBC is the important lab to look at. Many doctors don't intervene with helper drugs until ANC is below 500. My doctor let's it drop to 200. I was never told to stay away fron snot nosed kids :)

-- Jim

[sfbaygirl]

yep, your'e demoted alright! I was about same weight etc and the same dose of Riba. My HGB dropped from 16 to 11 in about 3 weeks. There are those dr's and patients here that say we need to drop Hgb to show the drugs are working enough.

I just got a new script of Riba in the mail, they want me to increase to 1200!!! Of course no one told me ahead of time. I was shocked. I sure don't know why they are changing me now. I did gain some weigt to 150, but CPMC dr actually mentioned upping the Riba, but ruled it out due to my horrible problems with ANC, and HGB. I am finally stabilized above the horrid number where I need Neulasta and ARanesp. I am at week 41 and am wondering will it do any good at this point?

[wyntre9]

I'm gonna quote this so I don't make KNOW mistakes. :)

Liver Core Biopsy consistent with Chronic Liver Disease (clinically Hepatitis C)

Mild Chronic Hepatitis Grade 1 with minimal Stage 1 Portal Fibrosis.

[sfbaygirl]

I know that ANC is the number, believe me LOL. Just some here are confused with the WBC and ANC and since the ANC makes up the WBC, I thought I would put them both, maybe a mistake, huh?

What do you think about my upping the Riba? Scares the bejeezes outta me!

[jmjm530]

This a very good biopsy report. It means you only have mild liver damage.

-- Jim

[compulsive]

Thats very good to know - about the platlets and WBC and ANC.  Thanks for the info. There never seems to be enough time to ask about everything in Docs office....All I knew was if they were TOO low - I would be on the rescue meds...

[jmjm530]

To simplify, a PCR is simply a viral load test and often used interchangeably with "viral load test" here. There's also another type of viral load test called a "TMA". Until recently, most TMA's were more sensitive than PCR's, but not necessarily the case now.
So rather than get bogged down into what type of viral load test tto take, the easiest thing (once you start treatint) is just to seek out a very sensitive viral load test, be it PCR or TMA. Quest diagnositics has a very sensitive test that combines both PCR and TMA technologies, called "Heptimax". LabCorp also has an equally sensitive viral load test.

[wyntre9]

Comp - yes, I meant PCR - Poly ----Chain reaction.  Got it.

HCA, yeah, I read Jmjm's post and will absolutely follow up on his suggestions.

JmJm - you there, JmJm?
(He's doing it again.  Haunting the thread.)

[jmjm530]

Yes, booo hooo...

btw the part about stopping treatment and cutting losses at week 12 if still detectible is just my general opinion and no doubt carries my bias against current SOC for all but those with significant liver damage. Geno 1's I'm talking about here. Therefore the logic flows that if you do decide to treat with little or no liver damage, then only continue on if you have a good viral response. In other words, don't risk the potential sfx of all those meds, including extended treatment, when the odds aren't in your favor.  Conversely, if you have significant liver damage, it's reasonable to push the treatment envelope because you have more to lose if treatment fails. Needless to say others disagree with this thought process but the important thing is how you feel about it after studying up and deciding what's best for you.  

Be well,

-- Jim

[wyntre9]

Yeah, my doctor already told me (and this was before new bloodwork results, which, btw, are from a sample taken 1/15 which was only 3 weeks into tx)

...And, he said if at 6 months I'm not progressing as he'd like he won't torture me for 24 weeks more.

FYI, I'm 1A, Stage 1 grade 1.

[compulsive]

*laughing*  Ok - so - just to clarify

TODAY you have been treating for 6 weeks.  On 1/15 from which these results are - you had only been treating for 3 weeks?

Therefore - this is your 3 week PCR (viral load test) - NOT your 6 week viral load test (PCR).

[jmjm530]

I thought you posted earlier that these were week 6 results, not week 3? As to waiting six months for a decision -- just keep in mind that even if you're non-detectible by six months, if you're still detectible at week 12, then you will need to treat a total of 72 weeks for a decent chance of SVR. So the decision then at week 12 -- assuming your're still detectible -- is are you willing to treat for 72 weeks.

-- Jim

[HCA]

If I were you,and I wish I was stage 1,I would pass on the torture and get with the moderate pain treatment programmes which will be availible in probably 2009.They will work better too!
But discuss it with your doctor-don't just do what a couple of internet know-all's tell you

[jmjm530]

If indeed these are week 3 results than you're responding but if it were me I'd bug my doctor for weekly viral load tests until non-detectible and still consider tweaking the meds if the response curve doesn't point to non-detectible at week 12 at the latest.  If that isn't possible, at least try for another viral load at week 6 and then take it from there.

-- Jim

[wyntre9]

Yes, C.  This is why I need you.

You understand me and my warped incompulsivity.

I didn't realize it was the 3 week report until I just looked at it and forced myself to do the math.  (It's as painful for me as it no doubt is for everyone else.  that's why I'm forcing myself to do Suduku puzzles, hoping it may help . . .something)

Started 12/22 with pre tx results as reported way way way up at the top of this thread.  

The report that I received today is dated 1/15 so that makes three weeks, right?

Sooorrry

[sfbaygirl]

I disagree Jim, there are the thoughts that if not UND at 12 weeks one should stop tx. She does sound like a slow responder, but if she is UND by 24 weeks she can still achieve SVR. Granted there will be an extension to 72 weeks. Several of us here have not achieved UND at week 12 and are going 72 weeks. Wytre, after lots of investment in tx, you may choose to stop at week 12 if you don't show at least a good drop (more than 2 logs) and you may take the risk to continue to at least 24 weeks getting lots of PCR's to see when you clear. If you do not clear at 24 weeks, it's time to stop. But if you do clear by week 24 weeks there are studies that show you have a good chance of SVR.

Also IDEAL? study? docs show that doing tx one time has a MUCH better chance of achieving SVR than if you try and stop, then retreat at a later date. Your chances of SVR go up with extention, rather than stopping and starting again.

[HCA]

Important point-please confirm how many shots you had had when the sample was taken.
It is critical information.

[compulsive]

*still laughing*

Hey - no worries, thats why I stuck around - I thought maybe something was a little "off" with the numbers and dates - but my brain isn't what it used to be. It wasn't until your last post that I realised what had "happened".

[wyntre9]

Oh, I'm getting so stressed.

I started 12/22
12/29
1/5
1/12
so that makes 4 shots before the lab results I got today which are
from a sample drawn on 1/15 and reported on 1/23.

I'm gonna put myself in Time-out.

[jmjm530]

Honestly, I forgot all your stats including stage and viral load numbers to date.

First, based on what you said, I'd confirm with your doctor that they actually want you to increase the ribavirin, as opposed to it being a mistake. At the same time ask why they are increasing it at week 41, especially if you're treating for 48 weeks. On the other hand, if you had a slow initial response and are extending to 72 weeks, it might make some sense although might go against conventional wisdom that riba makes more of a difference earlier.

-- Jim

[wyntre9]

I can't find my ANC's in my report.
As a matter of fact, I can't find my report (or anything else.)

(Organizing and filing paperwork is another one of the many skills in which I'm lacking; along with math, that is).

In all seriousness, you've been extremely patient with me while
trying your darndest to educate me.

I know it ain't easy.

But after this thread, when I see my Doc next week I'll be Soooo much better informed and then I can drive HIM nuts with my answerless questions.

[sfbaygirl]

To tell you the truth, I don't know my stats! I was stage 1/4 6 years ago with biopsy. 4 million IU/ml starting. At 10 weeks PCR I was between 75-200 IU/ml. UND at week 20 <75, 32 weeks UND <5. Working on getting an extention to 60-72 weeks. Dr. F says 60 weeks  total, dumb GI stop no matter at 48, me- go to 72 weeks based on recent studies.....Gonna start oxymatrine...

[FlGuy]

I just wanted to point out that your vl went from 1,140,000 IU/mL
to 92,200 IU/mL and that pretty good.  Was it HCA who said 1 log? Keep in mind that although you might be in week 6 right now, that pcr was a week 3 blood draw. Using that point of view you're making good progress.  Try to get a pcr at least the day before shot 9.  I think you'll see MORE good progress by then.

[sfbaygirl]

Forgot to add- Fibroscan was a 6 and my recent dr. appt. said he "suspects" early fibrosis....talk about confusing!

[jmjm530]

Assuming your doctor wants you to up the riba, it's a reasonable decision but not sure why he waited so long if that's his thinking. As far as how agressively you should handle treatment, so much depends on what you think your liver damage is, as well as your personal take on things. Since it's been 12 weeks since your last VL test, I'd get another sensitive VL now (at least <5) and ideally every month thereafter .

-- Jim

[wyntre9]

Thanks for the synopsis.

It allll makes sense now, yeah.  (not)

I think this should be the first AND the last time I post any hard numbers here.

Seriously, you made it so simple.  Why can't I?

SF - you must be going NUTS, between extending tx, upping your Riba.

I feel for you.

[sfbaygirl]

I meant early cirrhosis, not fibrosis on that last post. YOu know what a moron my GI is. I am seeing another Hep dr. on 1/29 to confuse me even more. My GI orginally wrote the script for 1200 Riba, 180 when started. The Pharm sent me the script as 1000 Riba (correct to weight) and said 135 INF. I didn't listen and took the 180 INF (GI said I could, if I could handle it). Major HGB and ANC low levels to this day (not that low). So I have been fully compliant with the meds. Calling my GI is futile, he is so complacant, I won't bother. I would rather email CPMC dr's, or wait and ask the new ins. approved one. Anyway, I think I may NOT add this extra Riba. I think I will ask HR what he thinks about it too. Just wanted your opinion and apprieciate it.

While I've got your ear...I have crusty skin stuff, only in some places where hair grows and maybe thrush? in my mouth...any ideas as to products?

[jmjm530]

Aren't you treating with the G*** group? I get confused who is treating with what initials. LOL. Anyway, if you are, run the xtra riba by them or whoever your new consultant is. If you're tolerating treatment well, it might be a good idea.

Is the "crusty" stuff on your hairline? If so, sounds like
Seborrhoeic Dermatitis. See a good dermatologist and they will give you something. Mine gave me Olux Foam but that's pretty strong stuff and mostly just for the scalp, certainly not the face. Don't know much about thrush, but always get a diagnosis before treating.

-- Jim

[sfbaygirl]

You should hear my husband. I told him about upping the Riba and he let out a howl that scared away the coyotes! Of course he believes my Riba Rage is due to tx and not his ex and stepkids. Hard to listen that even though I may get angry, sometimes it is REAL stuff! LOL So his thinking is that my Riba rage will increase and he is in deep trouble...little does he know he is anyway. LOL

[sfbaygirl]

How about armpits? I know this is such a pleasant subject but is driving me nutz.

[sfbaygirl]

Geez, we are almost the same finish dates, maybe. I have 8 plus 24 which is 32 weeks more. Gosh that sounds so awful to me! my patience is Nil. My daughter in law says I have negative patience. This isn't good. There could be some dead bodies by the end, and it won't be mine! I really want to stop at 48 and it is taking every thing I have to continue. As I said, the sx are worse now than a few weeks ago and I am unbearable to live with. Maybe I need to find a bear cave and hover in there with some nice bear for the winter...otherwise no one in my family will survive!

[FlGuy]

Even at your current weight 1000 mg is about 15mg per kg, which is the sort of the high end of the usual riba dose range (usually 13 - 15 mg per kg) and you seemed to have achieved hgb equilibrium - sort of.  Und at 20, and if you head to 72 that's 42 weeks of UND.  That's got to sound like a reasonable target. (BTW, I'm out afer 44 weeks on und).  Good luck with the decision.  It get easier when you settle in with a no-doubt, non-stop, no-quit number in mind.

[sfbaygirl]

Are they starring DR's names now? Yes, I want to tx with that group. I need to do due diligence and see the dr. my ins. co wants me to see first that is in our group, although Dr. F is in our network, not in our group. So I figure I will do a Jim and go to three Hep dr's and get all confused. LOL...No, I just want to get all those good, or not, opinions and make up my mind. If I decide to go with Gish's group, my appellate attny will draft the brief as to why they should pay....   The ins co sent a letter denying my claim for services from CPMG, now I need to appeal. As long as someone goes along with the recent studies and pays for my tx, I will be happy! You know what? My palms aren't nearly as red when I don't post so much! LOL

[FlGuy]

I think the editor (Jim) was doing some self-editing with the stars. Or, MedHelp's tools are getting more sophisticated and Jim spelled the name with the wrong vowel.

[sfbaygirl]

How are you doing!! Miss ya! So are you saying you are going 44 weeks after UND, which was at week 2 if I remember correctly. The pisser is I dont' really know when I was UND. It could have been at week 12. Remember that conversation we had about me getting a week 10 and if it wasn't UND, I would get another at week 12? Well, my GI said I was UND at week 10, so I never got that week 12 PCR. That Lab screwed up my results and I can't go back and redu them now. So I could be stuck with 72 weeks because of it. Am I angry? Yes. Ready to sue? Maybe. At least for my extended tx if no ins. will pay for extending. That is the whole thing right now. Will the ins. co pay for continued tx. I have been having those end of 48 week awful sx's, and haven't followed through on getting to C2C or much else. Fatigue rules these days. Yeah, it would be nice to know a number, John and I are argueing about 60 v.72. He hates this tx as much as I do.

How is tx doing for you? Sx's? No Neulasta I know, LOL! How's the Hgb and ANC? Are you able to get about and work etc?

[FlGuy]

The one thing you know for sure is und at 20. All else is cloudy.  I'm doing ok, lethargic, fuzzy and grumpy - but bearable. ANC and hgb both fairly stable and no P or N yet but both at low range levels which, oddly, makes me more comfortable.  I really think that more tolerability, this tx, is due to the switch to Pegasys.  But 33 to go and a lot can happen.  Hang in there, no matter what happens you'll be done in a few months, not a lot of months.

[jmjm530]

SF: How about armpits?
------------------------
Anything more or less than two could be cause for concern.


---------------
Seriously, you can get seb derm in your armpits or other moist areas like behind the ears, even on your chest and face. That said, it could be something else like psoriasis or contact dermatitis. Best to get it diagnosed by a good dermatologist. BTW after you get it knocked down by probably a topical steroid (assuming it's seb derm) ask your dermatologist about Elidel Cream for maintenance. That's what I currently use when I get minor flares.

-- Jim

[stangshelly]

I am geno 1a and did not clear until week 24..on 44/72 and blood work is all normal except tsh, but getting there. My inflamation (inflammation) is gone. To tx is a personal decision ,however, I am glad I decided to nip it in the bud so to speak. my damage was stage 2,grade 2 with fibrosis(cirrosis (cirrhosis)). My chances were not the best when I started but have improved since txing !we all respond to tx differently.my blood work has been boderline for weeks but has now returned to normal ranges. best wishes:) shelly

[sfbaygirl]

ANC is Absolute Neutrifil Count. It should be on you CBC

[stangshelly]

meaning to say fibrosis is the early stage term for cirroisis..scarring of the tissue. didn't mean to imply cirrosis (cirrhosis) at stage 2 ,not yet anyway..still have tumor lower lobe but unchanged so far..fingers crossed

[chcnme]

Great reading! And when I read Compulsive had figured out it was your 3 week PCR, it got even  better, and I said YAY!  It's looking good to me.  Your platelets look OK  (133 or... 130 something isn't bad yet, and so that's great news at this stage.)  Have you found out what your ANC is yet?  Somtimes it's not listed on the labs but your doc can tell you.  Did your GI doc tell you to stay home?  Even if it was just the regular doc, I think I'd be inclined to look at the couch real hard :)  Good luck.  You hang in there and let us know how you're doing and what they say.  

Hey Jim, I don't know much about the various viral load tests but have seen it discussed a lot here.  I came across this article a few days ago and was just curious - is this something that's going to be more sensitive if the FDA approves it?  

Roche Diagnostics Submits Hepatitis C Viral Load Monitoring Test to FDA
January 15, 2007 - 2:14 PM


Roche Diagnostics Submits Hepatitis C Viral Load Monitoring Test to FDA
January 15, 2007 - 2:14 PM

Test designed to give doctors highly accurate results and to improve workflow efficiency for labs

PLEASANTON, Calif., Jan. 15 /PRNewswire/ -- Roche Diagnostics announced today that it has submitted its automated test for Hepatitis C viral load monitoring to the U.S. Food & Drug Administration (FDA) for review. The FDA will review the application to determine whether the test can be marketed for diagnostic use in the United States. The test, called the COBAS(R) AmpliPrep/COBAS(R) TaqMan(R) HCV Test, is designed to provide highly accurate information about the quantity of Hepatitis C virus in a patient's blood, from very high to very low levels. This type of diagnostic, called "viral load testing," is a key measure of how well a patient infected with Hepatitis C is responding to drug therapy.

(continued at article)

[jmjm530]

Not that I'm aware of. Quest Diagnostic's "Heptimax" goes down to 5 IU/ml and LabCorp has a test about the same (2 IU/ml).

[sfbaygirl]

Okay, I'll check. I HATE this going back and forth. Us tx'er's have enough trouble getting here, let alone trying to figure out which side we post on! Do we walk on the 'Wild Side' or do we walk on the "other side", and who knows which is which?

[chcnme]

You're doing absolutely fine on the absolute newts :)   If they start getting down to 600 or 500 or 4,3, or.. omg 200, you're in big trouble. Just kidding, but seriously - 500 on the ANC is where most docs will get concerned; others won't and will let you get a little lower.  Your platelets look good.  You're doing great I think.  Go get some juice :)

[wyntre9]

"You're doing absolutely fine on the absolute newts :) If they start getting down to 600 or 500 or 4,3, or.. omg 200, you're in big trouble. Just kidding, but seriously - 500 on the ANC is where most docs will get concerned; others won't and will let you get a little lower. Your platelets look good. You're doing great I think. Go get some juice :)"

I don't understand.  (Unfortunately, the juices are only for others
consumption.  they don't help me at all.  that's because I am the SOURCE of the juice (confusion).

But seriously, how does 1.6 for ANC relate to your number of 500?
I don't get the conversion stuff, the math stuff.
Is it 1,600 vs. 500?
(In my defense, that really is a big reason for my confusion.)

I also don't get the other issue, about the WBC.
My Doc put me on neupogen for 2.2 and not for 2.8.
I don't understand what the cut-off point is.

But I admire your tenacity and persistence in trying to show me the light.  :-)

[sfbaygirl]

Yep, it sounds like those are ANC, Absolute Neutrifil count. 1.6 is awsome! I wish mine were that high! I hover btwn .9 and 1.1 these days and that is GOOD! When you see your hemotologist, and I am SO glad you are, he will give you a number of ANC that he will want to give you a booster shot. My Hemo said 1.0, I disagreed, so I hid from him for a while if they were lower, like .8 and get another CBC when they went up (which is frequently) I would send off the results. Platelets, ANC, WBC, VL can change dramatically in short periods of time. EVen Hgb, but I think that is slower...So don't worry too much when you see a low count, get another and keep on top of it. YOu will get the hang of it soon. Find out your Hemo's low #'s threshold to give his shots. Let us know...Great to get a Hemo in place to take care of things! YOu are doing great and are right where you should be! Good job! I will send you a big gold star, you deserve it. This stuff is tough to learn and deal with. I was just like you are now at the beginning of tx. Keep posting, learn alot and you will be great! You are asking all the right questions. You know there are no stupid questions!

[wyntre9]

Thanks for the clarification, SF.

At the risk of repeating myself ( I posted this on the other side, twice) please check your email.  I sent you something.

[wyntre9]

Oh, the neutrophils (Absolute)

That's the same as ANC, right?

mine is slightly lower than norm - 1.6  Normal in this test is 1.8 to 7.8.

WBC is also low - 2.7 and so are platelets, 133.

How low does WBC have to be for the Doc to recommend neupogen?

2 weeks ago he called me when it was down to 2.2 and had me see the hematologist for a shot.

CH, so glad you figured it out!

Guess my posts are a surefire treatment for brain fog.

Trying to decipher the indecipherable will, if nothing else, get the juices flowing.

[1dayatime626]

Just reading all this imformation and everytime i do i get alittle confused everytime and more frusterated, prob just like everyone one else..I do have regular doc appts monthly and they are more then willing to take the time to answer my questions and they do but the problem is by the time i get to my truck i forget  and to write them down i would prob loose the paper before the appt..... I was UND before my 4 week mark and side effects are managable. I requested the paper work for my blood work before treatment and my 3 week blood test  so i could review and maybe understand alittle better but havent of course, well somethings i have ... So my question is  being told i had a low VL 2.8 short term i guess, how do i find out what the long term is. I seen it at the doc appt but of course forgot and hate to ask again.. My VL is und but still question sitting on my mind and its been 2 weeks wondering the samething....And something else each week  take my needle i feel more grose the next day and each week seems to be a little more to it, by the way of feeling. Just wondering if anyone else experienced anything smiliar... Thank you for your input