viral load counts

Dear Doctor,

I am a ldlt due to hcv. post transplant over a year ago.  my viral load is very high over 100 millions.  without any treatment for hcv, my viral load went down very significantly about 86%. my question  is what is the reason for my viral load to go down that much? is it because my hcv is become chronic now? or something wrong? does this happen naturally?  i know viral load will go down sometimes but not this much.
thanks for your time.

[Thomas D Schiano, MD]

the HCV RNA level rises and falls spontaneously.  we typicall perform protocol liver biopsies to see if the HCV warrants treatment.  Patients with persistent higher viral loads may do less well.