Understanding before appt with GI

[djbn13]

My appt is next week.  My doc e-mailed me this so I would have more info.  But don't really understand it. Sorry it's messy, not very good at the copy, paste thing.

Office Visit on 04/28/2010HEP C RNA, SERUM, PCR, QUAL                    Date: 04/28/2010
Value: REACTIVE*   Range: NON REACTIVE      Status: Final          
   Comment: HCV GENOTYPE TO FOLLOW.HEP C VIRUS RNA VIRAL LOAD PCR (IU/mL)      
   Date: 04/28/2010Value: 5237276*    Range: Not Detected      Status: FinalHCV RNA, SER/PLAS, PCR (IU/mL)              
   Date: 04/28/2010Value: 6.72*       Range: Not Detected      Status: Final          
    Comment: THE QUANTITATIVE LINEAR RANGE FOR THIS ASSAY                       IS HCV RNA:  43 - 69,000,000 IU/mL  or                       HCV RNA (LOG):  1.63 - 7.84 IU/mL.                      
THIS TEST IS NOT FDA APPROVED FOR USE ON                       FROZEN UNALIQUOTED PLASMA PREPARATION TUBES.                       THE USE OF THESE TUBES AND PERFORMANCE                       CHARACTERISTICS WERE DETERMINED BY SOUTHERN                       CALIFORNIA PERMANENTE REGIONAL REFERENCE                       LABORATORIES, IMMUNOLOGY DEPARTMENT.
HEP C GENOTYPE LIPA                            Date: 04/28/2010Value: 1a*         Low:        High:        Status: Final              Comment: THIS ASSAY HAS NOT BEEN CLEARED AND APPROVED                       BY THE U.S. FOOD AND DRUG ADMINISTRATION FOR                       ITS USE IN DIAGNOSTIC PROCEDURES.  IT WAS                       DEVELOPED AND ITS PERFORMANCE CHARACTERISTICS                       DETERMINED BY SOUTHERN CALIFORNIA PERMANENTE                       REGIONAL REFERENCE LABORATORY.  THE FDA HAS                       DETERMINED THAT SUCH CLEARANCE OR APPROVAL IS                       NOT NECESSARY.  DIAGNOSIS SHOULD NOT RELY ON                       THE RESULT OF THIS ASSAY, BUT SHOULD BE                       INTEGRATED WITH CONVENTIONAL SEROLOGY AND                       CLINICAL CONTEXT.----------------

[portann]

Here's a link to a full study of something more recent, from 2009:

http://hepmon.com/view/?id=382   (Let me know if it doesn't open for you.)

Conclusions: Patients with COPD have increased prevalence of HCV infection, and patients with HCV infection, have increased prevalence of COPD. COPD may be an extrahepatic disease associated with HCV infection. Further studies are needed to clarify the relationship between HCV infection and COPD.

And this from HCV Advocate may be the same as above (sorry, on the run, so ignore if a duplicate):

March 16, 2010


Link between HCV and COPD?
www.newsrx.com

According to a study from Porto Alegre, Brazil, “chronic hepatitis C virus (HCV) infection may induce an accelerated decline of forced expiratory Volume in I second (FEV1)”.

The researchers performed a cross-sectional study to determine the Prevalence of HCV infection in a sample of chronic obstructive pulmonary disease (COPD) patients and in a control group of blood donors."

"The clinical characteristics of HCV-positive and HCV-negative patients were compared. Anti-HCV antibody was determined and confirmed by HCV-RNA. The prevalence of HCV infection in COPD patients was 7.5% (95% Cl 6.52-8.48) and in blood donors was 0.41% (95% Cl 0.40-0.42).

The HCV-positive patients had a lower FEV1 (34.7 ± 8.6%) and a higher BODE index (median=6) than HCV-negative patients (42.7 ± 16.5%, median=4, respectively) (P = 0.011 and 0.027, respectively).

Study results suggest a high prevalence of chronic HCV infection in patients with COPD in comparison with the blood donors," wrote D.R. Silva and colleagues.

The researchers concluded: "HCV-positive patients have a more severe disease."

Silva and colleagues published the results of their research in Epidemiology and Infection (Prevalence of hepatitis C virus infection in patients with COPD. Epidemiology and Infection, 2010;138(2):167-173).

http://www.hcvadvocate.org/news/newsRev/2010/NewsRev-353.html#_Link_between_HCV

Susan

[portann]

I can't look further right now but have a peek at this from way back in 2003 that supports Mike's position that COPD may be worsened by HCV:

http://chestjournal.chestpubs.org/content/124/5/2035.full.html

Something to think about and hopefully others will offer something more current to help you walk yourself through this.

TTYL.

Susan

[mikesimon]

I think I have read that HCV infection itself increases lung decline in people with COPD so not treating might not be helpful either. I haven't researched HCV treatment's (Interferon/Ribavirin) affect on HCV but when I get some time I will see what i can find.
I would suspect that hemolytic anemia caused primarily by ribavirin would be more difficult for a patient with COPD but I haven't read anything about it.
Mike

[djbn13]

  Thanks.  This forum has really helped. One thing that worries me (among many) is my COPD. What little research I can find so far, clinical trials etc. people with COPD who have gone through the standard treatment for Hepc have not done well.  The drugs advanced the lung disease.  I hope it's not a choice of curing the Hepc but having to go on oxygen the rest of my life or living with both chronic illness. Ah, decisions decisions.

[portann]

It's hard to pick out the key info from what may seem like gobbledeegook to you right now but once you know what to look for, it's easy.

These are the lines you want:

HEP C VIRUS RNA VIRAL LOAD PCR (IU/mL)   ....5,237,276  (commas added to your numbers by me)

HEP C GENOTYPE ...                           1a

As others said, the viral load is not unusal and I hope doesn't alarm you.

That number fluctuates and won't tell you how the virus is affecting your liver, which is where this particular virus hangs out.

You now know you have Hepatitis C and have the most common 'genotyope' in North America.

That's the same 'genotype'  I had and I'm now clinically cured of the virus after treating it.

Lots for you to think about and lots to ask about. I'd check out this site for starters in the "newly diagnosed" section of the link:

http://www.janis7hepc.com/

As a genotype 1A, the best move for you, in my opinion, is to get a liver biopsy.

For most people, it's very routine, although it's scary thinking about it beforehand.

My guess is that when you see the doctor next week, a liver biopsy is what he's going to want to schedule.

Most of us genotype 1's have done it. It's not a piece of cake but not hard, either, at least for the majority.

The key in the biopsy, though, is having an experienced person do the procedure and an experienced person read the results. Try to make sure that you're in experienced hands.

Take care and keep asking questions. The really good news about this is that unlike so many people walking around with HCV not knowing it, you now know and can do something about it to make yourself better.

Regards,

Susan

[mikesimon]

I didn't see your post in time - but at least we agree.
Mike

[mikesimon]

I see that your genotype is 1a which is the most common genotype in North America.
Approximately 50% of genotype 1 patients achieve SVR or are cured.
43 - 69,000,000 IU/mL is the detectable range of the test and the test appears to be a Quest Heptimax HCV RNA.
Your viral load is 5,237,276 IU/ml which is not extremely high and I have seen people with much higher viral loads go on to clear HCV.
I would guess that your doctor will want a biopsy. Those are not usually a big deal. They sound a lot worse than they generally are. I have had too many to count without any problems.

Good luck,
Mike

[Bill1954]

Hi there,

It looks like your doctor sent you a copy of your viral load test. The pertinent number buried in all this is ‘5237276’. This represents how much virus is present in your blood per cubic milliliter.

5.2 million International Units might seem like a lot, but it’s rather average, for the most part. This data will become more relevant if treatment commences; at that point, it can be used as a barometer to gauge response to the treatment drugs.

Depending on your genotype (which doesn’t appear to be listed here), it might be a good idea to discuss liver biopsy; this is a much better indicator of damage that might have been sustained to date. Have you discussed treatment with the doctor yet?

When the term ‘damage’ is used in here, it refers to the amount of scarring, or fibrosis that develops over time as a result of HCV infection. Some of us don’t progress very quickly; in fact, this disease is generally measured in terms of years and decades, not weeks or months.

Does that help answer your question at all? Hopefully, it inspires more questions; please feel free to ask more if you like.

Take care, and good luck--

Bill