RNA Levels of 6.2 what does it mean?

[Shelly268]

My husband refuses to learn about his diseases, or take care of himself in anyway.  I have researched, shared, begged and pleaded. I know a lot about Hep C and Chirrhosis, ( he also has been diagnosed as having diabetes type 2), is on glucophage ( though I wonder is it really type 2 or is it what I ran across last night...liver diabetes?). Long story short, I am having a hard time deciphering information about RNA levels, and what they mean, what they might indicate. He might not want to know, but I need to know. I have been widowed before, at 24, (colon cancer), I am only 40, still have two kids at home, and if things are progressing rapidly..I don't want to have my head in the sand. I know no one can predict accurately lifespan/prognosis, but, his enzyme levels are elevated, RNA is 6.2, his viral load is over 1,500,000 and he is slightly jaundiced, often nauseaus, frequent headaches, and at times, though not often very itchy. He has probably had hepatitis for at least 20 years, was diagnosed with chirrosis (early) 6 years ago, still drinks at least a few times a month, though not as heavy as before. And was diagnosed with type 2 Diabetes 4 weeks ago, though it was the first time he'd ever been tested. I know about Lactic Acidosis risks with liver disease and glucophage, plus the alcohol, anti-depressants, and that he is making a grave mistake not learning about his disease and medications, but...he won't even let me explain. Does the RNA level mean anything significant? Does it indicate progression of the disease? Or is it like ALT/AST means something but doesn't tell you much? If you know anything even REMOTELY concrete or where I can find the best information (other than his doctor...who actually prescribed the glucophage if you can imagine) I would greatly appreciate it. I am not frightened, or overly stressed, though I love him..he's making his choices, but I want to be as educated as possible. He's not the only one living with this disease..and I need to know what to expect as much as possible..I cope easier that way. It helps me plan for what to do in an emergency. If you are hesitant to reply in an open forum, I will be checking my inbox. Thank you and be blessed.

[Shelly268]

Hi,
  I had no idea about the Meld Calculator. I looked it up, and did find it. I need to get those numbers from his GI, but that's easy enough. Thank you so very much!

[GoofyDad]

I'm sorry you're dealing with these difficult times. Try googling 'meld score' and 'meld score calculator'. The meld score is what transplant centers use to track where patients are in the cycle - the higher your meld score, the greater your need for an organ.

There are only 3 blood counts involved. Plug them into an online calculator and it will spit out a number. The jaundice is not a good sign. Your husband needs to treat his hepatitis before it's too late. Good luck.  

[Shelly268]

Hello,
I appreciate your input. His Cirrhosis diagnosis was based on a biopsy, but in addition to that, he had his appendix out about 3 years ago. The surgeon knew about the Hep C, but I don't believe he knew about the Cirrhosis. He saw the liver and actually thought to take a color picture for us. It would have motivated me to move mountains, but not him. There was a wide band, maybe a quarter of his liver was white..maybe a bit yellowish, looked like fat...the surgeon told me it was part of the cirrhosis. Pictures didn't cause him to get motivated, begging and fighting...have not helped. I have sat down with him and said "Look at me while I explain the complications of this to you!" I gave him the gory details of Hepatic Encephalopathy, Ascities, Portal Hypertension, Varicies..he almost threw up. I told him, it's not to late, your liver can regenerate, you can live a life of spit and vinegar, life and vitality..for a long time. In the beg. he did go on interferon and riboviran. He stopped because of the sores in his mouth. It was working though! I have told him how much our daughter wants him at her wedding. I have begged him to at least take Milk Thistle, avoid salt etc. and of course quit drinking. He said he'd rather die then to not be able to live the life he wants to live. And now that dear doctor has put him on glucophage and asprin, UGH!...he thinks he will be just fine. I would like for you to take a peek at something. I am going to copy and paste something I found again tonight, this is what originally caused my question about RNA, but I was so tired when I found it last night I couldn't remember where I found it.  See what you think..and thanks again! God bless you during your treatment...keep up the good fight!

Risk of ESLD death was unrelated to the intensity of antibodies against the HCV c-22(p), c-33(p), c-100(p), and NS5 proteins, individually or combined, but it increased with HCV RNA level, say the researchers. The association between HCV RNA level and ESLD death remained significant after adjustment for alcohol consumption.


Based on these results, the NIH researchers conclude, “HCV RNA level is a predictor of ESLD death among persons with chronic HCV infection.”
12/13/05
Reference
ichie Hisada and others. Hepatitis C virus load and survival among injection drug users in the United States. Hepatology 42(6): 1446 – 1452. December 2005.

[IAmTheWalrus]

If it helps, I would point out that expressing the viral load in logarithmic form makes the numbers simpler and really more meaningful. It measures the change in viral load in powers of ten (x10).  Even though the viral load may fluctuate by 10,000 or 100,000 units, this really does not mean a great deal. If the virus goes up/down by 2 Log, that means the virus increased/decreased by 100 times (2 powers of 10).  So a good log for HCV RNA is 0, and a very high log is like 8 or higher. There is not much difference between a viral load of 1 million versus 2 million even though common sense says that it is twice as much.

AST and ALT are pretty good indicators (when elevated) of problems with the liver, but do not alone necessarily indicate the cause. The gold standard for staging liver disease has been the biopsy.

You should get hubby to a specialist.  

I hate to be glum, but if he was diagnosed as cirhossis 6 years ago, this does not look good. Was the diagnosis based on a biopsy, or just the liver functions (ALT/AST/Alk Phos, billi, etc.)?   If he progresses to the later stages of cirhossis, his only option may be a transplant. Most transplant centers will insist on a period of sobriety (no alcohol) for a period before they will even put a patient on the transplant list.

The first advice I got from a specialist when I was diagnosed years ago was "DON'T DRINK ALCOHOL, NOT EVER, NOT ANY AMOUNT!"  Hep C and drinking are a deadly combination. Despite the fact that I have not ever been a drinker, I still ended up with cirhossis (because of the hep C alone).

Anything you can do to get him to take an interest in his health would be good. I guess it is something he has to decide ultimately. I have had a transplant and am now treating the hep C.  It is all definitely WORTH IT!

Best of luck

[Shelly268]

Thank for your explanations of RNA levels, and your comments. It really helps, I am exhausted right now...and really need to lay down. But, I believe I will be around. I have a lot to learn and really need the support. I appreciate all of you!!
Have a blessed day.

[Shelly268]

Hi Trinity, I so agree with you! I don't understand anyone not educating themselves and fighting especially in light of the fact that he KNOWS liver disease can be cured, or halted, and the liver can regenerate! He simply cuts me off and it becomes World War 3. He has even accused me of "screwing" with his head because I begged him to go to the doctor. He went, though not to the GI. He went to his primary gp. And he put him on glucophage and then I tell him don't take that, get a second opinion..etc. I have a back condition that I am fighting to recover from, and learn about, and I have done extensive research, implemmented what makes sense, with my chiropractor's guidance, and it's working. I don't understand people who won't even read labels. I wonder...do they have enough sunscreen to cover their butts so they don't get burned, while their heads are stuck firmly and deeply in the sand??? I am angry because he could do something and I may have to watch another husband die, and this time preventable...I am angry because my daughter probably won't have her daddy to walk with her when she gets married...and I wonder how come he can be sooooo selfish and not care how it effects his entire family. Sometimes I can't help it but I want to..(though I don't do it) offer him another Jack! How can he not know that drinking and the medications are like pouring gasoline on a fire?

[Trinity4]

Shelly,
It's really a shame that he does not want to help himself.  If he were to read the posts here on a daily basis he would know the fear and desperation we go through trying to beat this disease.  Hours and hours of time spent trying to get the best possible information so that we can share it with our doctors and give ourselves every opportunity to clear this virus.  I can't understand his attitude because I really want to live a full life and that's why I'm going through this treatment which is not easy.  I wish you the best and maybe he'll have a reality check one of these days.
Good Luck
Trinity

[FlGuy]

The term 'drive' is meant to convey 'encourage', not put him in a car and get him to an emergency room.  However, putting him in a car and driving him to a specialist would not be a bad idea.

[FlGuy]

The 6.2 probably relates top the logarithmic method to express viral load.  The approximate logarithmic equivalent to a viral load of 1,500,000 is 6.2, give or take a few hundred thousand. I believe that, as you express, he is making some grave mistakes.  There are many factors which make up a complete view of a person's condition which include a liver panel of tests (you have the ast/alt), viral load (which is only a point in time) and the results of a current liver biopsy which assesses the condition of the liver and amount of fibrosis or cirrhosis.  Worsening blood sugar condition, and a few other blood values (like platelets) can help paint the picture for a liver doc.  But, hubby sounds like an unwilling participant who is not in good shape right now. Stuff like itching, bloating and mental confusion would be cause to drive him to medical attention.

[mremeet]

The 6.2 number is simply the viral load expressed in logarithmic form. Expressing the viral load in Log form is something that doctors commonly use to assess viral load changes, especially during treatment. It means the exact same thing as 1.5 million viral load, which is a very typical viral load (that was my viral load before I was successfully treated just last year).

Can't help you much with your husband's reluctance to do anything to help himself. Some people are just like that, I've seen a few dopers and drinkers go down that road before, and trying to reason with them is often useless. However, maybe your husband has given up hope because he thinks it's too late? If so do your very best to convince him it is NOT too late. If he is in early cirrhosis he can be saved. Hep C is treatable, you can be cured of it. If he were to get treatment, stop drinking and take care of himself he could absolutely get well again. His liver can recuperate too, the liver can actually heal itself over time if whatever's hurting it is removed (i.e. drinking, drugs and hep C). He could even put his diabetes in remission. It's all at his fingertips, but he has to act soon. It's a limited time offer, try and convince him of that, because it's all TRUE. He definitely can pull himself back from the precipice if he wants to, but it's him that'll have to do it. All you can do is tell him it's possible. Good luck...