What does viral load mean exactly?

[jazzy578]

I have been reading posts explaining that we need not be concerned with our VL as it goes up and down.  However, studies have indicated that persons are more likely to clear if their VL is below 800,000 going into treatment.  Is that true? How does that equate to a VL not being important? It sounds  like a very important marker if it effects treatment results.

Second question: Why does a VL go  up and down and what does that really mean?  If it is down, does that mean your body is eliminating the virus and when it goes up that it is multiplying?  What causes it to multiply?  I have noticed here that some people can have a VL at 20 M and be feeling fine where as others have a VL at 1 M and not feel fine. So it appears that VL is not a marker for a person's disease progression or severity of disease.  I know that many here have said that the condition of the liver is the most important part of determing a person's health.  But isn't it true that it is the virus that destroys the liver?  Wouldn't more virus floating in the blood be more virus effecting the liver?  If that is the case then it would seem we would want less virus in our blood so it would have less impact on our livers?  Thank you for helping me understand this?

[working dog]

you guy's are great!!! billy

[Bill1954]

Deb— You’re a sweetie!

Jazzy- good luck with your first shot; you might consider taking a couple of Tylenol (acetaminophen) an hour or so in advance of the injection; some of us develop body aches/headaches, fever etc. The first injection kind of whacked me, but nothing that would straighten out with a hot shower the next day; think hangover :o). Other than that, the treatment wasn’t terrible for me.

I don’t think it’s critical when you take the first ribavirin; probably best to take it after you’ve talked with the doctor; just in case there’s a change of plans or something. If you want, you can take it the morning of the injection, and then take the PM dose after injection. I imagine you’re dosed 1000 or 1200 mg/day? Best to break that up into two doses; i.e. 600mg/morning, 600 mg/evening. Try to take it with food, and preferable food that contains a little fat, like dairy, nuts, etc. This helps absorb the drug, and avoids tummy problems.

Good luck as you go forward, and let us know how you fare—

Bill

[jazzy578]

Thanks so much for your imput. I am understanding much more now.  I  also went to the Janis and Friends site and read about VL and then found a link where persons discussed their first shot experiences.  Since tomorrow is my first shot, and I have been rather unsettled about it, those posts helped me a lot.  Although most experienced some side effects, all said they were not as bad as they had imagined. I have much more courage now!

My Dr. is hard to get a hold of.  Do you think I should take my Riba in the morning and then my shot later, then my Riba in the evening, or should I take my shot then only one dosage of Riba in the evening?  I don't know if this matters or not.  Really do appreciate your thoughts.

[nygirl7]

Thanks Bill as always the 'expert' I didn't even realize I didn't put the janis link in.  But, I tried to be scientific for once.....and that's what happens when I'm just not being the typical hyper emotional that I usually do!

[Bill1954]

Hi Jazzy,

Viral load can exert influence over how rapidly we respond to the virus; the current accepted cutoff for low viral load is 400,000 IU/mL. Here’s an article that helps define this:

http://www.natap.org/2007/EASL/EASL_41.htm

That said, the level of virus in our blood doesn’t appear to *necessarily* correlate with the amount of fibrosis, or scarring we develop over the years. For instance, from a personal perspective, I’ve tested many times for viral load, and it never exceeded 150,000 IU/mL. I had sustained stage 3-4 liver disease, and had a dickens of a time achieving SVR (cure).

I’ll link you directly to Janis and Friends and their page on viral load; NYgirl mentioned it above:

http://janis7hepc.com/Viral_Loads.htm

Be sure to explore any other topics of interest in the right hand column of the page under ‘other HCV information’ as well.

Take care—

Bill

[nygirl7]

When infected by the hepatitis C virus, liver cells (hepatocytes) trigger a series of events that initiates both an inflammatory and an immune response.

Since hepatitis C infection tends to become chronic in most cases, it follows that the inflammatory process would progress from acute to chronic inflammation.  In time, chronic inflammation leads to the formation of microscopic areas of scar tissue in the liver tissue, known as fibrosis.

If the scar tissue causes disruption in the structure of the liver, the condition is called cirrhosis.  In it's early stages, fibrosis is reversible, but cirrhosis, once developed, may be permanent.


(From the Janis website certainly not my words ;)

[jazzy578]

Thanks for the comments and website.  One more question: if the virus doesn't actually damage our liver, then how do our livers become damaged? I read somewhere that the virus is spread to all our organs via our blood, but the liver is the only organ that it affects. I then assumed that the virus must be responsible for the damage.

I like your comments about our WB cells possibly being the important factor in the meds taking hold and clearing the virus. It makes so much sense.  Thanks again for your insightful comments here and in other threads that I have read.  You're a huge gift to this commuinity!

[nygirl7]

PS The virus doesn't actually damage your liver it is your liver cell death that leads to fibrosis and cirrhosis.

[nygirl7]

Is that true? How does that equate to a VL not being important? "

There are many of us out here who started with low starting viral loads who took more medication than we should have been even prescribed and yet - we did not respond as fast as someone with a VL in the millions.

On occasion your immune system can be hyped up and already fighting the virus down - then the meds are not as effective because the purpose of them is TO ramp up your immune system.........so it can't do it as well cause it's already going (this is what we surmise however I doubt it has been proven).

"So it appears that VL is not a marker for a person's disease progression or severity of disease. "

Yes it is not a marker whatsoever. I had a low VL before i started yet had stage 3 liver damage.

As for going up and down we are talking per IU of blood not the total in your body - if you then realize how tiny the virus is in the tiny amount of bloood you realize a few hundred thousand here nor there means nothing at all really over all.

the Janis and Friends website explains viral load extremely well in simple laymans terms so it's understandable.  I'd start there it will help you to understand.