Hep C Genotype 1b-very high viral load, but normal liver function

[Orv]

I am a 62 year old male and was diagnosed with Hep C, Genotype 1B, in 1998. My liver function tests were high but no overly so. My viral load was very high. I did have symptoms at the time I was tested and had similar symptoms in the past. New test results today reveal normal liver function, but a very high viral load, 25,100,000. Iam not and have not been symptomatic for quite sometime. What does this mean???

[Idyllic]

This is sad in a way. I mean sad about the system. A distant family friend diagnosed with HCV 8 or so years ago has always had low viral load, normal liver enzymes and no symptoms. Why, she even runs a few marathons a year! (insert eye roll here)  This has been her rationale to do absolutely nothing all this time. Last week her first biopsy ever showed stage 3 marked bridging fibrosis. I think the word necrosis was tossed in there along with something about the portal areas.

I guess it's like OH above said, if it were me I would want to know. I just do not understand how someone could not wonder what stage of the disease process they are in.

[SusieS2010]

Funny you should ask this today. I read an article just yesterday that said that people with a high viral load and genotype 1b have the best chance to get rid of the virus with the new drugs. And seeing you are treatment naive (never treated) your chances are even better. I will look for the article and post it if I can find it.

[Dee1956]

Hi have not statistics for you but I do have experience.
My liver function tests were slightly elevated when I was diagnosed with Hep C.  My doctor told me I had plenty of time to think about treatment.
After the biopsy I was diagnosed with cirrhosis and the need to treat became urgent before I developed decompensated cirrhosis which makes the Hep C look like nothing.  The damage is not linear, i.e. it took me 30 years to get here so I have another 30 to go.  The virus accelerates the older you get.
I hope you can find a good Hepatologist, get a biopsy and find out how your liver is really doing.
I finished tx 4 months ago and I am better than I have been in years.  Hep C is very insidious and you don't know how it is affecting you until you no longer have it.
You can do searches on here to educate yourself.  When I first came here in 2007 I thought I knew a lot.  I did not know anything.
Good luck to you

[orphanedhawk]

I get so tired of saying this but viral load doesn't equal liver damage.
Mine was only 750,000 when I was diagnosed with ESLD, decompensated cirrhosis.
As pooh said, the fact you have no symptoms doesn't mean anything about the condition of your liver.
If it were me, I'd want to know how my liver was faring before assuming anything.
Are you seeing a hepatologist ? What does your doctor say about your condition ?

[pooh55811]

Welcome to the forum.

Many people are not symptomatic even though they have had Hep C for decades. Liver Function tests can be normal even in the face of worsening liver fibrosis and/or rising viral loads. The viral load is not an indication of how much liver fibrosis a person has or how many symptoms the person has.

So, basically, your tests means you have Hep C  Genotype 1B with a current VL of 25,000,000 and normal liver function tests. That is really all they tell you.

If you want to find out what condition your liver is in you probably need a liver biopsy. A liver biopsy will tell you at what stage your liver is in terms of fibrosis.

I know you did not ask this but, at 62, it would be wise to give some thought to treatment in order to rid yourself of the virus. Liver fibrosis progression picks up speed as we age. Plus, we can get other diseases which may complicate treatment. If you have a liver biopsy and your fibrosis stage is 3 or 4, it would be wise to treat sooner rather than later. Mine is Stage 2 and I elected to treat immediately.

There is currently a triple medication regimen (Interferon, Ribavirin, and a Protease Inhibitor, either Incivek or Victrelis) which has a 75-80 % chance of curing the virus. The triple med regimen is the treatment that is currently recommended for Hep C Genotype 1 (A and/or B).

There are also drugs in the trial stage which should be available in 3-5 years.

This is an excellent forum so hopefully you will visit it often and ask any questions that you may have.