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Genotype 3 HCV with 6.4 log viral load
I was diagnosed with HCV genotype 3 about 7 months ago. My viral load is 6.4 log m/l, which per the charts I've seen works out to about 2,750,000.00.
I know that genotype and viral load are predictors of treatment response, but scholarly literature still lumps genotype 3 in with genotype 2, an easier to treat genotype without the unique genotype 3 features of hepatic steatosis irrespective of BMI, and increased likelihood of hepatocellular carcinoma. I am waiting for approval for sofosbuvir/ribavirin and have several extrahepatic manifestations such as sialadenitis, rheumatic factor, and fatigue.
What I want to understand is why there seems to be little interest in checking for these manifestations except when specifically requested by me, based on symptoms and knowledge of these manifestations? I had to specifically as my doc to order these tests, specifically for cryoglobulinnemia, a common manifestation of Hepatitis C.
I have reviewed multiple studies regarding HCV genotype 3, and more current studies acknowledge that with the success of sofosbuvir (Sovaldi), genotype 1, the most common US genotype, genotype 3 has become the most difficult to treat, given its significantly lower SVR rates, and rates of relapse.
Where can I get more current information regarding genotype 3? I am a person who needs as much information as possible in order to deal with this disease without undue anxiety.
Any info anyone has would be greatly appreciated
I know that genotype and viral load are predictors of treatment response, but scholarly literature still lumps genotype 3 in with genotype 2, an easier to treat genotype without the unique genotype 3 features of hepatic steatosis irrespective of BMI, and increased likelihood of hepatocellular carcinoma. I am waiting for approval for sofosbuvir/ribavirin and have several extrahepatic manifestations such as sialadenitis, rheumatic factor, and fatigue.
What I want to understand is why there seems to be little interest in checking for these manifestations except when specifically requested by me, based on symptoms and knowledge of these manifestations? I had to specifically as my doc to order these tests, specifically for cryoglobulinnemia, a common manifestation of Hepatitis C.
I have reviewed multiple studies regarding HCV genotype 3, and more current studies acknowledge that with the success of sofosbuvir (Sovaldi), genotype 1, the most common US genotype, genotype 3 has become the most difficult to treat, given its significantly lower SVR rates, and rates of relapse.
Where can I get more current information regarding genotype 3? I am a person who needs as much information as possible in order to deal with this disease without undue anxiety.
Any info anyone has would be greatly appreciated
Hi Penny,
I have GT3. If you do a simple web search on GT3, you will find all new information will say that our GT is now the most difficult to treat with the newer DAA's. This is mainly because GT1 and GT2 are more prevalent in the US and all the lab work went into these more lucrative GT's.
GT3 is also much more damaging to the liver in shorter periods of time, causing fatty liver (steatosis), and faster damage and higher cancer rates through mechanisms not yet entirely understood.
That said, pretty soon we will be seeing new drugs on the market that are highly effective on GT3, and will mean that there is no need to use ribavirin, which has a host of side effects, and can cause anemia in a percentage of people particularly treating for the longer 24wks. These new drugs will be short courses of twelve weeks with minimal side effects, and should be here hopefully within a year or so, all going well. Watch for daclatasvir and Gileads new GS-5816.
Personally if I didn't have stage 3 liver disease or later, or serious autoimmune diseases that were damaging my organs to a degree that I felt couldn't wait a bit longer for these new treatments, I would most certainly wait for them rather than treat with ribavirin for 24 wks.
I have cryoglobulinemia that has started causing peripheral neuropathy, and suffer from such extreme fatigue and other symptoms and have taken chemo agents such as rituxan to try to contain the damage in the meantime which shot my viral load up to 60 million. So I took a risk on trying harvoni and ribavirin for 12 weeks, which is not recommended due to lack of study, thinking it might give my liver a break at least in the meantime while waiting for the newer drugs to come on the market, because I am not prepared to use ribavirin for any longer than 12 wks, and feel that there's a good possibility I will clear the virus anyway.
I think you will find this article interesting. It details the latest thinking on treatment, and on GT3.
Best to you!
http://www.gastrojournal.org/article/S0016-5085(15)00014-1/pdf
I have GT3. If you do a simple web search on GT3, you will find all new information will say that our GT is now the most difficult to treat with the newer DAA's. This is mainly because GT1 and GT2 are more prevalent in the US and all the lab work went into these more lucrative GT's.
GT3 is also much more damaging to the liver in shorter periods of time, causing fatty liver (steatosis), and faster damage and higher cancer rates through mechanisms not yet entirely understood.
That said, pretty soon we will be seeing new drugs on the market that are highly effective on GT3, and will mean that there is no need to use ribavirin, which has a host of side effects, and can cause anemia in a percentage of people particularly treating for the longer 24wks. These new drugs will be short courses of twelve weeks with minimal side effects, and should be here hopefully within a year or so, all going well. Watch for daclatasvir and Gileads new GS-5816.
Personally if I didn't have stage 3 liver disease or later, or serious autoimmune diseases that were damaging my organs to a degree that I felt couldn't wait a bit longer for these new treatments, I would most certainly wait for them rather than treat with ribavirin for 24 wks.
I have cryoglobulinemia that has started causing peripheral neuropathy, and suffer from such extreme fatigue and other symptoms and have taken chemo agents such as rituxan to try to contain the damage in the meantime which shot my viral load up to 60 million. So I took a risk on trying harvoni and ribavirin for 12 weeks, which is not recommended due to lack of study, thinking it might give my liver a break at least in the meantime while waiting for the newer drugs to come on the market, because I am not prepared to use ribavirin for any longer than 12 wks, and feel that there's a good possibility I will clear the virus anyway.
I think you will find this article interesting. It details the latest thinking on treatment, and on GT3.
Best to you!
http://www.gastrojournal.org/article/S0016-5085(15)00014-1/pdf
Hi, welcome to the Forum. I am one of those Gt3s JimmyMose referred to. I would have posted sooner but I had to look up the list of medical conditions you listed.
Sounds like you have done your homework - you surely know more about the related conditions that I.
Are there questions you have? It is easier for you to ask specific questions. There are a number of us on here who have or had Gt3, plus many others who are so knowledgeable about all phases of hepc.
Having said that, I will add, hepc, in all its genotypes, is now very treatable. There are several new meds out since Dec 2013, and more in trials, each is easier than the one before, with fewer side effects and less residuals and shorter and shorter times. It is a really great time to be diagnosed. Plus, hepc is a slow developing disease, so, unless diagnosis is made way late into the disease, there is time to wait, if need be.
The Forum is an awesome place for caring, support, and information. Just take a deep breath, exhale, relax, and ask your questions.
You listed your genotype and viral load - which by the way, is mostly used to diagnose that you have chronic hepc AND for seeing whether the meds are working -- have you been given a prescription or told treatment you will be placed on? Have you ever treated before for this? I think that probably is not the case, as you said you were only diagnosed 7 months ago, but had to ask. That can affect treatment choices.
Again, welcome to the Forum and feel free to ask your questions.
Sounds like you have done your homework - you surely know more about the related conditions that I.
Are there questions you have? It is easier for you to ask specific questions. There are a number of us on here who have or had Gt3, plus many others who are so knowledgeable about all phases of hepc.
Having said that, I will add, hepc, in all its genotypes, is now very treatable. There are several new meds out since Dec 2013, and more in trials, each is easier than the one before, with fewer side effects and less residuals and shorter and shorter times. It is a really great time to be diagnosed. Plus, hepc is a slow developing disease, so, unless diagnosis is made way late into the disease, there is time to wait, if need be.
The Forum is an awesome place for caring, support, and information. Just take a deep breath, exhale, relax, and ask your questions.
You listed your genotype and viral load - which by the way, is mostly used to diagnose that you have chronic hepc AND for seeing whether the meds are working -- have you been given a prescription or told treatment you will be placed on? Have you ever treated before for this? I think that probably is not the case, as you said you were only diagnosed 7 months ago, but had to ask. That can affect treatment choices.
Again, welcome to the Forum and feel free to ask your questions.
Hi there,
I have been referred to a gastro group at the University hospital where I live, but they have not done anything other than the basic liver function panels until I asked. The doc here is one of the top in the US for HCV, so I hope to be approved soon, though my insurance company has denied me already. I was asked if I had cirrhosis by one of the nurses my first visit there, answered "I don't know, and was told "if I had it, I would know." Since my liver enzymes are not elevated, I guess they are not testing? I do know that you can have cirrhosis with normal levels, so I guess I just need to keep asking questions.
I have steatosis, so I know there must be some damage, I just want to understand. Thank you for any info, this is the first time I've been able to communicate with other HCV folks, it is reassuring.
I have been referred to a gastro group at the University hospital where I live, but they have not done anything other than the basic liver function panels until I asked. The doc here is one of the top in the US for HCV, so I hope to be approved soon, though my insurance company has denied me already. I was asked if I had cirrhosis by one of the nurses my first visit there, answered "I don't know, and was told "if I had it, I would know." Since my liver enzymes are not elevated, I guess they are not testing? I do know that you can have cirrhosis with normal levels, so I guess I just need to keep asking questions.
I have steatosis, so I know there must be some damage, I just want to understand. Thank you for any info, this is the first time I've been able to communicate with other HCV folks, it is reassuring.
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