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Viral
I finally got my Viral Load & Geno Loads taken. My doctor says they are 3 & 2 Million (& then some). Should I be concerned about this?
Since viral load is not the optimum for assessing liver disease or status of the liver's condition, a biopsy is the gold standard for making that determination.
Viral load has never been associated with the health of the liver, not in any independently funded study.
And, since interferon therapy does NOT turn back the clock on the health of the liver, any damage that is seen on biopsy needs to be under a doctor's care, regardless of treatment outcome. For this reason, it is folly to think alcohol consumption, smoking or exposure to liver toxic substances is just fine after a course of successful treatment. These substances can further damage the liver regardless of the viral status. Unless you have had a post treatment biopsy and know for a fact that your liver is "healed," it is a mistake to assume this is so based on studies of other people.
Research into a cure for hepatitis C is now directed at anti-fibrotic agents for just this reason. Eradicating the virus MAY stop progression, but there is no guarantee of that. Studies have shown that those who sustain a response do better over the two year post treament than those who do not, no doubt, but this is not 100% and it is still only a two year window. Caveat emptor.
Without a biopsy, you will not have a "snapshot" of the condition of your liver at the point in time PRIOR to interferon therapy. It may be important to know at some point whether the interferon did you any good from a histological perspective. In fact, it could be critical information that is lost if a biopsy is not done.
NO genotype is associated with worsening progression. There is no bad genotype other than those that expose a patient to a higher rate of potential adverse events. Genotyping is a matter of determining what the length of treatment will be for those who need to treat and that is all.
And lastly, your doctor is the expert on you, not anyone on the internet. The only thing that is worth demanding, in my opinion,is the biopsy. Your doctor has your medical chart and has the experience to treat you and assess where the level of risk BASED ON YOUR MEDICAL CIRCUMSTANCES lies for you. If you are not satisfied, discuss you dissatisfaction with your doctor. Getting into a confrontation with your doctor isn't in your best interest.
You will not die without treatment or if treatment does not succeed. Please do not fall into this melodrama of the "dragon eating your liver." Gather your relevant facts, your support system, and discuss all of the potential benefits and costs with your doctor.
Make decisions at strategic points. But continuuing treatment is not worth any risk/cost unless you decide it is and if your doctor agrees. There are only a few cases where that would be true. Very few. And that decision should be a medical one, not one based on internet superstitions about liver eating dragons and interferon in shining armour.
If the interferon succeeds and you realize an SVR, you are not off the hook in caring for yourself and maintaining good health and liver friendly habits. Alcohol ( and smoking) abstenance is prudent for anyone who has ever had liver disease. Alcohol isn't good for anyone's liver.
If treatment fails you, you are not doomed. There is reason, and lots of it, for hope and the promise of new, less toxic, and more effective treatments in the relatively near future. The United States is not the only place, or even the best place, where good research is taking place. Australia, Canada and France, Germany, even Italy have committed many more resources to basic research and services to patients than the USA currently is committing. Patients in those countries have demanded it.
I hope this helps,
thanbey
<a href="http://www.hcop.org">Hepatitis C Outreach Project</a>
Viral load has never been associated with the health of the liver, not in any independently funded study.
And, since interferon therapy does NOT turn back the clock on the health of the liver, any damage that is seen on biopsy needs to be under a doctor's care, regardless of treatment outcome. For this reason, it is folly to think alcohol consumption, smoking or exposure to liver toxic substances is just fine after a course of successful treatment. These substances can further damage the liver regardless of the viral status. Unless you have had a post treatment biopsy and know for a fact that your liver is "healed," it is a mistake to assume this is so based on studies of other people.
Research into a cure for hepatitis C is now directed at anti-fibrotic agents for just this reason. Eradicating the virus MAY stop progression, but there is no guarantee of that. Studies have shown that those who sustain a response do better over the two year post treament than those who do not, no doubt, but this is not 100% and it is still only a two year window. Caveat emptor.
Without a biopsy, you will not have a "snapshot" of the condition of your liver at the point in time PRIOR to interferon therapy. It may be important to know at some point whether the interferon did you any good from a histological perspective. In fact, it could be critical information that is lost if a biopsy is not done.
NO genotype is associated with worsening progression. There is no bad genotype other than those that expose a patient to a higher rate of potential adverse events. Genotyping is a matter of determining what the length of treatment will be for those who need to treat and that is all.
And lastly, your doctor is the expert on you, not anyone on the internet. The only thing that is worth demanding, in my opinion,is the biopsy. Your doctor has your medical chart and has the experience to treat you and assess where the level of risk BASED ON YOUR MEDICAL CIRCUMSTANCES lies for you. If you are not satisfied, discuss you dissatisfaction with your doctor. Getting into a confrontation with your doctor isn't in your best interest.
You will not die without treatment or if treatment does not succeed. Please do not fall into this melodrama of the "dragon eating your liver." Gather your relevant facts, your support system, and discuss all of the potential benefits and costs with your doctor.
Make decisions at strategic points. But continuuing treatment is not worth any risk/cost unless you decide it is and if your doctor agrees. There are only a few cases where that would be true. Very few. And that decision should be a medical one, not one based on internet superstitions about liver eating dragons and interferon in shining armour.
If the interferon succeeds and you realize an SVR, you are not off the hook in caring for yourself and maintaining good health and liver friendly habits. Alcohol ( and smoking) abstenance is prudent for anyone who has ever had liver disease. Alcohol isn't good for anyone's liver.
If treatment fails you, you are not doomed. There is reason, and lots of it, for hope and the promise of new, less toxic, and more effective treatments in the relatively near future. The United States is not the only place, or even the best place, where good research is taking place. Australia, Canada and France, Germany, even Italy have committed many more resources to basic research and services to patients than the USA currently is committing. Patients in those countries have demanded it.
I hope this helps,
thanbey
<a href="http://www.hcop.org">Hepatitis C Outreach Project</a>
comment above by thanbey,..."you will NOT die without treatment or if treatment does not succeed..."
please give me THE STUDY TO BACK UP THis STATEMENT...if you do not increase your chance of morbidity by keeping the virus, than why go on interferon at all????? common sence here....
if alchohol increases your liver damage rate than you can bet hep c does too. why do we need further testing beyond 2 years for this? this is common sense!!! if we can kill the virus we should...
JUST AS I CAN NOT TELL SOMEONE THAT THEY WILL DIE OF HCV YOU CAN NOT TELL THEM THEY WILL NOT...
please give me THE STUDY TO BACK UP THis STATEMENT...if you do not increase your chance of morbidity by keeping the virus, than why go on interferon at all????? common sence here....
if alchohol increases your liver damage rate than you can bet hep c does too. why do we need further testing beyond 2 years for this? this is common sense!!! if we can kill the virus we should...
JUST AS I CAN NOT TELL SOMEONE THAT THEY WILL DIE OF HCV YOU CAN NOT TELL THEM THEY WILL NOT...
Wow, it amazes me how anyone can make a definitive statement as to whether we are going to live or die, almost sounding like gospel, based on their opinion.
Do your own research to reputable sites and the ultimate decission lies with YOU with the assistance of a provider to monitor the progress. Find one that will work WITH you and for you, but he is not the absolute last word on anything about hep c, NO ONE is.
Do your own research to reputable sites and the ultimate decission lies with YOU with the assistance of a provider to monitor the progress. Find one that will work WITH you and for you, but he is not the absolute last word on anything about hep c, NO ONE is.
Morbidity and mortality studies support the statements made above.
Everyone is going to die. But very few die of hepatitis C.
Those who do are generally those who were diagnosed too late to be treated with interferon therapy or to make significant changes to lifestyle. That is what the studies tell us.
best,
thanbey
Everyone is going to die. But very few die of hepatitis C.
Those who do are generally those who were diagnosed too late to be treated with interferon therapy or to make significant changes to lifestyle. That is what the studies tell us.
best,
thanbey
I believe those are studies on liver disease/failure related to hcv. Given.
Some studies found cryoglobulins present in various tissues in our hcv infected body. Who can really say if this presence is not contributing to the deterioration/failure of this organ and our possible demise in the future? Stats won't show that illness to be contributed to by chronic hcv and liver related.
NO one really knows, we should take most information on hcv as an educated scientific guess based on limited data.
WE (in tx) are the data of the future retrospect studies. Some of us might not be around to see them.
I believe the unknowns of hcv to be significantly higher than the present stats show. That is why I would never dare to present a statement on hcv as the ultimate truth.
Some studies found cryoglobulins present in various tissues in our hcv infected body. Who can really say if this presence is not contributing to the deterioration/failure of this organ and our possible demise in the future? Stats won't show that illness to be contributed to by chronic hcv and liver related.
NO one really knows, we should take most information on hcv as an educated scientific guess based on limited data.
WE (in tx) are the data of the future retrospect studies. Some of us might not be around to see them.
I believe the unknowns of hcv to be significantly higher than the present stats show. That is why I would never dare to present a statement on hcv as the ultimate truth.
Cuteous,
Fair enough. But why assume, in the face of so much evidence to the contrary (50 years of data, by the way), that people are going to die without being treated or if the treatment fails them?
It seems to me that it is less likely anyone will die of cryoglobunemia (has anyone ever died of cryo?) or hepatitis C whether treated or not.
Until we do know more,and I certainly agree we need to, why in the world assume the worst and keep believing that the sky is falling? Why dash hope for so many people who cannot treat for various reasons or for whom the treatment has made things worse, not better, or for whom it has had little effect at all? Only a small percentage of those with hepatitis C have the choice to treat, can tolerate it, or realize a rsult from it.
There is simply no generalizable scientific basis for the treat or die point of view. None.
thanbey
Fair enough. But why assume, in the face of so much evidence to the contrary (50 years of data, by the way), that people are going to die without being treated or if the treatment fails them?
It seems to me that it is less likely anyone will die of cryoglobunemia (has anyone ever died of cryo?) or hepatitis C whether treated or not.
Until we do know more,and I certainly agree we need to, why in the world assume the worst and keep believing that the sky is falling? Why dash hope for so many people who cannot treat for various reasons or for whom the treatment has made things worse, not better, or for whom it has had little effect at all? Only a small percentage of those with hepatitis C have the choice to treat, can tolerate it, or realize a rsult from it.
There is simply no generalizable scientific basis for the treat or die point of view. None.
thanbey
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