geno type viral load

[caiti87]

Ok all I just recently saw hep doc and he ordered his own labs which came back as saying that I have Genoa type 1a and a viral load of 70million. Its still a little while before I see him so I'm dying to know what this means. Especially in terms of treatment.  Doc also said there is no reason. To have a biopsy fine's but I disagree id like to know what shape I'm in, is he right or should I demand s biopsy? Thanks in advance for the wonderful answers I know I'll receive

[caiti87]

Hmmm I posted answeres to all of your questions and asked a few more of my own, but I don't see it here??! I'm in the hospital and using my phone to access the sight. Maybe that's the problem. Anyway, yes the viral load is right at 69mil. I don't believe the doctor did a fibrosure test. This was not my first diagnosos but gi doc wanted to order his own lab work because the labs I broughjt him were inconclusive to him I guess, he said that there was no viral load or genotype on old labs to even indicate that I had the virus. Confusing! @desert, this doc is in el paso and his name in edwin ojo (pronounced O joe) and I haven't been around hum enough to have an opinion. I have an appt with him this thurs, I will keep you posted on him ;). Does anyone have any questions they think its important for me to ask him?

[pooh55811]

As the others have said, Genotype 1 is the most common in the US. You would treat with Interferon, Ribavirin, and a protease inhibitor (either Incivek or Victrelis). The triple med treatment has a cure rate about 75% (sometimes higher).

I am not sure why your doc does not want a biopsy. A biopsy is the gold standard for determining the amount of liver fibrosis. Personally, I would want to know if I was at Stage 1 or Stage 4 (cirrhosis).

Your Viral Load does not sound correct. Unless I am mistaken, the VL tests only go up to 69,000,000. If that is the case, one could only say your VL is over 69 mil (but they could not say it is 70 mil). In addition, you had a VL of only 324,000 this spring. Viral Loads can jump around but going from 324,000 to 70,000,000 in 2-3 months is a pretty big jump. Could your VL be 700,000 or 7 million instead of 70 million?

Keep us posted. Best of luck.

[can-do-man]

If one has decided to treat and with the high rate of SVR more and more doctors are not doing a Biopsy... Blood tests can pretty much tell if cirrhosis is there and like jpinthekeys said there is always the fibrosure blood test. Welcome to the forum and wishing you the best.

"The presence of advanced or worsening fibrosis has traditionally served as an unequivocal indication for therapy, and clinicians still use the degree of fibrosis as a means for justifying therapy sooner rather than later. The availability of direct-acting antiviral (DAA) agents, which bring the promise of rapid viral negativity with therapy, intuitively appears to lessen the need for biopsy in therapeutic decision making; this is analogous to previously held perceptions about genotype 2/3 patients, who had higher sustained virological response (SVR) rates. Because of the increased efficacy of the newer regimens and even better regimens around the corner, clinicians and patients may choose to forgo biopsy with the compelling argument that the benefits of such effective therapy justify its use, even in those with minimal disease."

http://hepatitiscresearchandnewsupdates.blogspot.com/2012/05/is-there-still-role-for-liver-biopsy-in.html

[jpinthekeys]

      
    A couple of questions
Was this your first diagnosis of hep C ?
Did he do a fibro-sure test as part of the blood work?
     In my case they used a previous biopsy along with the fibrosure test.
A biopsy is really the only way to go as the fibro-sure test is accurate around 87%. and for early or late stage only but not inbetween.
     The viral load while very high is only an indicator of the active virus in your blood.
      The good news is the newest treatment for geno 1a treatment naive has around 80 % or better for clearing the virus.
        Did your labs come back with everything in the normal range??
The new treatment protocal is Pegasys and co-Pegasys with Invicec. You would start all three meds--interferon, ribavirin and incivec, Most people become undectecable at week 4, if so you would go 8 more weeks and drop the incivec and continue with interferon and riba for another 12 weeks.
        The old treatment was just interferon and riba for 48 weeks and only had a 44% SVR so the new on almost doubles that.
         Some people do fail the triple treatment but only around 20 %

          Or if your liver is at stage one and your doctor feels you could wait there will be an all oral treatment coming ouit in 2 or 3 years that has better results and less side effects in a shorter duration of treatment.

          this link will give you some better information.

          http://www.pegasys.com/hcp/pegasys-hcv/triple-therapy/genotype-1/index.html


     Good luck and please keep us all updated.   John

[desrt]

Hey caiti. Geno 1 is the most common form of HCV in the US. 70,000,000 is your baseline viral load. It's considered 'high', but really means nothing other than a place to start measuring your treatment response, once you've started. I've seen people with comparable v.l. drop quickly to undetected, and others with much lower be slow to respond. If your doc recommends tx, he'll probably put you on triple tx with IFN, ribavirin, and a PI  --  that is unless he's involved with some trial that he thinks shows promise. I agree with you on the biopsy, but if you and he are both determined to tx regardless, it might not be worth pressing the point.
I assume you traveled to Lubbock. PM me if you wish, with your opinions/impressions of this doc. Thanx.

d