Viral load: what does it really mean?

[mike716]

I just got back my first pre-therapy baseline PCR of viral load. It was some kind of weird test that can only measure loads of between 600 and 850,000 IU/mL (I can figure why a PCR couldn´t detect less than 600, but why wouldn´t it be able to detect over 850k?)

Anyway, does anyone out there have any idea what 850,000 IU/mL is saying?

Mike

[mike716]

Thanks for the info on biopsies. I'll keep it in mind. I hope they get a good, big specimen, and that the guy who looks at the slides isn´t myopic.

I had some better news today: Fist, I went back over to the university teaching hospital this morning, collared the chief hepatologist at the outpatient clinic, and got into a heated discussion with him about biopsy vs. other tests. After showing him the pics on FibroTC he gave me the order for the tomography. Then I got an email from the radiology secretary at my hospital (a very sweet person who has been at bat for me) to the effect that she talked them into doing the tomography for me if I pay for it. Only thing she left out was the cost . So, if I can get the folks in Sevilla to get moving, it looks like I might get my FibroTC after all.

Now, now....don't get all p****d off at me, I'm gonna do the biopsy, too, just as soon as my hepatologist wakes up.

M.

[lolitriqui]

sorry mike, still couldn't get her to the computer; NYC .... very busy....

[lolitriqui]

well, i remember as i first went to do some checkups in argentina; i lived 5 years in mexico before i went, so i spoke the language somewhat; argentinians are in general not afraid of anything as far as i can tell; it sounds like more a communication problem; also their medical system is based on the french system, which means they don't get paid for unnecessary procedures; much like mayoclinic does it here in the states they generally don't try to hussle up procedures you don't need; however medicine is very good there; el italiano is a very good hospital; my wife did her cardio rotations there during her residency; sanatorio otamendi is private and you can get whatever you want; it is very upscale so the best docs in argentina go work there; i will show your post to my senora later today, she is working right now; talk to you later...
ciao

[Marcia2202]

Congrats on your endoscopy results. It must be a burden off your shoulders. Go and get the biopsy done. :-) and good luck with it.

I finally got the referral to the hep, so I'm happy, but waiting. Really want to get the biopsy done, but again.... waiting.

All the best for now,  Marcia

[willing]

congratulation on your good endoscopy results. I go in for my pre-screen Weds. and am hoping for something not too alarming. Trish has done such an outstanding job about nagging you on the bx there's not much to add but, with all its faults it's still the best indicator of where things are. Also, you may already know all this, but collecting the specimen and reading the resulting slides are two entirely separate activities. For the former you want somebody who will collect a large enough sample without fragmenting it and without hitting something else in the process. Once you have slides, they're part of your permanent record and you can easily get more than one pathologist's opinion about amount of collagen, level of inflammation, bridging, etc.

Re - the hcv kinetics, I know it's counterintuitive. A standard post here is from someone who has just found out their VL is in the millions and now wants a referral for a good funeral home.  You may want to look at
http://www.ncbi.nlm.nih.gov/pubmed/9756471
the original hcv kinetics paper, or some of the many follow ons.

Here's one at medscape with full access
http://www.medscape.com/viewarticle/543530_1

Probably the single most striking point is "the daily production rate of the virus was estimated to be 10**12 virions" (from the above review) - ie the virus is so remarkably prolific that any measurement is basically only an indicator of the effectiveness of suppression.

[mike716]

Hi, lolitriqui. Thanks for the info re Sanatorio Otamendi. I'll check it out.

But please tell your wife this: A lab in Rosario named CIBIC S.A., which administers Fibrotest in Argentina for the French inventers of the test, is refusing it to me because my hospital in Buenos Aires doesn´t have it on their list of approved procedures, My hospital doesnt approve any procedures that cant be done by my hospital, because of the costs. And Cibic won't take the order from another doctor, apparently for fear of my hospital.

So if I go to sanatorio Otamendi, what do I have to do, lie about being a patient at the Italian Hospital? Please ask your wife.

That's what it's like here in Argentina, see? Everyone's afraid of everyone else. Like it was a police state.

Mike