Just Received Lab Results - Comments Welcome (and needed)

[LindyK]

Profile:

Female
Age 51
Dx with Fibromyalgia in March 2005 (Symptomatic with fatigue, pain, sleep disurbance, lowered cognitive functioning since November 2004)

Was out of work last year for 12 weeks due to above symptoms and am currently out again since Oct 6 for 12 weeks - symptoms above have increased plus nausea, lack of appetite and weight loss (40 lbs) since May.

Learned of Hep C Infection after donating blood in August, 2006.

First visit with Infectious Disease Specialist October 23, 2006.
Following are the results of the Labs done that day:

Protein, Total, Serum    7.8
Albumin, Serum           4.4
Bilirubin, Total         0.5
Bilirubin, Direct        0.16
Alkaline Phosphatase, S   78
AST                       33
ALT                       35

Genotype 3
V/L 1,930,000

When I saw the specialist he told me that if I was Genotype 1a or 1b he would order a liver bx (I took this to mean that if it was any other type there would be no bx).

He also said if V/L was more than 2,000,000 - would treat, if less than 2,000,000 would not treat.  The V/L is very close to 2,000,000 so I don't know how he will interpret it.

I have been so prepared to come back as Geno 1a or 1b that I haven't even looked at Geno 3 so I'm off to do some research.  My next appt is November 20th.

Any information you all have would be very helpful!

[friole]

Everything you ever wanted to know about viral loads

http://janis7hepc.com/Viral_Loads.htm

I am surprised that your doctor would say he only treats those with copies over 2,000,000 (which you do have).  We have seen a lot of people here who have viral loads under 1,000,000 IU and have advanced liver disease.

My beginning viral load was about 1,520,000 IU (3.8 million copies).  I thought it was really high until I found this forum and saw loads into the 10's of millions.  In Clinical Care Options the doctor says there is little difference between 10 million and 1 million (that is a one log drop) and they show you charts as to how the Vl bounces around

http://www.clinicaloptions.com/hepatitis/treatment%20updates/hcv%20core%20curriculum.aspx

you will get so much information - in the form of a slide show - I think you find it very valuable.  It takes about 20 minutes to go thru it and I learned so much.  You have to register but it is free.  It is a sight for doctors to earn continuing education but open to anyone.
frijole

[Hepatitis Researcher]

You have a sharp eye for detail. I have cofounded NGI and am the inventor of all these tests. But now I am working on advanced treatment options for people with hepatitis, since many still fail to control their disease. I run into this site since I am trying to elucidate the " Alinia paradox" - the fact that this ( very available drug) has enormous in vitro potency - but only 50 % HCV negativity reported after 24 weeks in the Egypt study.Doctors in the US are using it on a few dozen patients " off label" for HCV.Was hoping to find some VL reports from people in this site.Then I saw all these questions here and thought to help a little, time permitting. Problem is, that the inherent complexity of the issues does not allow a realistic answer within the constraints given in this format.
A copy is a virion. Period. Conversions are different, because the standards that methods use are not from one source or method. Thats how the IU came into existence. To measure a standard itself is very hard.     Best if a patient sticks with one method or lab so differences are more meaningful. For HCV in the end what matters is to go UND BY THE MOST SENSITIVE TESTS FAST.Does that mean there is no more virus in the body at this time? Of course not. It means, that if you reduce your virus within four weeks to " negative" that the mechanism by which you block its replication is working well enough to reduce adaptive mutant formation AND that you will then further reduce your whole body burden of HCV ( now unmeasurable,BUT STILL IN YOU)( thats why you continue to treat and cannot stop right then!. This process of "invisible' further virus reduction must go on until you have nothing but a few copies of virus left that have been so poisened in their genomic information  by the Ribavirin that they cannot raise against some immune control by T cells and maybe some antibodies.

The difference between the two NGI tests I mentioned? One - "the quantasure" is a combo of the NGI superquant with the NGI ultraqual combined with a poisson distribution in case you fall neg on the quant and pos on the ultraqual ( if you are between 5 and 100 copies/ml). Confused? Only if you are very close to UND you need an ultraqual or quantasure , otherwise the superquant is all you need. If you want further details, happy to explain on the phone, no charge, is pro bono work.

[Kalio1]

Thank you so much for your informative post and the work you do for all of us with HCV in developing these tests.


There are a few that visit here who have taken Alinia, maybe if you put Alinia in your heading they might see it and share their info. with you.

[jboyhk]

I am an inactive carrier of Hep B but also carry the HepC antibodies 8 yrs ago.

After I was tested positive, I was also tested for genotype and viral load (one dr did VL the other genotype). The genotype came back 2b but the VL came back undetectable.

I have had VL tests over the past 8 yrs and always returned negative.

No dr has been able to explain to me how the genotype test could have come up 2b with undetectable virus.

Is it possible that there was some error in the lab? It was done in 1998 with Speciality Labs.

[willing]

interesting..accuracy and interpretation of HCV RNA amplification technology is a regular topic of discussion here. While the reliability of TMA over standard reverse-transcriptase PCR seems fairly well established (eg Germer'03, Desombere'05), the reliability of the  real-time  quantification of reverse-transcriptase PCR(eg, Radkowski'05 seems not to be generally accepted by physicians, notwithstanding endorsements like Halfon'06. As someone who works in this field do you have any reason to believe the real-time quantifications are suspect?

[jmjm530]

Thanks for the information. Don't want to pry, but since you more or less told us who you are, your credentials plus your interest in Alinia, sound very much like someone a recent poster referenced in terms of some sort of Fibroscan research in California. Several of us, including myself, have already had a Fibrosca at one of the U.S. trial centers and would be interested to hear more about your work, if you are involved and if appropriate.

Thanks for any information you may want to share.

-- Jim