Re: Viral count vs. ALT/SGOT count in hepatitis C

Posted By HFHSM.D.-D.M. on November 22, 1998 at 18:20:27:

In Reply to: Viral count vs. ALT/SGOT count in hepatitis C posted by R.J. on November 15, 1998 at 08:53:08:






Would you please discuss the relative importance of viral count and ALT levels in hepatitis C. How much does viral count flucuate over the course of the illness and what does it mean. How accurate are the tests used to determone viral count? I have heard people mention counts as low as 250,000 and as high as 10,000,000. Mine went from under 1,000,000 to over 5,000,000 in three months time. Please also talk about ALT/SGPT counts on the liver panel and what flucuations in that number mean. Thank you very much.



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Dear RJ:
Thanks for you questions.  Ill see if I can provide some useful comments.
Viral titers of hepatitis C can have some significance.  Patients with consistently low titers have a better chance of responding to interferon or the combination of interferon and ribavirin than patients with high titers.  Low titers are considered less than 200,000 copies per ml and high titers are considered more than 2 million titers per ml.  However, patients with high titers often still good candidates for therapy and many do respond.  Moreover, viral titers can bounce around quite a bit and its not clear this means anything.  
Similarly, liver enzymes (ALT/SGPT)  are not always as meaningful as we would like and do not always correlate with the amount of liver damage present.  While you are generally better off having low enzymes than high, plenty of patients with low enzymes have advanced disease and plenty of people with high enzymes have early disease.
Finally, viral titers absolutely do not always correlate with the ALT and these two parameters can move in entirely unrelated ways.
Good luck with you situation.   I hope this information is helpful to you.  If you have any additional questions or concerns, you can post them through MEDHELP or contact us directly at Henry Ford.  The direct number to our liver clinic is: [phone].  At Henry Ford, we have a very active group of hepatologists with a strong interest in the care and research of hepatitis C.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation.  Always check with your personal physician when you have a question physician when you have a question pertaining to your health.

[ravinderk]

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[virgils]

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