My Wife VL increased dramaticaly, Please help

Hi All,
My wife VL tested on Nov 20, 2008 was
3.68 x 10*6 IU/ml (6.57 Log)  (20-Nov-08)

And when I checked her Genotype and I checked again her VL now is
1.10 x 10*7 IU/ml (7.04 Log) (15-Jan-09)

Within two and half months increased a lot... I am really worried for her because her
Genotype : 1b and VL is very high. Kindly encourage us for following questions:

(1) She is 6 1/2 pregnant  and maybe because of she is taking vitamin ? Like OBIMIN ? Shall we stop taking these pails?
(2) Will she be alright to wait another 6 months? ( 3 month delivery and another 3 month to gain strength for her), Please advise... When she shall get treatment...
(3) We haven't see her Liver Doctor yet, but her doctor told us her other Blood Result and Urine result are normal

ALT/SGPT    21.5 <33
AST/SGOT   18.5 <32

Thank you all please help us to release our worried...
Aung

  

[HCA]

The viral load is not important-it goes up and down with everyone.
High load does not mean bad news,low load does not mean less disease.
The ALT/AST are quite normal meaning that there is not much inflammation at this point.
You don't have to worry or change anything-just continue with your plans.

[FlGuy]

You should ignore the fact that she has hcv, at least for a while and concentrate on her pregnancy instead.  Viral loads, when not on treatment, are expected to fluctuate so the results are not surprising. And, the plan to start tx 3 months post-birth seems a little aggressive.  Having a baby around while on treatment could be a difficult undertaking for all of you (that's not even considering her intention to breatfeed or not).  Have any idea what her liver condition is?  Good luck.

[aungkyawsan]

ႈWe thank you very much for the encouragement. After seeing HCA and FlGuy replied..(She was near me) now my wife went to bad with released.... Thank you guys...

FlGuy,
Thank you, we will now only concentrated on our coming-baby.  I really don't know her Liver situation... yet... I will check only after delivery. I will post and tell you guy..later.. She is 34... Liverbiopsy is not available at the moment in our country.... I will do other possible test... If you all have any advise, regarding Liver test apart from Liver Biopsy, please tell me... ( I think once I saw in this forum...I will also look for it..)
Thank you all for the encouragement....
Love you guys...and wish you all the best..
Aung

[nygirl7]

FYI I had two children when I didn't know I had the disease yet and both kids are just perfectly fine.  MOST of us women have given birth with HCV and our children have not gotten it. Tell her to relax, worry about the hep at another time and right now enjoy the pregnancy with all her heart.

[aungkyawsan]

Thanks nygirl7....
I will show your message in the morning... She couldn't sleep last two nights.  THanks you guys....

[shupeg]

Congratulations on the pending birth of your child.

For the next 8-11 weeks the sole focus should be supporting your wife. Until she delivers, it is unlikely that anything that can be done to reduce your wife's viral load.

Is your wife's OB is aware of her hcv? If so, he should be able to determine if the pre natal vitamin is safe for her.
My Ob consulted with a heptologist during my pregnancy and I was on a prenatal vitamin the entire time.

Once the baby is born, you and your wife should consult with a heptologist, have a biopsy and determine what the best course of action will be for your wife.

I delayed my treatment because of several reasons. I wanted to recover from a C- section. breast feed, and spend time taking care of my son. This was of course a decision I made with my Doctor and the fact that my genotype is 2 stage1 vl under 60,000. I postponed treatment for over 4 years. My son is not infected.

I hpoe this helps,


Shupeg

[aungkyawsan]

Thanks Shupeg.... It seems Your genotype and VL not as bad as my wife..
All advise that we should concentrate now on her delivery and that we are convinced. We are seeing one heptologist and thinking of to change another one after delivery as he is very quite and don't explain us very much..
We have well informed our OG about her HCV and she is aware of it.  We still hesitate to make decision for her breast feeding... Because of her high VL? Is it related?

Did you breast feed? Like VL she has, will that be safe for breast feeding?
Thanks SHupeg..
Aung

[GreatBird]

VL shouldn't have any impact on breast feeding.

I breast fed both of my children long before I ever knew I had the virus and they are both healthy adults now with no HCV.

[aungkyawsan]

Thank you GreatBird,
We will do breast feeding then..thank you...

[Marcia2202]

You cannot transmit HCV through breast feeding. I breastfed all my five children. The only way this could possibly transmitted through breast feeding, is if one would be bleeding from the breast and the baby had a cut in it's mouth. If a woman's breast would be so sore that she was bleeding, she would not be able to breast feed anyway, it would be much much too painful.

Also I wanted to say again that the Viral Load has nothing to do with the progression or severity of the disease. So please do not worry about VL. Also the fact that your wife has genotype 1 doesn't mean that her hepatitis is more dangerous. It just means that it will take a longer period of time to treat and is a bit more tricky. She might even be able to wait for the new drugs and will have a much better chance of clearing with less treatment time. You can find out all that later, once she has given birth etc...

If you cannot have a biopsy in your country, maybe you could have the fibrosure test. I believe it is a blood test. You would probably have to send the blood to S'pore too, as it is a quite new way of testing. It is not as accurate as a biopsy, but an alternative.
I'm not so knowledgeable about this test, but it has been discussed a lot on the forum.

[FlGuy]

I recall (haven't read it lately) that ribavirin (in case wife decides to treat) and breastfeeding don't mix.  That was the purpose for my earlier reference to breastfeeding.

[Trinity4]

Absolutely correct FlGuy.  She would have to wait until she is no longer breastfeeding the baby.  

[FlGuy]

I haven't gone back to look at the riba warnings. But, it may be cessation of riba plus 6 months - not sure.

[shupeg]

During the time between birth and starting treatment, breastfeeding is by far the best thing for everyone. It will help her heal, bond with your child and is the best nutrition for the baby. Once she decides to treat, she must stop breastfeeding. Best wishes to you and your family.

[jankar]

I had a baby at 34 when I had HCV - a beautiful boy who just turned 21, no HCV for him.  I breastfed him for 13 months - until he no longer wanted to be breastfed - he decided.  Now I have a beautiful grandaughter as well.  I am now 55 and am now treating.  Have your baby and wait until things settle down - please try not to worry too much.  

[aungkyawsan]

Thank you all again for the encouragement...

Please understand us if we asked again and again same questions (such as breast feeding...) as this forum is only one that we can rely on not only information, but also encouragement.

We made firm decision for breast feeding. Thank you all.
Yes Maricia, now all her blood test had been done at Singapore, National University Hospital. There is a service company in Myanmar only the fact that every times it costs U$ 250/-... We will do fibrosure test  before treatment, . Once I also saw on this forum just hope not very much expenses and also hope for more cheaper drug coming along before she start treatment.

God bless you all...
Aung

[jankar]

I understand how stressful it must be when you are processing new information like this.  I have been very careful with my son, my partner and still make them go and have HCV tests so I don't worry - it can be worrying but rest assured it is very difficult to transmit HCV and it is such a slow moving disease you have a lot of time to make decisions about what to do and how to do it.

[aungkyawsan]

Thanks Jankar
Seeing my wife, I can easily understand about motherhood and how stressful she is now with pregnant at the same time living with HCV.  I really admire and respect all mother, especially with HCV... how they are fighting ...
I will give all my support...
God bless you all...
Aung