'Inactive' HepC

[Laika]

My huz got the results on his biopsy yesterday--stage 1.  Really good news there!  He is 59 years old, geno 2.  Here is what I understand from what he told me:  He does not have elevated ALT & AST, his vl is 7,000,000.  The gastro is recommending treatment, if his cardio will agree that he can undergo it "safely".  As I understand it, the steadily normal ALT & AST indicates that his immune response to the hep C is not destroying his liver.  Couldn't the stage 1 liver damage be a result from years of drinking? (not recently!)  So...why treat?

I'd sure appreciate your comments.

Laika

[What Next]

Thanks for helping me understand a little bit more the report copied ok it looks exactly the same on the paper. I quess i can conpair it to mine when i get a copy of mine from my doctor. my husband goes to the va and i go to a specialist at our local hospital. i don't know if that is a good ideal or not but that is the cheepest way for us right now.i don't hold alot of faith in the va sometimes. i hear all these horor stories and i get a bit afraid but i probaly just am parinoid thanks again

[cuteus]

it is hard to interpret these numbers since it does not seem to be in proper order, the PCR result is on top area while the IU/ML is in the bottom somewhere,  and can't determine which numbers go with them. Basically, when I look at my bloodwork, I focus in  what is listed on the "out of range" area and research that. those numbers are usually followed by the reference range so you can compare where the out of range falls. If a PCR that goes down to <50 IU/ML in 3 to 6 months show him negative, he is one lucky guy, and should enjoy his fortune.

[What Next]

Here is the first page if you or anyone can read this thing please help
BLOOD
10/10
2002
08:19
*** WORK COPY ONLY ***
---- Hemoglobin Ale ---Reference Units    Ranges
Printed: 08/24/2005 16:31
GLY HB     5.5 %   4.3-6.2
Comments:    a
a. "Collect in 31-90 days
Evaluation for GLY HB:
Ref. Range prior to 10/1/02 - 4.4-6.4%
---- MISCELLANEOUS TESTS ----
DATE
TIME
SPECIMEN
TEST
VALUE
Ref ranges
08/04/2005 09:50  PLASMA HCV-VL:
HCV RNA not detected by PCR.
FOR RESEARCH USE ONLY.
NOT FOR USE IN DIAGNOSTIC PROCEDURES.
07/22/2005 08:14  SERUM DIR LDL:
"Collect in 5 to 7 months
"Collect in 5-7 months
"Collect in 5-7 months
Evaluation for DIR LDL:
Desirable: <100 mg/dl
Borderline high risk: 130-159 mg/dl
High Risk: >160 mg/dl
10/06/2004 15:22  24 HR. URINE      NORMETA:
10/06/2004 15:22  24 HR. URINE      METANE:
METANEPHRINE REF. RANGE 35-460 UG/24 HR
NORMETANEPHRINE REF. RANGE 110-1050 UG/24 HR
10/06/2004 15:22 URINE 10/06/2004 15:22 URINE Evaluation for VMA-CRE: 1.7-8.3 MG/G CREATININE 10/04/2004 08:32 URINE 10/04/2004 08:32 10/04/2004 08:32 10/04/2004 08:32 01/27/1999 15:49
VMA: VMA-CRE:
GREAT C: VOLUME: E TIME:
CREA: RHEUMAT:
URINE
URINE
URINE
SERUM
Rheumatoid Factor results from PITTSBURGH, PA "For Test: RF FACTOR "PITTS 0100 206 Evaluation for RHEUMAT: TEST PERFORMED AT PGH VAMC 09/29/1998 08:35  SERUM BUN:
SERUM GREAT:
SERUM NA:
SERUM K:
*** WORK COPY ONLY
09/29/1998 08:35
09/29/1998 08:35
09/29/1998 08:35
comment   lU/mL
68.0   mg/dl
151
131
4.3 cane
mg/24 hr MG/G
1.8-6.7 1.7-8.3
125.8   ml/min   61-166 1725   ml 24  hours
2173.5 H mg/24 hr600-1800 NEG NEG@1:20-(CONS).
18. mg/dL
1.2 mg/dL
138. mmol/L
4.4 mmol/L
7-21 0.8-1.5 137-145 3.6-5.0
(continued...)

[cuteus]

is there a reference range? that is where it is state how low the test goes, it does look good, though. one less worry.

[What Next]

I have his results here
HCV RNA not detected by PCR


Two page report I don't understand all this stuff.

[cuteus]

I would get copies of the PCR tests and verify that they are sensitive enough, at least <50IU/ML, just to make sure he does not have a very low viral load lurking. and I would re test in 3 months or so, just to make sure.

[What Next]

I was just diagnosed this month with hep c type 1 viral load 10million. My husband tested pos also on July 17 this year The VA doctor called today and said my husbands body cleared the virus he said he is stil hep c but not active. I am very confused I go for a liver biop on Monday. History for him ok no fatigue or as i call myself lazy. Me sleeping all the time moody Hell to live with for 2 years. Myquestion is can a body cure itself and can i make him sick if we are actively sexual. The va doctor said i should ask my doctor and she is closed already and I don't want to make him sick if he is cured. I am just confused

[Laika]

Tim...wow, you are right behind me.  Fatigue was the worst symptom for me because it was untreatable.  I used to wonder if I would ever clean my house again.  I don't think I did any cleaning for the 24 wks I was on treatment, and I totally resented the filthiness...just couldn't do it.  So this week I have shampooed the carpets, and today cleaned 24 wks of dust off of everything, up on ladders vacuuming cobwebs off the ceiling, etc.  That is very vigorous stuff for someone who couldn't even load the dishwasher after making a short-order dinner just 5 days ago!  So, it won't be long now, my man.  You're going to feel much better soon!  Yes, I do believe that not topping off the riba every day makes a HUGE difference!  

friole-- I looked back thru my records--it was 11.5, not 11.2 (what I was remembering was that it was down .2 from the 11.7 it had been at for awhile).  So it was actually a teeny bit higher than yours.  Anyway, no I won't go back to the dr for 6 months now.  I can tell from the way I feel that my hgb is coming back up.  There would be no reason why it wouldn't, once you stop the bombardment of riba, right?  If I were to continue to feel fatigued or any other symptoms of treatment, I would just call the dr and get tested.  When I first started treatment, I was tested weekly, then biweekly, then monthly.  I hope your dr is testing you often.  You are so right--having been thru this will definitely be helpful when my husband starts treating.  I'm glad it turned out that I went first.

Good luck with your doctor problem.  Is there no one in your area who is an experienced hep C dr?  I know it's hard weeding through the BS.  I found my dr by titling a thread in this forum "anyone know a good hepC dr Tampa area?"--something like that.  A few folks responded, and it worked out great.  Very fortunate, because I sure wasn't going back to the SOB who I had been seeing.  I hope you get it worked out.

Laika

  

[friole]

That is wonderful that you are done and are feeling better.  I try to piece together things from thread to thread, but unless I write it down, I forget.  So you are done and hubby will just begin.  I hope he is a good patient.  Your experience should be most beneficial there.  You said (on the other thread) your hbg was 11.2 (same as mine).  Now that you are done, will you get regular blood tests to see if it comes up?   Good luck
Kathy

[timlotus]

I am so pleased that you are already feeling better and are more active! That's what I want too: I do shot 24/24 tonight and have one more week of riba, then maybe I will gradually feel better like you.

I am kind of prepared for it to take longer but posts like yours give me hope. My sides have not been too bad, mostly fatigue  from low blood counts and a bit of riba rash. I think there is a good chance my blood cell levels may come back quite quickly after I stop the pills. I realise the half-life of riba is very long, but not topping it up on a daily basis has got to make a difference hasn't it?

Anyway I hope you continue to feel better.

Tim

[Laika]

Thank you all for your posts.  I just keep trying to understand as much as I can about this virus.  There are so many details! Tim, I appreciate your itemized approach.  Very straightforward and logical--just the thing.  Jim, I always read your posts...you have a lot of information on a variety of topics here.

My husband sounds as though he plans to treat, if his cardio releases him to do so.  I am hoping (assuming he treats) that he is able to do the short course of treatment.  It's certainly not up to me, but it's good to know that it's a possible option.

Rearfang...how are you doing?  It has only been 4 days since I took my last riba, and I'm happy to report that I have more energy already, the sciatic pain that I was having for the last 2 wks of treatment has ceased, and the fog is sparser!  Every little thing that is an improvement, I notice and cherish.  My appetite is coming back.  I actually cooked fish tonight, and it tasted pretty good!  AND I cleaned up the mess after cooking for the first time in 24 wks!  My hair is still falling out like crazy.  I was trying to be prepared for the "withdrawal" or "detox" feelings some people describe following treatment, but in fact I just feel a little better every day, so far.  

Thank you all for your inputs, I do appreciate it.  Hang in there with your treatment, there's light at the end.

Laika    

[rearfang]

Laika,
As I understand it, the AST, ALT and vl can all fluctuate greatly, and there have been recent posts from people whose stages have jumped very rapidly in relatively short time periods. The point is, you can't know what will happen next month or year. Hope you are well, good luck to your husband.
Lauren

[jmjm530]

Stage 1 is very good news in a relative sort of way. :)

Tim lays out the pro's and con's very well. I'll just add that geno 2's have about an 80% chance of success. That's a good number compared to us other genotypes.

Given his low level of liver damage, your husband doesn't have to treat now but, it is tempting given the shorter course and high success rate. Also, if he's relatively healthy, that's a plus. Treatment would be more difficult to handle if he develops other health problems in the future.

If he does decide to treat, make sure his doctor does a very sensitive week #4 PCR test to check viral load. You want a test with a sensitivity of at least <50. A newer study shows geno 2's who are undetectible at week 4, can treat for 12 weeks with the same degree of success as 24 weeks.

http://www.hivandhepatitis.com/hep_c/news/2005/ad/062405_a.html

I'm not necessarily recommending the "short-track" approach, but the 4-week test does give you one more piece of information to help make a decision on.

Knowing what I do now about treatment and side effects -- I personally would be tempted by the 12 week approach, especially if I had only stage 1 damage. Worst case, he wouldn't be cured but only invested 12 weeks of time. He could always re-treat longer or simply wait a few years when hopefully there will be better drugs.

Re: the 12-week approach, I'm sure you will get other opinions on this. :)

-- Jim

[timlotus]

Hi
I believe that AST/ALT levels have now been found to be unrelated to the progression of liver disease. some like myself had very high ALT (410 pre-treatment) and not mch fibrosis at all, whereas others have advanced fibrosis and normal range ALT.

As the previous poster said these levels and VL do fluctuate.

As I see it (not a doctor)
Reasons to treat:
1. Good genotype requiring only 24 weeks of Tx
2. Low level of liver damage increases chance of Tx response
3. Older people are seemingly harder to treat successfully. If your husband waits too long this may be a factor
4. If he clears the virus and doesn't drink alcohol, the fibrosis can heal and repair almost completely.

Reasons not to treat:
1. Low level of damage, and i assume none or not many debiltating symptoms currently
2. Better treatments may be on the way but will take 3-5 years at least to arrive
3. Worries about the side effects and stress of treatment, but there is a ton of support available.

Only he and you can make this decision with the help of doctors. The opportunity for treatment on the future will still be there even if he decides to wait for now.

Best wishes to you both
Tim