lab numbers heptimax question

I received my test result for the heptimax, I have Hep C, what does out of range 224,000 H range mean?  Is that bad?

[epiphiny]

Could you type in all the info that is on your result form, please?  If possible what the linear range of the test that was used is.  It should look something like this: Linear range: 50 to 50,000,000 IU/mL

Without that it's hard to be specific but it would seem to me that the test result is saying that you have a Hep C viral load that is above the highest range of the test used.

Epi :)

[zazza]

"Out of range" in this context means that you are not within the normal, healthy range, which for hep C is UND or rather 0 IU/ml. So "out of range" simply means you HAVE a viral load.

Your viral load is 224,000 IU/ml, which is considered a low viral load, and therefore you have greater chance of success with treatment. So it is good, not bad.

What genotype are you?

[epiphiny]

yay for zazza!

[jamie2009]

Thanks, yes here it is.

The range of the HEPTIMAX (TM)  assay is 5 IU/ml to 50,000,000 IU/mL. This test was performed using the HCV RNA real-time PCR method.
Reference range Less than 5

Genotype 1a  Hepatitis C viranl genotype

What is considered to be high?

[zazza]

There are different opinions among doctors and studies on what is considered a high viral load. The most commonly used limit is anything above 600,000 IU/ml. Sometimes 800,000 IU/ml is used, often nowadays 400,000 IU/ml is used. I prefer to go by the lowest - 400,000 IU/ml, figuring that it is better to err on the side of caution.

[jmjm530]

Under 600,000 is considered "low".  Whether that is good or "bad" depends on where you are in the treatment process. Are you on treatment or off treatment? Have you ever treated?

Assuming this is a pre-treatment test, and assuming you have have your biopsy and decided to treat already -- then a "low" pre-treatment viral load is good. In fact, if you are certain at this point that you want to treat, I'd start ASAP since: (1) low pre-tx viral load will give you a better chance of being cured; and (2); viral load tends to fluctuate.

[epiphiny]

200,000 to 1,000,000 low
1,000,000 to 5,000,000 medium
5,000,000 to 25,000,000 high
above 25,000,000 very high

So it looks like yours is low!  Good!!  Better chance of treating successfully...

[jamie2009]

Thanks for that information.  I am glad to know that its not that High.

[zazza]

Have you had a biopsy done?

With a low viral load like yours, you stand a better chance of becoming RVR (UND by week 4). In that case, and if you have a good reading on your biopsy, you might want to consider shortening treatment to 24 weeks. According to studies, this is said not to affect the SVR rate for geno 1s with low baseline viral load and RVR.

[jamie2009]

I have not done a biopsy or decided to do the treatment in fear I wont be able to work, and I am the sole supporter of my kids. But I want to be cured because I am very afraid of getting sick from it.

[zazza]

I just learnt myself recently what "out of range" in this context means. :)

The listing of viral loads you posted above looks old to me. That is the way it used to be divided. No good anymore, at least when it comes to what is considered a low viral load.

[epiphiny]

Yes, I noticed that too when I read your follow up post!  It's a little annoying that I got that info from a well recognized Hep C site, I guess it's hard to keep everything up to date but still...

And, it was cool to learn what "out of range" meant so thanks for that!

[Bill1954]

It’s also important to understand that there have been several ‘units’ used to describe viral load in the past. For instance, the information Epiphany posted might be referring to copies/mL, rather than the IU/mL that is internationally recognized now. This difference can be very confusing at times; for the most part, EQ/mL, and copies/mL have been abandoned in favor of IU/mL.

[zazza]

If you have a biopsy done, you will get information about your liver status which will help you decide what to do. There are new drugs coming which will be added to the present treatment. They will increase the SVR rate and may also shorten treatment duration. If your biopsy results are good, you might want to wait for these new drugs. 2011 is mentioned as a possible time for them to be approved.

Low baseline viral load is good. Our SVR rates are better than for those with high viral loads, but we may still become slow responders to the present treatment and have to do 72 weeks. So it is a gamble, even if our chance to win "The Cure" is greater.

[Bill1954]

Information regarding new definition of ‘low’ viral load:

http://www.natap.org/2007/EASL/EASL_41.htm

[justme53]

When I got my last VL, it was 848,000 and I was thrilled that it was so much lower. But my Dr. said the limits for a low VL are now 800, 000 or less. I believe I've seen 600,00 mentioned in the meantime, so things have definitely changed.

I asked what log drop we want to see at 4 weeks...3...4? She fired back 6!! Guess I've got my work cut out for me........

Pam

[zazza]

Both Bill1954 and I had low baseline viral loads but had to do 72 weeks. I was not UND until week 15, but I am SVR now. And Bill was UND 1 month post, so it is looking good for him as well. Endurance and determination is needed to get rid of this virus.

[zazza]

Of course the more logs the viral load has gone down by week 4 the better, but as a geno 1 two logs is good enough, or at the least one log. I think GrandmaBRZ even had less than a one-log drop at week 4, and still managed to have a 2-log drop by week 12 and become UND by week 24, which is the criteria to continue treatment.

Epi,
I think I know where you got that list. So they still have it posted there. Amazing.

[jamie2009]

Did the treatment/medicine make you sick where you could not work?

[epiphiny]

Yup, I just checked it and it was referring to copies.  It can be so confusing out there, thankfully we've got this place and each other!

[Bill1954]

Zazza, you either have a remarkable memory, or a very comprehensive spread sheet; how can you remember all these details? LOL, I can’t even remember these things about my own treatment :o)! Always good to see you posting in here,

Bill

[epiphiny]

Everyone reacts differently to treatment...  Some people choose to continue working right through (and make it), some choose to do less hours, others choose to not work at all, it's very individual and of course is based on each person's circumastances.

I for one, have to keep working as I am the main earner in my household and our mortgage is quite high.  I have had to take a couple of days off here and there, but honestly no more (and often less) than my fellow co-workers.

If you have your own business or work from home then it's even easier.

You don't really know til you begin how you are going to react....

[zazza]

70% is mentioned as SVR rate for low baseline viral load below 400,000 IU/ml in the link Bill provided. So 30% do not get SVR. Among these 30% are perhaps 10% null-responders who are taken off treatment at week 12. Leaves 20% who do not get cured with the present treatment even if they make the 2-log drop at week 12. Some of these patients might be slow responders who did not treat long enough, some had to stop treatment because of adverse side effects, some were not UND by week 24 and were taken off treatment, a few got viral breakthrough.

Anybody know the relapse rates for low baseline viral load?

[Bill1954]

Bobbettmw, just off the top of my head, I’d say that about 70% of the people that report in here continue to work, although many of them on an adjusted schedule. I did not work, but also am an insulin dependant diabetic, and have other issues as well. I’m also a carpenter, and have to work outdoors in very hot weather. I applied for and received social security disability… I might have done that regardless of HCV. If I had a desk job, I would most likely have continued to work.

This treatment hits all of us differently; some get *very* ill, and stay that way; others breeze through with little difficulty. We’ve had members here that have run marathon races, while others are bed-bound. The only way to find out how you’ll deal with this is to try, unfortunately.

Keep reading  in here, as well as other places, and take your time making any decisions. A good site for basic information is Janis and Friends:

http://janis7hepc.com/

Good luck, and stay in touch—

Bill

[can-do-man]

Zazza, you either have a remarkable memory, or a very comprehensive spread sheet; how can you remember all these details? LOL
-----------------

ca, you don't have a chance guy. :)

Hope all is well with you both......

[zazza]

No spread sheat, just remember things that interest me. Not fool proof though. When were you UND for example? It slipped my memory now. I know you are a relapser, but is that why you extended or is it because of slow response? And when is your 6 month PCR coming up? We want to have another party for you!

[zazza]

Lol!

[Bill1954]

And what’s more impressive than that, it’s 3:00 am in Sweden right now, and you can still think. I can’t do that well at mid-day!

This treatment I was RNA negative to <615 at 4 weeks, and <5 at 8 weeks. I extended treatment to 96 weeks based on a number of reasons; late responder (20 weeks) in the first treatment, insulin resistance, and most importantly, the ability to tolerate the drugs. I was able to walk/jog here in the mountains 6.4 KM/day for the first 8 months of treatment, and never required GCSF or epo at any time. While there was no science to support this, the doctor agreed that it was indicated for the reasons posted above.

I will have the results of my 6 month post Tx test about February 1st; I’ll report in with the news when it’s available.

Thanks for asking, and take good care—

Bill

[zazza]

"I was able to walk/jog here in the mountains 6.4 KM/day for the first 8 months of treatment"

What is more impressive than that?! I had trouble walking to the grocery store across the street during treatment.

* * * * *

About the relapse rates for low baseline viral load:

"In the 72-week treatment group, virological relapse rates were statistically highly different when comparing baseline viral load  400,000 IU/mL (6% vs 29% in low vs high viral load; P = 0.001)."

"In the 48-week treatment group, relapse rates with respect to low vs high viral load cut-off of 400,000... IU/ml were 15% vs 36%..."

http://www.hivandhepatitis.com/2006icr/aasld/docs/103106_d.html

So a relapse rate of 15% for 48 weeks and 6% for 72 weeks! Wow, looking good, looking good...

[zazza]

Oh, and that was using a fixed dose of ribavirin too! Not weight based.

[zazza]

"In the 72-week treatment group, virological relapse rates were statistically highly different when comparing baseline viral load less than 400,000 vs greater than 400,000 IU/mL (6% vs 29% in low vs high viral load; P = 0.001)."

[bev1964220]

my husband's blood work came back last week, and the heptimax was 11.0  What does this mean

[FlGuy]

It might be a little more helpful to indicate what the lab report actually said.  Do you have a copy of it?   '11.0' by itself is a little out of place as a result, there should be a little more to it.

[jmjm530]

it simply means that your viral load is 224,000 IU/ML. This is considered low, which bodes well for successful treatment, everything else being equal. If you have significant liver damage you might consider treating as soon as possible to take advantage of your low viral load. Unfortunately, viral load can fluctuate, sometimes substantially, so there's no guarantee that load today will be low tomorrow.