Viral Load

I was just wondering with a viral load of over 7 million, if this is considerd very high or on the low end..my Husband was diagnosed with HebC about 2 month ago and was told that his viral load is over 7 million, but that his enzyme levels had stabilized..He has to stop drinking all together (Which he is), has to stay sobber for one year before they will determine whether or not he needs treatment. Is this the usual approach? We understand if he doesn't stop drinking this could end up being fatal, while of he does stop and stays sobber he should be able to live a full life. He is only 40 and I plan on keeping him around for quit some time. They doctors told us that they won't be able to get a clear picture of what kind of damage there is and how bad until he is sobber and they can redo the viral load and possible biopsy. Has anyone here been thru the getting sobber and biopsy? If so was the outcome promissing after stop drinking? Any information and help would be greatly appreciated. We have 3 kids to raise and a new one on the way, so i certainly can use any help on this in what i might have to expect thru out all this, especially if it comes to having to have treatment in a year. I hear it is a killer on the body,mind and soul and the loved ones around him.

[doglover28]

Can-Do-Man posted the following yesterday:
Viral Load Chart
Viral Load in eq/ml
Classification
Remarks

below 200.000
very low
below detection limit of bDNA test

200,000-1,000,000
low


1,000,000-5,000,000
medium
average viral load at 3,200,000 eq/ml

5,000,000-25,000,000
high


above 25,000,000
very high

I am recently diagnosed and haven't started treatment.  However, he will need to stop.  I know some people that used L-Glutamine to help with quitting.  It's suppose to take the desire for alcohol away.  It's an amino acid.
As far as treating, he will need to be sober, and the viral load does not really tell how much damage has been done.  I liver biopsy is the only way.  I plan to get one when I go in to see the specialist next month.  Welcome to the forum

[jmjm530]

First, you have to find out want units your 7,000,000 viral load is expressed in. Most probably it's in IU/ml. Note that the chart above is in eq/ml. Therefore you might need to convert before drawing any conclusions.

[NYgirl]

Alcohol and HepC...do NOT MIX.

First off alcohol is quite LITERALLY POISON to the liver, think of it as cyanide to the liver sort of. Would you keep taking cyanide over and over if you were on the verge of death from it?

When alcohol is mixed with HepC it MAGNIFIES GREATLY, more than you can imagine, the amount of KILLING of the liver it does.

Now - I'm an alcoholic who never really "got" that.  As a result my liver is more than half dead and gone.  I am a Grade 2 - Stage 3 hep patient on treatment.  Were it that I had quit drinking longer ago perhaps I would not have such a severely damaged liver. But I never really understood how FATAL this can be.

Hep C by itself is usually a VERY slowly progressing disease that won't kill you on it's own.

I've had it only for 25 years without knowing but could have gone on longer had I not been tested.  Until it was too late.

So you ask why if there is a potentially fatal disease would they not treat him until he is sober a year???? There really is NO POINT to because he's killing his liver anyway. It won't have any chance to heal. THAT is the REASON that we treat - to save our livers and hopefully help them to get a little, tiny bit better as a result.

We don't treat just because we want to be able to say we don't have the disease or something.  We treat because we CARE about the damage that has been done to our livers and want to live a healthy full life.

Sorry to sound hardcore but one of my best friends, Frank, died of hepc this week. He even had had a transplant - but went back out drinking again. Because he didn't stop partying - he continued to kill his liver off and off and eventually got liver cancer. He died Friday night after a very long, very tragic illness. I just found out this morning. He was one of the most talented musicians I have EVER known on the circuit. What a WASTE.

Drinking and hepC can mean death.  

HepC on it's own can be CURED but if you are drinking the Interferon MOST LIKELY WONT WORK anyway - so it means progressively worse and worse liver damage until sickness and death perhaps.

If you want to keep him around - there is only one way to do so and it's not treatment.  It's sobriety and THEN treatment.

[jmjm530]

Just wanted to add that since your husband may not be treating right away that there is no reason to be alarmed about his viral load whether high, low or medium. Viral load fluctuates wildly. In my case it went as high as 35 million IU/ml and three years later it was at 16,000 IU/ml. Three months after that it was 1.5 million IU/ml. Viral load does not indicate the ammount of damage to the liver. That's what a biopsy will tell.

[NYgirl]

PS the biopsy is NOTHING it does NOT hurt even though it sounds like it is going to.

I was able to get sober and STAY that way.  There is a picture in one of the Be In Charge books that the doctor gave me...it had a picture of liver progression in it. Whenever I "wanted" to drink I remind myself of how that DAMAGE looked and how LUCKY I AM that I found out I had this disease so I could treat it.

If he could see what he's done - and REALLY get a grip on how it can KILL YOU...it would perhaps help with the sobriety.

For me I now just have to remember my friend Frank - transplanted, one leg amputated due to the diabetes and now dead of liver cancer.

That should help.

There is no secret to sobriety - AA is the ticket.

Good Luck, it's not an easy road this whole thing but it is one that a LOT of us are on.

[52TELE]

nyg , I just want to steal a little bit of this thread to ask you someting I was wondering about .Do I understand correctly that you have both genotype 1a and 1b. How does that happen? Two seperate viruses or does the virus have characteristics of both genotypes?
tanks..
52tele

[NYgirl]

Kal - I was sober only a little while before I started - or was diagnosed.  Anniversary January 18th, 2004  :)  Started treatment Sept., 2005   I have to say if ever there was a time I wanted to drink /get high diagnosis day was one of them...but it passed of course and I didn't.



52Tele

For all intents and purposes it's two separate things really because although they are both Genotype ONE - it's two completely different strains of the virus two different subtypes.  So it's like having two different kinds in that respect but they are both a one.

My luck right!  Of course!!!  ;)  There are a couple of us combo people in here - it's very difficult to kill but...we ain't giving up and there have been cures...we just have to be more stubborn then most :)

PS I don't mind you can ask me whatever you want to guys nothing is really sacred anymore as far as things like this goes :)

[cuteus]

I would not wait a yr to get a biopsy, please question that suggestion. He needs to know how much damage there is as soon as he can.


52- a person can be co infected with more than one genotype in any combination possible. The person can have both variants of the same genotype or different genotypes altogether.

[MrsOckert]

You asked what to expect thru this.  Usually a biopsy is done first to determine the amount of damage to the liver.  I do agree with others here that waiting a year for a biopsy seems a little strange.  However, many doctors will make someone wait a year for tx if alcoholism is an issue.  

If you both do decide to treat then yes, treatment can be very difficult for both your husband and the family.  There are lots of websites you can go to that list various side effects from tx.  Make sure you know what all of them can be going into tx.  Then realize that not everyone gets every side effect.  And some people don't have many sides effects at all.  Most likely he will feel like **** most days.

Most people are able to continue working.  I don't say they want to...but they are able.  

The goal at the end is getting rid of the virus (hopefully) and preventing cirrosis (cirrhosis) (sp?) and/or liver cancer and/or needing a liver transplant.

Hep C is not a death sentence and more people die with Hep C than from it.  Good luck to you both and keep us posted.  If you have any other questions there are lots of answers/opinions here!  LOL   Valorie

[returntosender]

As a recovering drug addict and alcoholic I can say with some certainty, since I have done it myself on a number of occasions - that people like us tend to choose good news rather than bad as an occasion to drink.  Although bad news has worked for me too.  I have managed to walk past the open windows though for about 20 years now so anything is possible.  I did have some help from my bad liver that really made drinking less enjoyable - damn hepatitis! LOL

mg - The difference between having hepatitis c and drinking while having hepatitis c? One of those two choices kills you and the other inconveniences you.  IMHO.

[jmjm530]

Non dectectible by Quantitative Heptimax TMA (<5 IU/ml) and by RNA Qualitative TMA (aka Bayer Versant)(<10 IU/ml). Tests taken six weeks after last shot and five weeks after last riba. Recent discussions regarding Heptimax was the reason for the two TMA's, which could be construed as redundant, but each is performed using a different technology. These results are a BIG relief but won't be popping any corks until the three and six-month post treatment results are in. This has been a stressful week waiting so hopefully I'll be able to enjoy the weekend.

-- Jim

[Mountain_Girl_2006]

First of thanks to everyone and their responses..second, the reason they make him wait is the fact that he is an alcoholic..he has been drinking since he was 15..when i first met him (almost 3years ago) his choice of drink at 4am was vodka instead of water..by time we found out he was down to a six pack of beer...no more hard liquor since february of '05 by his own choice..we found out in march of this year my test results for life insurance..once we knew and the doc. told him he had to quit he started to cut back..all of march he had 2 Tallboys (equal to 4 little cans) versus 3 Tall boys...for this month now he has been only drinking one Tallboy and starting after this weekend he will be done all together...the doctors felt given his history and the fact that he had already brought him self down from all the hard stuff that the stepdown approach would be best for him to eliminate some of the side effects from stopping..so far he has been doing well considering..he has a few nights where he has trouble sleeping, has his moodness..(who wouldn't living with a pregnant woman...lol) but is still in full swing with work and everything else we're doing (like finishing to build our new house..the doctors said they don't believe he has cyrosis "YET" and think as long as he quits and stays that way he won't have to worry about...but they won't know for sure what other damage is there until he is sobber for a year and gets the biopsy..i'm just glad i found this forum, because i need to vent at times and have noone to turn to who can understand this...it is very hard for him to talk about this, but i know he is aware of what will happen if he doesn't quit...he told one of our closest friends that he had HebC and that it will kill him if he doesn't stop drinking..so i think that is the first step in the right direction to acknowledge the problem...I know it will be a long hard road ahead of us, but i also know he can do it and has plenty reasons to make it happen..especially the new baby on the way...so hopefully all the good things in our life will help him to have the willpower to make it....

[mikesimon]

Pop the F'n cork already. Seriously - congratulations Jim!!!!!!! That's just wonderful news and thanks for sharing it. Mike

[jmjm530]

Thanks. I do have a big grin going. Maybe a sip of Amstel Light? Still very respectful of the virus though, so won't jump up and down on Opra's couch till the three-month.

[returntosender]

Dont want to jinx anything but that is a nice piece of news and one that I know you were really anxiously awaiting - 1 down - 2 to go.  Dam* - two TMA tests - talk no nonsense news gathering!

[NYgirl]

First off - congrats on the pregnancy! Be warned really really really good though - the medications that we take for treatment (the Ribavirin really) is INCREDIBLY damaging to a fetus, you cannot go NEAR the meds I mean it you can't even TOUCH it or you could have a big problem.  Also while he is on them, you'd most likely believe it or not want to practice safe sex and use condoms. This medication is just bad bad bad stuff so you need to be careful and protect you and the baby!

I know you are desperately worried about hubby but you will need to worry about you too.

He really, really needs a biopsy. As an active alcoholic (and sorry but yeah one beer every once in a while doesn't change the fact he's an active alcoholic - he's still drinking and doesn't yet realize he CANT drink end of story no more ever (it's hard I know first hand so I just think "None today, maybe tomorrow" when I have to).  A biopsy is the only way he will be able to determine if you need him to treat RIGHT NOW or not.

Given your pregnancy situation I'd make sure that he was advanced (but sorry a really good chance there with the hard core drinking) before I just let the Ribavirin in my house and near the baby you know?  

Still if you are careful all should be fine there. He needs to know where he stands - it's painless really even though it doesn't sound it.

Hey RETURNTOSENDER
This was the BEST way I ever heard it put before

mg - The difference between having hepatitis c and drinking while having hepatitis c? One of those two choices kills you and the other inconveniences you. IMHO.

That says it ALL right there.

Mountaingirl - alcohol can make the Interferon NOT work so if he does have even ONE drink there is a chance that the virus CAN start replicating again. There is NO drinking not at ALL on tx otherwise...there is just no sense to bother. Treatment is LONG and HARD and if he's not going to drink free and get a chance at being cured there is just no sense to suffer the side effects etc. just for the sake of saying "I'm in treatment" you know?

Best of luck.

I

[cuteus]

YOU ARE DONE! FINITO! THE END OF THE CHAPTER, close the hcv book.  One less thing to worry about.


mountain girl, Given that he has been drinking for that long, I would not wait a yr for a biopsy, especially with hep c involved.  Give it further thought and good luck

[jmjm530]

Is this the same "I'm not going to relax until my 1-year post tx viral load test" Cuteus? LOL.

Thanks for the encouragment and support!

-- Jim

[can-do-man]

Great news jim, could have just gave me the money cause i all ready knew it............ Bet your still guarding them ribas though.

[Mountain_Girl_2006]

thanks again for the responses..his doctors know we are expecting, maybe that is another reason they won't to wait till early next year since we're due in ealry december..plus he needs to be sobber before they will do anything..atleast for 6 month..than the biopsy and than whatever they say needs to be done..i'm not sure either 100% why they say one year..in any case he is completly off any alcohol now..(well starting this sunday that was our goal to take him down to)...I know he was really worried about infecting me and he certainly worried when we found out we are expecting, but the doctors told him the odds of him infecting me are slim to none as long as you faithfull and don't do any weird stuff...and i been tested and i'm fine..and they told us HebC is passed to the baby only thru the mother...so atleast one piece of good news...but it is scary no matter which way you look at it...

[cuteus]

LOL! but I had nothing to worry about in hindsight, correct?

remember, I was in the throes of that Greg relapse after the 6 month negative 50 IU/ML PCR, so terror had reclaimed its hold. Relapses on folks that took the same PCR you did, have that effect.
You secured one of the most sensitive tests out there, your SVR is almost 100% certain.  I wonder what results this Greg would have gotten on a TMA?
So, use my example, I worried for nothing, because most that read negative at wk 4 post tx will remain so.

I did not have any more drinks(after the wedding champagne at 5 wks post tx) until the 3 mo PCR was down.  I was craving for a cold MILLER so bad! But, there is a study from Denmark( ;-} ) by Thomas Truelsen, that states that folks who drink red wine weekly, were 70% less likely than wine abstainers to develop dementia after age 65, but beer drinkers(even if just once a month) were 50% more likely to develop mental deterioration  than non drinkers. The study needs confirmation, of course.
Enjoy that cold one, whenever you can safely do it.
Wasn't there a study on red wine being good for the liver?

You must be on cloud nine, in spite of the little voice telling you that you are not out of the woods yet. So far, the numbers have been on your side, there is no way you will be part of the minority who relapses. Perish the thought.

That goes for INA ALSO!!
of course we know Willing is already negative...and the goof man.

[Dale_Ray]

Where are you at Beagle. I guess we are going to have to put one of those invisible fences in and the collar on you. Hope you're having a good day and cell count is rising. Dale

[willing]

hey - so busy tracking pictures in thread below that I missed the good news. Two TMA tests - that's congratulations^2, and you better get started with that cork - sounds like Mike's getting thirsty.

[jmjm530]

Cuteus says: states that folks who drink red wine weekly, were 70% less likely than wine abstainers to develop dementia after age 65, but beer drinkers(even if just once a month) were 50% more likely to develop mental deterioration than non drinkers.
---------------------------------------------------
I attribute that more to the habit some beer drinkers develop of crushing the can on their forehead than the difference in beverage.
Seriously, I'm a happy and relieved camper today but I guarantee I'll be stressed out the week before my 12-week TMA :)

[jmjm530]

There's always a bottle for Mike, but I may have to buy a case as it looks like Goofy, Ina and yourself are SVR's as well,  and Cuteus just might want a bottle if she can get over her dementia worries. LOL. BTW I was thinking all day of what would happen if one TMA was neg and the other positive.

-- Jim

[dyce]

That is really good to hear jim! Bet yur on cloud 9 today.Bet your liver is in good shape now after all that riba ya took! I just got my weekly labs today and the hmg is 11.8 and the anc is 1.5 ,the ast came back up a little but is only 47 but the ggt is 213. The ggt is a very sensitive test and is no doubt high from the prescription pain meds I take. So far ,so good for me and thank god no blood boosters yet but that could change . Way to go jim!

[can-do-man]

said...........was neg and the other positive.......... Never trust them home pregnancy tests. Oh never mine got confused again, hows the night cream doing ya?

[Snookmiester]

I know that there has been alot of talk about "occult" infection, and residual RNA present even post SVR.. I'm not sure if I missed something, but assuming we obtain SVR, is it safe to drink? I was told by Schiff during my last visit, that even after SVR, drinking was out of the question. I am definately going to be running this by him next month, as now I have a 6 month post clear PCR under the belt, but this was his advice at the time.

How many have popped a cold one post SVR? I'm over here droooooling at the thought of an ice cold Heineken, or "green lizard", as we call em down here.
I mean I would drink with moderation, say a 12 pack or two for dinner, kidding of course, but what is safe? I haven't touched a beer or ANY alcoholic beverage since my stage 3 findings in '04..

I'm just curious as to how many have picked up a cold one post SVR?

[jmjm530]

cdm asks: hows the night cream doing ya
-------------------------------------
Oh...didn't I mention I sent it to the labs for the TMA's?

[can-do-man]

Thanks for the info

[goldyn]

Congratulations ,im so glad to hear your good news i think it gives everyone a shot in the arm to keep on going.

                 God bless
                          angie

[GoofyDad]

Jim, I'd say you're good to go! Why not add some tinsle or something to the bee keepers mask to celebrate? Nevermind, you wouldn't want any strange looks or anything.....

[FlGuy]

Good news, never a doubt.  Is there equally bad news for the moths?

[prettydamscared]

Hi,

Sounds like you have a lot of good things going on in your lives in spite of the hep c.  I'm new too but I wanted to chime in and say everything I've read here and on a gazillion other sites say it doesn't make any sense to wait a year for a biopsy.  There's NO reason to stop drinking for a year or 6 months before getting a biopsy. The biopsy is the best measure of liver damage.  If your husband has been drinking for years, it seems to me that's its very important to know the extent of liver damage, if any.  And, if he does have any liver damage, knowing that might just help him to quit all that much sooner. It does make sense to not treat until a person has stopped drinking for a year or 6 months but most doctors seem to want to get the biposy much soner so they know what they're dealing with.  Worse case scenario, if a person did have advanced liver disease, they would not want to wait a year to know it because that would preclude the option of treating it before it advanced further.  Just my 2 cents.  Char

[Moniker]

Jim, Very good news! I’ll keep my fingers crossed for the 3 and 6 month tests, but really things are looking so good for you right now. Relax and enjoy your wonderful new life. CONGRATULATIONS!!!
Bob

[jmjm530]

Let me take the opposite tack re biopsy to balance things out. If a decision has already been made not to make a treatment decision for six months to a year because of previous drinking, then what benefit is there from doing a biopsy now?

A leading hepatologist (forgot his name) recently did a paper on very subject basically saying that he never does a biopsy unless needed for a treatment decision -- in other words, curiosity is not a good reason. Also, the biopsy results will probably be more useful closer to the time of treatment.

Sometimes, doing too much at once can become counter productive. It seems that the very best thing your husband can do right now is to put all his energies into stopping drinking, whether that be counseling, AA, or whatever. Because if he can't stop drinking -- biopsy, treatment, everything else becomes academic.

-- Jim

[fishdoc]

to your health... and slain dragons..

[jmjm530]

Just to add a little...

So let's say he does a biopsy now and it says no liver damage. So maybe your husband will say..."well the heck with treatment then, I think I'll just keep on drinking, doesn't seem to hurt any..."

Or let's say the biopsy says he has signficant liver damage ... maybe this will act as motivation to stop OR maybe it will put him in a depression figuring whatever he does it won't matter...

I suggest thinking about doing as the doctors say and just stop drinking for now. Then deal with the Hep C.

[mikesimon]

I drink a glass or sometimes maybe a glass and a half of red wine Friday night with dinner. Ocassionally I'll have a glass with my meal on another night but I try to keep it at once per week. Mike

[Bill1954]

Mountain Girl--best of luck to your husband as well as you and your children. The treatment can be a little demanding at times, but with the proper attitude, you folks will come through with flying colors. If you haven