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Viral Load - need interpretation
Hi guys:
The doctor said my VL was 8478000. How do I interpret this number? Is is eight million, blah blah....?
Thanks.
The doctor said my VL was 8478000. How do I interpret this number? Is is eight million, blah blah....?
Thanks.
Hi guys.
You know, I was thinking. His nurse is the one who told me about the '02 VL. I do have copies of my test results since coming back to him last year (thanks to you). I have a Basic Metabolic panel from 5/15/08, a Hepatic Function Panel from 4/25/08, An Iron and Total Iron Binding Capacity test from 1/14/08, another from 12/04 ( I also have Hemochromatosis), a Basic Metabolic Panel from 11/07.
Would a viral load be listed on any of these? How bout the HFP?
You know, I was thinking. His nurse is the one who told me about the '02 VL. I do have copies of my test results since coming back to him last year (thanks to you). I have a Basic Metabolic panel from 5/15/08, a Hepatic Function Panel from 4/25/08, An Iron and Total Iron Binding Capacity test from 1/14/08, another from 12/04 ( I also have Hemochromatosis), a Basic Metabolic Panel from 11/07.
Would a viral load be listed on any of these? How bout the HFP?
Just wanna tell you to not get to upset about this most people until resently had a standard protocol geno 3 and 2 24week geno 1 48w.
I think you got some good suggestion from trish and flguy, get lab copies try to have a 12w vl test aswell.
I have to wait 2weeks for vl tests but thats in Sweden.
Everything can very well end up fine for you its not much you can do but wait for answer.
Its hard when things messes up and when on riba its even harder I´ve been there i know but dont let the negativ thoughts get to you, remember its the meds.
and please don´t hesitate to keep on asking questions.
we are with you in this.
ca
.
I think you got some good suggestion from trish and flguy, get lab copies try to have a 12w vl test aswell.
I have to wait 2weeks for vl tests but thats in Sweden.
Everything can very well end up fine for you its not much you can do but wait for answer.
Its hard when things messes up and when on riba its even harder I´ve been there i know but dont let the negativ thoughts get to you, remember its the meds.
and please don´t hesitate to keep on asking questions.
we are with you in this.
ca
.
I also cannot believe the doctor started treatment without a recent baseline viral load. And no, 2002 is not recent. How else can he evaluate how you respond?
btw: you may also hear the viral load number expressed as a exponential. Yours would be 6.9 [LOG]. That is basically telling you how many digits in the number (ie. 6 LOG = 1,000,000; 7 LOG = 10,000,000). It just makes the number easier to deal with and really correlates better with the effective changes in viral load. It still means the same thing.
btw: you may also hear the viral load number expressed as a exponential. Yours would be 6.9 [LOG]. That is basically telling you how many digits in the number (ie. 6 LOG = 1,000,000; 7 LOG = 10,000,000). It just makes the number easier to deal with and really correlates better with the effective changes in viral load. It still means the same thing.
Kelle - time to switch doctors - or to find one that will work with you and knows about HCV.
You should have had one prior to starting TX --- one at 4 weeks one at 12 weeks and one at 24 --- one at 42 - 28 weeks - plus one at end of TX ---- then one 6 months post TX --- and then 1 year later... (1 year 6 months post).
It's a lot of money - but that's the only way to tell if the virus is actively in your blood at that time.
And it's the only way to know if you are responding --- and just how much you are responding.
I think maybe you got the blood test - but the doctor didn't advise you of all of it maybe?
Holy Toledo... WOW~
FL is so right.
Meki
You should have had one prior to starting TX --- one at 4 weeks one at 12 weeks and one at 24 --- one at 42 - 28 weeks - plus one at end of TX ---- then one 6 months post TX --- and then 1 year later... (1 year 6 months post).
It's a lot of money - but that's the only way to tell if the virus is actively in your blood at that time.
And it's the only way to know if you are responding --- and just how much you are responding.
I think maybe you got the blood test - but the doctor didn't advise you of all of it maybe?
Holy Toledo... WOW~
FL is so right.
Meki
I have to say that I find it inconceivable that your doctor started treatment without doing a viral load test. You are a 1B and therefore headed into 48 weeks of treatment. At Week 7, you might want to ask yourself if a second opinion might be warranted. If you are interested in that and able, I would suggest you do it asap seeing as you're already at Week 7. Your doc sounds like he's incredibly inexperienced or uninformed on treating persons with HCV. Are you seeing a gastroenterologist for your treatment?
In the meantime, I would suggest you get another PCR done at 12 weeks since that is a milestone marker for persons on treatment...it's where we see if we've got our two log drop, etc. Unfortunately, in your case, that will be impossible to know. At the least, you'll be able to measure from Week 7 to Week 12. That's my suggestion.. others may have a different thought to throw into the mix.
Trish
In the meantime, I would suggest you get another PCR done at 12 weeks since that is a milestone marker for persons on treatment...it's where we see if we've got our two log drop, etc. Unfortunately, in your case, that will be impossible to know. At the least, you'll be able to measure from Week 7 to Week 12. That's my suggestion.. others may have a different thought to throw into the mix.
Trish
That viral load from 2002 has no significance at this time. The only one that matters is the one you got today. It takes a few days, but you should have resultss by end of next week. Make sure Doctor Doorknob gives (faxes) you a copy.
I just did a PCR today @ week seven. I had to ASK my doctor to order it (thanks to you guys). I am 1B.
Thats f...cking amazing you can´t know for sure how you are responding to tx then.
Ok if you were Und week 4 it maybee dosent matter that much what was your 4w vl result and what geno are you?
Ok if you were Und week 4 it maybee dosent matter that much what was your 4w vl result and what geno are you?
Sorry to hear about your biopsy trouble. I have a clotting issue, so they will not allow me a biopsy. What happened to you, shows why they are concerned.
This VL was taken from my first diagnostic test in 2002. I then had a biopsy and ended up bleeding internally and was hospitalized for four days. I never went back to the doctor until 2007 when I was ready to try again.
My doctor has not done a liver panel since that time.
Zazza, thank you for taking the time to write me such an informative answer. You're really educated.
My doctor has not done a liver panel since that time.
Zazza, thank you for taking the time to write me such an informative answer. You're really educated.
Here is a paper you can read on the basics of HCV, "Chronic Hepatitis C: Strategies for Optimizing Current Treatment and the Potential Impact of Emerging Therapies".
http://www.medicalcrossfire.com/onlineLearning/cme/2006/06-LC-27-M-100.pdf
Concerning logs, the interesting thing during treatment is not how many thousands or millions of international units of virus our viral load has decreased with so far, but how many percentages.
A 1 log drop equals a 90% decrease of viral load.
A 2 log drop equals a 99% decrease.
A 3 log drop equals a 99.9% decrease.
A 4 log drop equals a 99.99% decrease.
What you need by week 12 is thus a 99% decrease. One reason for this is the variance in the results of viral load tests. A test result might vary half a log up or down from the actual viral load. Thus to be sure an actual change has taken place in viral load one has to count with a variance of half a log for each of the two tests one is comparing, i e a one log drop is not sufficient to be sure any decrease has actually taken place.
With HCV we express our viral load in log10 form, which means expressing viral load numbers in exponents of 10. Thus your viral load of 8'478'000 IU/ml (that was the unit used, right?) equals 10 to the power of 6.928.
http://www.medicalcrossfire.com/onlineLearning/cme/2006/06-LC-27-M-100.pdf
Concerning logs, the interesting thing during treatment is not how many thousands or millions of international units of virus our viral load has decreased with so far, but how many percentages.
A 1 log drop equals a 90% decrease of viral load.
A 2 log drop equals a 99% decrease.
A 3 log drop equals a 99.9% decrease.
A 4 log drop equals a 99.99% decrease.
What you need by week 12 is thus a 99% decrease. One reason for this is the variance in the results of viral load tests. A test result might vary half a log up or down from the actual viral load. Thus to be sure an actual change has taken place in viral load one has to count with a variance of half a log for each of the two tests one is comparing, i e a one log drop is not sufficient to be sure any decrease has actually taken place.
With HCV we express our viral load in log10 form, which means expressing viral load numbers in exponents of 10. Thus your viral load of 8'478'000 IU/ml (that was the unit used, right?) equals 10 to the power of 6.928.
I'm wondering when this viral load test was done and what week you are at in treatment?
Trish
Trish
What is more important to know is that your viral load expressed in log form is 6.928. As a geno 1, you need to drop at least 2 log by week 12 to continue treatment. Best thing of course is to become UND as soon as possible. Rough numbers are:
20% of geno 1 are UND by week 4 - rapid responders
40% of geno 1 are UND by week 12 - complete early responders
20% of geno 1 are UND by week 24 - slow responders
20% are non-responders - null responders, partial responders, breakthrough
20% of geno 1 are UND by week 4 - rapid responders
40% of geno 1 are UND by week 12 - complete early responders
20% of geno 1 are UND by week 24 - slow responders
20% are non-responders - null responders, partial responders, breakthrough
8 million high? Yes.
But it has no correlation to the progression of liver disease or if you can clear the virus during treatment (SVR).
Viral load will be used by your doctor during treatment to see how you respond to treatment.
So nothing to worry about.
Cheers!
Hector
But it has no correlation to the progression of liver disease or if you can clear the virus during treatment (SVR).
Viral load will be used by your doctor during treatment to see how you respond to treatment.
So nothing to worry about.
Cheers!
Hector
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