What does HCV 7.86 WEAK REACTIVE mean?

[agonghelp]

Hi All,

My mum admitted at a local hospital due to non stop caughing. Her blood test result showed elevated liver funtional test readings. Second blood test was done and it shows HCV 7.86 WEAK REACTIVE. Other Hep A & B NON REACTIVE.

What does HCV 7.86 WEAK REACTIVE mean?
Does this mean she is HCV positive?

The doc said, further test needed to confirm this and might take 3 weeks.
Pls share your inputs.
Thanks.

[candid72]

"my mother has hepatitis c reactive with 154.4 what does mean"

[candid72]

"my mother has hepatitis c reactive with 154.4 what does mean"

[agonghelp]

After a long waiting for close to 4 months, the docs at government hospital have rated my mum as having Cirrhosis based Child-Pugh score with Grade B

They did endoscopy-OGDS Oesphageal varices HCV and found the followings:
1. Small submucosal dilated veins at distal oesophagus. No ulcer/bleeding.
2. Extensive erythema at antrum with modular erosions at the body.
3. Portal gastropathy. No fundal varix seen.
4. D1 duodenitis.
5. D2 normal.

Mum's blood platelets count is 86 and they refused to consider her the therapy. Also they indicated her chance of living for another 5 years is 50%-50%. They never mentioned anything on liver transplant options.

Question for experts on this forum:
1. Is my mum really having less than 5 years to live or it can be more?
2. Does she has any other option like liver transplant for her age(60)?
3. Any latest medication for Cirrhosis?

Hope to get some answers. Thanks All!

[Aaron57]

I don't know what your doctor recommends during tx regarding supplements during Tx , but it seems after looking around some .. PPC (Essential Forte main ingredient) is ok to take during Tx ..
However herbs and anti oxidants .. seems not a good idea.

PPC is very famous for helping the liver  .. just didn't know it was in Essential Forte ...

I believe it is good to try to get the liver as healthy as possible before starting tx if the person can wait ..

I used before starting tx :

Curcumin - Temaluwak
Licorice root - kayu manis china
Milk Thistle
Selenium
Vitamins C , B12 multi

Diet & lifestyle change - no deep fried food , no processed sugar (white),  lots of vegetables , fruit , less rice and carbohydrates ..

there is allot of info here on this site and the "net" on diet , herbs , supplements + hcv ..

I hope you can find out your mom's liver condition to help guide your Tx decision ...

[agonghelp]

Yes. It's being sold in pharmacies at Malaysia.

I think it's a very good supplement for liver health.

More readings :
http://www.drugscase.com/liver-disease/essentiale-forte.html

[Aaron57]

Sorry , I don't know about this supplement ... but it looks interesting , can you buy it in Malaysia or would you have to order it ?

[agonghelp]

Thanks buddy for the useful infos.

My mum doesn't consume alcohol at all.

When the doc asked, she recalled that in year 1982 she had an operation and had blodd transfusion. So high chances, HCV got into her body via this mode.

The doc also requested her to take Essentiale Forte for fatty liver:
http://www.amazon.com/Essentiale-Forte-N-30-capsules/dp/B0036BDOBC

Do you think Essentiale Forte will be good for her?

[Aaron57]

Fatty liver can result in elevated liver enzymes ... but so can being hcv+

I have both HCV+ and a bit of fatty liver + enlarged spleen .. my fatty liver & enlarged spleen, liver edges smooth (good) ... all found with (USG) Ultrasound ....

Fatty liver is pretty common in hcv+ folks ...

Fatty liver can be seen with Ultrasound ... it's less expensive than the CT .. but the CT does diagnose the fatty liver more clearly than USG ...
Sorry but, sounds to me like your doc is after the Ringgit's ...

Sorry ... but I have to ask .. is your mom drinking alcohol or did she in the past ?

There is NAFLD (non alcoholic fatty liver disease) or NASH : good explanation below -

http://www.emedicinehealth.com/fatty_liver_disease/article_em.htm

Again , I stress the point of finding out your mother's actual liver condition for fibrosis when considering Tx options .. Fibroscan or Fibrotest (Fibrosure) or Biopsy are the only choices I know of.

Liver condition/fibrosis is what you need to know before deciding to treat or not ... IMO
If she has none or little fibrosis ... the need to Tx is not as urgent ... if she is F2 or above .. HCV Tx will be something you will want to consider ...

One factor that is not known in hcv science .. is why some people live many decades with HCV , but their livers are not impaired or develop fibrosis very slowly if at all ...

Others develop liver fibrosis faster ... there really is no "normal" progression of fibrosis know at this time ....

Because of my liver condition F2-F3 ... I decided to try Tx .. I would have chosen Not to Tx if my liver was in better condition ... but it is a very personal decision .....

VL (viral load) apparently is not an indicator of liver fibrosis or condition ... VL does fluctuate .....

Get your mom's liver checked for fibrosis, only then will you know what her condition is !

Hope this helps

[agonghelp]

Guys, Thanks for the details and help.

The doc is a gastroenterologist and hepatologist. I called him up today and asked few questions regarding my mum's liver functional test results.

He said, my mum could have fatty liver and he'll conduct a CT scan next week to check on this.

Do you think fatty liver could cause elevated liver test readings?

How severe is my mum condition having HCV and fatty liver?

[exaddict24]

hi, i am living in singapore , if you need my help i can try with Aaron57 asisstance. stephen

[Aaron57]

I know very well how the doctors are in SE Asia ... it's all about money ... if they see there is the virus .. Automatically they want to Tx .. this may not always be necessary at the time of diagnosis .. Tx options should be researched and considered very carefully ..

Where are you located and what type of liver doctor are you consulting with ? A general practitioner , GI or ?

If you want to know your mom's liver condition ... To me, liver condition is the most important factor when considering treatment ...

You might consider getting a Fibroscan (imaging machine) conducted ... or a Fibrotest (blood test) ... I'm almost 100% sure these machines and blood tests are in Malaysia, probably KL .. we have them in Indonesia, Fibroscan at Klinik Hati - Rp 1.5 Jt .... and they are also in Singapore $400 Sing ...it is non invasive (no risk of bleeding) and will give a 75 - 80 % accuracy of liver condition ...

Kalo ada pertanyaan apa saja .. jangan malu !

[agonghelp]

I've asked the doc whether she needs any biopsy. He said, it's not needed and liver biopsy itself could damage the liver(internal bleeding) and she's 60 now. I'll be bringing my mum to meet to doc again next week to check on her liver functional test results.

Many thanks for the sharing inputs. Will keep you all posted on the outcomes.

[Aaron57]

If you are close to KL ... you might give this doctor a call .. not a personal reference but taken from
http://www.hepatitis-central.com/hcv/drs/toc.html

Ismail Merican, MBBS
Senior Consultant Physician

Hospital Kuala Lumpur
Kuala Lumpur, Malaysia
Phone: [phone]

If you don't mind to go to Singapore there are a few options
i could suggest & and amazingly Jakarta has a pretty good liver clinic
Dr. Sulaiman - Klinik Hati

Consulting with a HCV specialist will help in many ways.

Salam

[curiouslady1]

Is she going to have a biopsy?  That might be a good idea due to so many lab tests having abnormal values.  If she doesn't have a high viral load and no significant scarring than what would be causing the elevations?  

[agonghelp]

Today, the genotype has been confirmed as type 3a for my mum.

TEST : HVC RNA REAL TIME PCR
RESULT : 9,960
REFERENCE RANGE : < 43
UNITS : IU/mL

TEST : HCV GENOTYPING
RESULT  : HCV subtype 3a
COMMENTS : HCV RNA detected  with subtype 3a. Duration of 6 months therapy is recommended.

Question : Does 9,960 for HVC RNA REAL TIME PCR testing refer to current viral load?
I asked the doc, he said 9,960 is the viral load and it's kind of low for my mum.
Need confirmation from this forum.

Can the therapy be delayed for another 3-6 months as I need to get ready with some financial help before starting the therapy for my mum. The doc said, should be find but should not be delayed for too long.

[copyman]

She needs to be seen by a Hepatologist (liver specialist). You can get answers on the internet but for the best care and answers take your loved one to the specialist.
Best of luck

[agonghelp]

Thanks Will.
Another question: what type of diet HepC patients need to be in during the treatment?

[willbb]

Hi there ..as Bill 1954 has not been around for a bit...let me take a shot at trying to answer your questions(certainly not an expert,just an opinion)

It sounds like your mum has had a positive antibodies test and has now had a RNA/PCR test to confirm she has the active  HCV..

And it sound like the doctor has now done a genotype test to ascertain what type and what treatment  regime would be considered.

The only way to know for sure how much damage(scaring/fibrosis) has been done to the liver is for her to have a biopsy and then treatment is usually based on thse two  results(geno type and biopsy).

No -one can say how long she will live without treatment . there are many factors that go into that .however treatments today are in the 75% success rates (depending on many factors)

The labs you posted are not of that much significance at this time ...however with the Albumin somewhat low and the Bili somewhat high ..I would advise (as hopfully the doctor has) that she does indeed have a biopsy  ,as these are sometimes markers of liver damage severity.

Good luck to you and your mum...

Will

[agonghelp]

Any answer for my doubts/questions? Thanks

[agonghelp]

Hi Bill,

My mum has been confirmed as having HCV. I couldn't take this news at all. The result was out yesterday. The doc requested her to go for another round of test to identify the genotype in order to start the therapy. Blood drawn yesterday and the result will be out in 4 weeks.

My whole life has changed now. I need to gain more knowledge on HCV and related specifics in order to assist my mum in her remaining life.

Question :
1. How do we know that my mum is not developing scar tissues? Any specific test needed to identify this?
2. Is biopsy needed for my mum case as she's 60 already? Or she must go for the treatment once the genotype is identified?
3. How long does she can live if she refuses the treatments?
4. Is weak reactive 7.86 can be considered as mild and can wait for the therapy/treatment?
Other liver functional test results:
Total Protein : 83 g/l Reference Range : 64-83
Albumin : 28 g/l [low] Reference Range : 35-50
Globulin : 55 g/l [high] Reference Range : 28-43
A/G Ration : 0.5 [low] Reference Range : 1.1-1.8
Total Bilirubin : 28.2 umol/l [high] Reference Range : 3.4-20.5
Alanine Transminase : 42 U/l [high] Reference Range : 0-31
Alkaline Phosphatase : 83 U/l Reference Range : 40-150
Gamma-Glutamyltranferase : 71 U/l [high] Reference Range : 9-36
AST : 61 U/l [high] Reference Range : 5-34

Need your advice on this. Thanks

[agonghelp]

Thanks Bill1954

[Bill1954]

That would depend on other factors; if her liver isn’t developing significant scar tissue, she might never require treatment/therapy.

If she has developed much fibrosis, the preferred treatment will include the drugs pegylated interferon with ribavirin, and perhaps a third drug as well.

Her doctor should order further testing if required and counsel her appropriately.

Best of luck to you and your family,

Bill

[agonghelp]

Thanks for the reply Bill1954.

I know no vaccine or cure for Hep C.
My mum is now 60 and if she's confirmed HCV positive, any idea what type of medication she should follow thru?

[Bill1954]

This is probably the results from a ‘HCV antibody’ test; it means it’s possible that your mother might have been exposed to Hep C at some point in the past:

http://www.cdc.gov/hepatitis/HCV/LabTesting.htm

Her doctor might suggest she receive follow up, confirmation testing to determine if active RNA virus is present; the results of this test, “HCV RNA by PCR” can take 10 to 14 days to receive from the laboratory.

Good luck to your mother,

Bill