Hep C Viral Load?

[mmoe316]

My wife just got her results from her confirmation test that puts her Viral Load at 93,111 we first got the positive anti HCV test last week and where waiting on these results from her OB as we only got these results from her first pregnancy blood work. She is 25 and the only risk factor we could come up with is that at 3 months old she had H Flu meningitis and needed a blood transfusion. I guess my question is how bad are her numbers and whats next? We are getting an appointment with her GI ( she had her gallbladder removed in January of this year) and our primary care is getting an order for me to get my blood work done. We are so scared and are just trying to figure out how much our life is going to change now? Thanks

[Trinity4]

Many of us are married or have been in long term relationships and didn't know we had hepc and our partners or children are not infected.  Having not known, we didn't take any extra precautions so the odds of passing the virus to family members is extremely low.  I understand that you want to keep her calm and be supportive but the best thing she can do is educate herself about hepc and make sure she follows up with a good GI or hepatologist so she can make a plan for the future.  Hepc is not death sentence, we don't have cooties and she can live a long and productive life by living a healthy lifestyle and avoiding things like drinking and drugging.  

Here are a few good websites which will help her realize it's not the end of the world and there are many others in the same boat.  You have to hit this disease head on, can't hide your head in the sand or have a pity party.  It is what it is and knowing what the options are will give your wife a much better outlook and whole lot more confidence.

Trinity

http://www.hepatitis-central.com/
http://www.hcvadvocate.org/
http://www.hepcadvocacy.org/
http://www.hepcstraightup.com/

[eureka254]

It's natural to go through quite a spectrum of emotions and thoughts when first diagnosed, and to think the worst, but it's often not as bad as it first seems.  The likelihood of infection to household members and spouses is very low (less than 5%), and even lower with appropriate precautions (no sharing razors, toothbrushes, etc.).  It's important that your wife educate herself about hep c to help alleviate her fears.  Encourage her to join the board!  I know I found it a great place to get answers and support when my husband was diagnosed.  Welcome to the forum.

The knee-jerk reaction with hep c diagnosis is panic and fear, but your wife has a more immediate concern:  her pregnancy -- and congratulations to the both of you!  It's is not unusual for women to learn about their hep c status after routine OB blood work.  Keep in mind that your wife has only 9 months to optimize her health in relation to the pregnancy but will have plenty of time to address the hepatitis concern after the delivery.  Treatment of hepatitis c is not recommended during pregnancy, and because biopsy is usually done under sedation, it may be wise to delay the procedure for after the baby arrives.  A consultation with a GI or hepatologist should shed more light on the process for both of you.  One note:  because your wife has active hep c, if her OB is not experienced in maternal viral infections, your wife should be referred to speak with a Perinatologist to discuss management plans to minimize the risk to baby for hep c (risk to baby is approximately 4%).  

Diagnosis of hcv can change your mindset quite a bit, but that doesn't mean your life will alter drastically -- a few more doctor's visits and possible treatment down the line, but the diagnosis does not have to change your life as you know it.  Hep c as a rule is a slow-progressing disease, and the fact that your wife has a 'low' viral load is encouraging that she will have success when the time is right to pursue treatment.  In the meantime, the best thing she can do is to learn about hep c and treatment options, and keep herself and baby healthy and happy!  Best wishes.
~eureka

[mmoe316]

Thanks everyone and I am doing my best to keep her calm. See keeps telling me about her fear of getting me or others sick as well. I know this isn't probable unless she had direct blood to blood contact but what have you guys found to ease the mental stress and pressure from the stigma and realities of having this disease?

[Bill1954]

As Trinity and GFRY suggested, HCV progression is generally measured over decades rather than years. There are, however, exceptions to that; I agree with Trin that a biopsy might be a good idea if she thinks it’s been twenty years since she was initially exposed.

Once the initial shock and awe of diagnosis is absorbed, the disease is usually more of a pain in the butt than anything else. A rather big one at times, but it’s not the end of the world. Not everyone requires immediate treatment for it either; many folks adopt a ‘watch ‘n wait position, and bide their time waiting for more efficacious drugs/treatment modalities to show up on the horizon.

If she’s now pregnant, it’s important to know that HCV is unlikely to transmit from mother to child; it appears to happen in less than 5% of patients. She might be concerned about this, so if she hasn’t already, make sure she discusses this with her OB/GYN.

Best of luck to you both, and let us know how things proceed—

Bill

[Trinity4]

If her exposure was at 3 months old due to tranfusion I would recommend talking with her doctor about having a liver biopsy done to ensure you know the extent of liver damage due to the length of time she has had the virus.  Biopsy is painless and will be very useful in determining if treatment is necessary in the near future of if she has time to watch and wait.

Trinity

[GFRY]

first of all come down , there is no need to be scared , virus c thank god has a cure now & new medication are on its way next year so eventually every one is going to be able to beat this virus , hepatitis c is a very slowly progressive disease so don't panic , now your wife needs liver function tests & liver sonography , hepatitis c is unlikely to be transmitted sexually so don't worry but get tested any way

[mmoe316]

Yes we do have good health insurance. It will be interesting to see how things progress.

I am just scared. Thanks for the support.

Her OB seemed to just tell us everything will be ok and that because of the low numbers she should be fine. We tried to explain to her that it is serious to us but have just decided that once this pregnancy is over with we will be moving on to a different doctor.

I know the GI is a great doc. Thanks again for the support as we move forward.

[Bill1954]

Hi there—

Sorry to hear of your wife’s diagnosis. If you and she didn’t share IV drugs, it’s unlikely you’ve been exposed to the virus; the virus doesn’t easily transmit via sexual intercourse.

Her viral load is relatively low; actually the cut-off for low viral load is now considered to be 400,000 IU/mL. However, unlike many other viral diseases, the load, or amount of virus in the blood doesn’t necessarily correlate with disease severity or progression.

She’ll likely get a referral to a GI doc or hepatologist for further care and management; that doc will order more tests, including a HCV genotype test. This is the ‘strain’ of Hep C (HCV) and will help determine the length of treatment required as well as her odds of responding favorably with the currently available medications.

The doctor might also order an ultrasound scan and perhaps a liver biopsy; he’ll discuss all this with her at the initial appointment, no doubt.

Do you guys have health insurance?

Good luck, and welcome to the discussion group, by the way—

--Bill