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Quickly drop viral load?
I've just been offered a transfer overseas and will be disqualified if test for hepatitis.
In 1998, 2 years after becoming ill, I tested and showed a HEP C PCR QUAN of 362.0. I understand that is quite low per: http://www.hepcprimer.com/tests/pcr-1.html
I did not show anti-bodies at that time. I assume if I hadn't developed anti-bodies by then it is unlikely I have since...
My question: I'll be tested by my company within the month. Assuming my current viral load as low as previously, is there anything I can do to quickly drop it below the 100 eq/ml qualitative PCR or 200 eq/ml quantitative HCV RNA (via PCR) test detection limit?
Might two weeks of pegylated interferon treatment help?
If so, I will test privately ASAP to determine my current viral load and begin treatment.
If not, how quickly might I hope treatment to help? I expect I could put off the transfer for some short time. I understand some significant reduction is expected by week 12?
Thank you.
(And yes, I am very grateful to the transfer offer for moving me past denial. Once beyond the test, I'll more responsibly deal with this.)
In 1998, 2 years after becoming ill, I tested and showed a HEP C PCR QUAN of 362.0. I understand that is quite low per: http://www.hepcprimer.com/tests/pcr-1.html
I did not show anti-bodies at that time. I assume if I hadn't developed anti-bodies by then it is unlikely I have since...
My question: I'll be tested by my company within the month. Assuming my current viral load as low as previously, is there anything I can do to quickly drop it below the 100 eq/ml qualitative PCR or 200 eq/ml quantitative HCV RNA (via PCR) test detection limit?
Might two weeks of pegylated interferon treatment help?
If so, I will test privately ASAP to determine my current viral load and begin treatment.
If not, how quickly might I hope treatment to help? I expect I could put off the transfer for some short time. I understand some significant reduction is expected by week 12?
Thank you.
(And yes, I am very grateful to the transfer offer for moving me past denial. Once beyond the test, I'll more responsibly deal with this.)
At the beginning of current treatment I had the need to get to zero viral load quickly, the speed of 'viral response' dictated my length of planned treatment. I double-dosed the interferon for a few weeks and was virus undetectable after two weeks. As you read more and talk to experienced docs, there may be some out-of-the-box options to explore, if you have a viral load at all.
I am embarassed that I did not answer these questions in 1998. I'm very appreciative today for resources like this site and the kindness of you all.
Though I have a renewed frustration - as I read here others struggling to interpret test results - with Doctor's inability to communicate clearly. Unbelievable.
Though I have a renewed frustration - as I read here others struggling to interpret test results - with Doctor's inability to communicate clearly. Unbelievable.
Hope it works out for you. The opportunity to get an overseas assignment gives one a lot of benefits.
The disqualification would be based on the host country's residency permit restrictions, FIGuy. Not much wiggle room there.
I did see a nurse today and had her take a look at my 1998 test results. She agreed that a AB negative and PCR positive result most likely the result of contamination. And that I should be confident am HEP C free.
I'm going to track down my initial 1996 test and see what it shows. I expect it to be AB negative.
Only if it is not will I privately test and see what my options to suppress are.
Thanks, Jim.
I did see a nurse today and had her take a look at my 1998 test results. She agreed that a AB negative and PCR positive result most likely the result of contamination. And that I should be confident am HEP C free.
I'm going to track down my initial 1996 test and see what it shows. I expect it to be AB negative.
Only if it is not will I privately test and see what my options to suppress are.
Thanks, Jim.
Assuming your viral load is still that low, a couple of shots of peg could get you below 100, in fact you would probably be below 100, 24-hours after the first shot, when viral suppression is the highest. In fact, it's even possible that a couple of shots could cure you, although this is speculation and I'm not a doctor.
All said, you will need a top-level doc to work with you on this, as most docs treat conventionally and will only test at weeks 4 and 12. If you live near Boston or New York, check out Drs. Afdhal in Boston or Dr. Dieterich in New York City.
If it were me, first step would be to get a very sensitivre viral load test done ASAP. I suggest Quest Diagnostic's "Heptimax". It's a quantitative test that goes down to 5 IU/ml. All your doc has to do is write on the rx "Heptimax" and the diagnosis code and you then bring it to any Quest lab.
All the best,
-- Jim
All said, you will need a top-level doc to work with you on this, as most docs treat conventionally and will only test at weeks 4 and 12. If you live near Boston or New York, check out Drs. Afdhal in Boston or Dr. Dieterich in New York City.
If it were me, first step would be to get a very sensitivre viral load test done ASAP. I suggest Quest Diagnostic's "Heptimax". It's a quantitative test that goes down to 5 IU/ml. All your doc has to do is write on the rx "Heptimax" and the diagnosis code and you then bring it to any Quest lab.
All the best,
-- Jim
I'm surprised that a U.S. company (presumably it is) would, or have the right to, deny an overseas placement decision based on anything other than ability, past performance, skills and willingness. Are you saying that the company will receive discreet results of a pcr and other diagnostic medical tests? That does not seem reasonable to me. Same limitations on other conditions like high blood pressure, diabetes, MS, IBS, GERD and all inherited and genetic diseases? As Ricky Ricardo would say, the company has some splainin' to do.
A couple of things spring to mind
It is possible that your tests were false negative and a false positive. With the early tests this was relatively common especially with EIA. PCR tests are more reliable but you can still get false readings.
I think is possible to be AB negative and PCR positive, but only just after you catch HCV.
It takes a few days for your body to recognise the virus and then create anti bodies. But create them it will unless you have HIV. If you have or have had HepC then you will have the anti bodies for life.
As you were tested after you became sick it is possible that you have HepC and cleared it naturally. Most people who spontaneously clear HCV were symptomatic.
The only way you are going to be able to know for certain is to have an anti body and then a PCR test privately. Just don’t be surprised if it is negative. If positive knock the job or sue em for discrimination.
CS
It is possible that your tests were false negative and a false positive. With the early tests this was relatively common especially with EIA. PCR tests are more reliable but you can still get false readings.
I think is possible to be AB negative and PCR positive, but only just after you catch HCV.
It takes a few days for your body to recognise the virus and then create anti bodies. But create them it will unless you have HIV. If you have or have had HepC then you will have the anti bodies for life.
As you were tested after you became sick it is possible that you have HepC and cleared it naturally. Most people who spontaneously clear HCV were symptomatic.
The only way you are going to be able to know for certain is to have an anti body and then a PCR test privately. Just don’t be surprised if it is negative. If positive knock the job or sue em for discrimination.
CS
I'm sorry James --- I'm like uhm... I have no clue... That's rocket science compared to my little pea-brain.
However - I've never met anyone with a HCV Viral load --- and popping negative on the antibodies...
But you could be the total first - And I could say I know someone!
So tell us how it goes, please.
And yeah - depending on your Genotype - you could go undetectable if you're a rapid responder.
However, you'd still have the presence of antibodies in your system if you have HCV.
Privately re-test... But exclusion based on ANTIBODIES would not be appropriate - if your VL is way down past PCR and UND or SVR.
If you're looking for a way to deny antibodies - then I don't have a clue.
Good luck.
Don't pass the disease on - and hopefully you'll treat well, this silent killer.
Meki
However - I've never met anyone with a HCV Viral load --- and popping negative on the antibodies...
But you could be the total first - And I could say I know someone!
So tell us how it goes, please.
And yeah - depending on your Genotype - you could go undetectable if you're a rapid responder.
However, you'd still have the presence of antibodies in your system if you have HCV.
Privately re-test... But exclusion based on ANTIBODIES would not be appropriate - if your VL is way down past PCR and UND or SVR.
If you're looking for a way to deny antibodies - then I don't have a clue.
Good luck.
Don't pass the disease on - and hopefully you'll treat well, this silent killer.
Meki
Think I'll try to go to sleep thinking that the NONREACTIVE HEP C AB test was the EIA test.
("The enzyme immunosorbent assay (EIA) is the conventional, initial screening test to diagnose hepatitis C infection. The EIA measures specific antibodies to small pieces of the hepatitis C virus proteins (antigens). This test, therefore, is referred to as the anti-hepatitis C virus antibody test.")
And that it failed to detect antibodies not because I immunosupressing,
("...certain patients whose immune systems are impaired [suppressed] may not have detectable anti-hepatitis C virus antibodies even if they are actually infected with hepatitis C virus. Such immunosuppressed patients include those who are on renal dialysis, suffer from cancer and are receiving chemotherapy (drugs to kill cancer cells), or have active HIV infection. These patients cannot produce enough anti-hepatitis C virus antibodies necessary to generate a positive EIA test.")
but because it accurate, and that the viral load detected because of contamination.
("RT-PCR is a very powerful tool for detecting relatively low amounts of genetic material (RNA or DNA). The basis of this technique is the amplification of a target piece of nucleic acid several million times so that this target becomes measurable. Due to the extreme sensitivity of this technique, however, the slightest contamination can lead to a false positive result.")
Reasonable?
I'll sleep better, anyway.
("The enzyme immunosorbent assay (EIA) is the conventional, initial screening test to diagnose hepatitis C infection. The EIA measures specific antibodies to small pieces of the hepatitis C virus proteins (antigens). This test, therefore, is referred to as the anti-hepatitis C virus antibody test.")
And that it failed to detect antibodies not because I immunosupressing,
("...certain patients whose immune systems are impaired [suppressed] may not have detectable anti-hepatitis C virus antibodies even if they are actually infected with hepatitis C virus. Such immunosuppressed patients include those who are on renal dialysis, suffer from cancer and are receiving chemotherapy (drugs to kill cancer cells), or have active HIV infection. These patients cannot produce enough anti-hepatitis C virus antibodies necessary to generate a positive EIA test.")
but because it accurate, and that the viral load detected because of contamination.
("RT-PCR is a very powerful tool for detecting relatively low amounts of genetic material (RNA or DNA). The basis of this technique is the amplification of a target piece of nucleic acid several million times so that this target becomes measurable. Due to the extreme sensitivity of this technique, however, the slightest contamination can lead to a false positive result.")
Reasonable?
I'll sleep better, anyway.
I'm afraid I don't know the test criteria, Deb. And I can hardly ask. But one only tests for viral load after testing for the presence of HCV antibodies, right? So I'm sure the first test would disqualify me before they bothered with the second to find the viral load below detection level. Sigh.
Does it mean anything that my HEP C AB test reads NONREACTIVE NONREACTIVE? This the test for antibodies?
Does that mean that I'm immunocompromised (http://www.medicinenet.com/hepatitis_c/page6.htm)? That I would pass the first test but not the second?
Frustrating these tests so difficult to read. I still don't quite understand my 362.0 HEP C PCR QUAN (<200 COPY/mL) number. I do remember being told it was low, but I don't see a conversion here: http://janis7hepc.com/Viral_Loads.htm
Thank you for your help, I appreciate it.
Does it mean anything that my HEP C AB test reads NONREACTIVE NONREACTIVE? This the test for antibodies?
Does that mean that I'm immunocompromised (http://www.medicinenet.com/hepatitis_c/page6.htm)? That I would pass the first test but not the second?
Frustrating these tests so difficult to read. I still don't quite understand my 362.0 HEP C PCR QUAN (<200 COPY/mL) number. I do remember being told it was low, but I don't see a conversion here: http://janis7hepc.com/Viral_Loads.htm
Thank you for your help, I appreciate it.
Question about the "test" for the transfer. Does it disqualify for positive antibodies to HCV? You can't have a viral load without having a positive anti-HCV test. If that's the criterion, it is my understanding that we always will have HCV antibodies.
If the criteria is a "real" pcr number my suggestion is that you privately test.
Also, there really is no short term fix for hep c. I was an acute, initial VL 42,000, down to 192 and then back up to 4000.
Not good news probably. But what is important here is dealing with the Hep C.
Deb
If the criteria is a "real" pcr number my suggestion is that you privately test.
Also, there really is no short term fix for hep c. I was an acute, initial VL 42,000, down to 192 and then back up to 4000.
Not good news probably. But what is important here is dealing with the Hep C.
Deb
"In general, they like to see at least a one-log drop the first month..."
http://www.medhelp.org/posts/show/100919
That's encouraging.
http://www.medhelp.org/posts/show/100919
That's encouraging.
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