acute hep cand chronic hep c

been diagnosed with acute hep c in early september. since then lucky to have found this site...been lurking here,been asking a few questions and getting more satisfying responses than my doctors!! You guys are great!
have got opinions from an internist...then a gastro and finally a hepatologist...with the same conclusion that they suspect I have aute hep c and not chronic
initially symtoms (symptoms) were:
severe jaundice with the ALT and ALT levels shooting up more than 15 times the normal
total bilirubin shooting up but now it has really come down though still in the red
HCV RNA positive
no biopsy as all three docs suggest starting possible tx in mid feb without one
All the doctors seem to be playing the wait and watch game

On this forum too have seen a lot of comments which recommend to wait and see before starting tx if we are in the acute stage..but here lies my question...there seems to be a very thin grey line between acute hep c and chronic hep c...are there any specific symptoms which differentiate the two since this would definitely help in making a decision? txs!

[desrt]

Have any of your doctors been doing viral load tests? I believe that's the only way to tell whether you will be one of the lucky 20% who completely resolve the chronic on their own.

[desrt]

Just re-read your post. If you are still HCV RNA + in another month or so you will be considered chronic. You are getting close to the point where you should start considering treatment, if you want to catch it in the acute phase.

[chcnme]

With your enzymes elevated that bad and jaundice,  I would think you were in the acute phase or recovering from it.  I don

[HepCBoy]

>but is there really a 90% success rate for Geno 1

[chcnme]

Hi HepCboy, I'm more confused now, I think, lol - on the 90% thing. Are they treating acute Hep now for 24 weeks with Peg and Rib regardless of what a quantitative PCR might show six months post a suspected case of acute hep C?

[GrandOak]

Studies apparently showed an 80 - 98% rate of clearing virus if treated in the acute stage.  This seems to greatly improves one's chances of attaining SVR than waiting for it to reach the chronic stage.

My guess would be that during the actue stage, the virus is undergoing mutation replication to mask itself from a persons natural immune system.  Thus, by attacking it with the treatment while it is attempting to hide from your natural immune system you can catch it off guard.

I can only speak for myself, but if I could improve my odds of clearing from 20 (naturally) to 80 or 98 % (with treatment), it would be a no-brainer for me, especially given where I find myself today!

[cc4mickey]

I personally would not consider treatment without a biopsy.You need to find out your genotype...You may already be in the chronic stage.You might have been acute months before the jaundice surfaced.I didn't have any symptoms when I was exposed.I think your Drs.really need to do some more testing.I think you were given some really good advice about waiting for new drugs around the corner.
cc

[shastri20032003]

I am 45 years old,used to have alcohol daily for the past 6 years and stopped the day i was diagonised with hep c. Gigarettes....having a hard time to stop that and doubt will be able to stop once tx begins..docters here in Singapore and Indonesia are giving a 90% possibility of SVR since in the acute stage
Have children and working but as you suggested have changed my lifestyle to a more relaxed mode and living a healthy diet now
The only symtoms (symptoms) now are a bit of fatigue and an uneasy feeling at the liver area and a slightly yellow tongue besides the elevated LTFS
No genotype and viral load testing yet...guess the docs are waiting  to do that once they decide that treatment needs to start
Desrt...you are right...reaching the point where i need to decide whether i need to proceed with tx now
thanks guys for yr comments..its been very helpful

[GrandOak]

A biopsy will not tell you your genotype. Genotype is determined by blood test. See my c7 post "side effects of treatment ?" thread for what a biopsy will show you.

[HepCBoy]

In truth I don't think there is any defininative way to tell acute from chronic, acute is just the infection in the first 6 months.

Generally here in the UK they wait about 12 weeks from infection to see if it will clear by then, if not the sooner you start treatment the more effective the treatment will be, greater than 90% chance of sucess.

[aiuta]

Shastri, I am currently being treated for acute Hep C.  Since you asked, here's my advice.  First, get your VL tested; it's the only way they can tell if you are clearing (since the symptoms you have experienced will go away if you do OR DON'T clear).  Try to figure out the exact date you got infected, and if your VL is not UND after, at the most, 16 weeks from that date, I WOULD START TREATING ASAP.  Women do have a higher spontaneous clear rate than men (up to 40%) but that statistic is for younger women.  At 45 you are by no means old, but the "younger the better" in this case.  As others have said, time IS of the essence in your case and could make a difference in your chances of SVR.  Please keep us posted.  All my best, Aiuta  

[shastri20032003]

aiuta,
thanks for the timeline reminder and the other tips regarding viral load...btw i am a male
meeting with my hepatologist tomorrow and will bring out these points with him
will keep you all posted on the progress
how about you...how are you doing? have you started treatment already?
shastri

[chcnme]

Hi Shastria.  Hope everything works out for you no matter what you decide.  I'm still not sure on the 90 % thing.  You mention that your docs are playing the wait and watch game.  I would ask them why - if they believe treating you in the acute phase will give you a 90% chance of succeeding with treatment - are they waiting?   What are they waiting for?  

Best of luck to you!  

[aiuta]

Sorry about the gender goof.  Seriously, though, since you ARE a male (only about 15 - 20% chance for spontaneous resolution) and given the time frame you've told us, I'd REALLY get on top of this NOW.  I am doing alright, thanks for asking.  I just did my 24th shot.  The sides have been, like many share here, difficult, so that's why I'd advocate treating sooner than later in your case (sooner = shorter + better chance of SVR).  Good luck with your Dr. tomorrow.  Please keep us posted.  Aiuta

[cc4mickey]

OK..........There are other problems that can cause Jaundice and elevated AST/ALT besides Acute Hepatitis..Autoimmune Hep.Gallstones,or blocked Bile Duct.Iron overload.When the AST/ALT levels are 15 times normal,that is a serious assult on the liver.An Abdominal Sonogram can rule out Gallbladder problems.
If the biopsy showed nothing but Stage 0,,I would feel safer to assume that the Hep could be acute.I would hate to see him get treated for a shorter period of time and not clear,when he might if treated the standard time.
Best of luck to you,what ever you decide.
cc