viral load question

[Jay_555]

my hep C viral load test shows the following:

Hepatitis C Quantitation    25960  IU/ml
HCV log10                            4.414    log10  IU/ml


Can someone explain this please?  How does this translate to simple viral load amount?

Thank you!

[Bali05]

i would take advantage of your currently low viral load and go for
treatment if you can.
low viral load is a good predictor for treatment success.
you could be SVR by time the new drugs come out.

[Jay_555]

thanks again for your experienced feedback.  clears up some things that I always forget to ask when in the doc's office.  Will have to decide on treatment - can't take time off from work, in case the inteferon is difficult to handle.  This fever thing might be something different since my WBC count has been low since Jan.  primary doc says I have mild infection but can't say what it is...
this whole experience has been quite a challenge for me and my spouse, but could be worse...so counting my blessings.
will update after next doc visit - or miracle!
This forum is really helpful, in many ways and the support system is priceless.

[Bill1954]

Hi again,

I’ve had one Fibrosure test in the past, but for what it’s worth, I’m not personally convinced they actually portray an accurate picture. Of course, biopsy has it’s won issues, but is still considered the ‘imperfect’ gold standard for this purpose. I really don’t understand the differences between ‘sure and ‘spect; I think they use different biochemical markers as well as different algorithms.

It’s important to understand that viral load and damage/fibrosis don’t necessarily correlate with viral load. Unlike with other diseases like HIV and Hep B, viral load is most important only when treatment commences; at that point viral load will be used as a gauge, or barometer of response to the treatment drugs. For instance, I had stage 3/4 fibrosis, but my viral load never exceeded 150,000 IU/mL. Others have reported very little fibrosis (scarring) per liver biopsy, but had viral loads in excess of 50,000,000.

There are special considerations made for someone with a viral load of <400,000 IU/mL and that respond very rapidly to therapy; some of these patients might benefit from truncated treatment protocol. Other than that, viral load means little in terms of disease progression, unfortunately for those like you and I :o).

I can’t help you with symptoms like fever, etc; fever isn’t typically associated with chronic HCV. You should continue to explore this with your doctor; hopefully it’ll be something simple and easy to resolve.

Continue to ask questions, and welcome again—

Bill

[Jay_555]

Thanks for the feedback and welcome - I haven't discussed this much with anyone besides my doc and I am grateful that I can seek questions without having to pull out a medical dictionary!

I checked the test results page and it indicates that the test was for HCV FibroSURE

is there a difference between this and Fibrospect?

and is the damage to my liver more advanced than normal even thought the viral count it low?  

I have been feeling feverish every week for a year now.  but no loss of weight or appetite.

[Bill1954]

I see; so the fibrosis scoring was per Fibrosure of Fibrospect? If this is truly representative of the state of your liver, you could most likely wait for more efficacious drugs to avail themselves.

The current drugs include pegylated (long lasting) interferon and ribavirin; genotype 1 patients respond to these drugs about 45-50% of the time with current meds.

The new drugs will be used in conjunction with interferon/riba; in clinical trials, they increase the efficacy to roughly 75%, and in some patient populations reduce treatment duration from 48 to 24 weeks.

Specifically discuss ‘Telaprevir’ and ‘Boceprevir’ with your doctor; they are currently available in clinical trial; press releases from their marketing departments suggest FDA approval and market release for Telaprevir as soon as 2011.

Welcome to the discussion group, by the way—

Bill

[Jay_555]

No biopsy yet.  Doc thinks I have had this all my life since it is in the family.  no high risk lifestyle expect - I did used to enjoy my beer and spirits - completely off that now.

I have been tested for just about EVERYTHING because of my initial symptoms - low energy, fevers, breathing problems.  Heart, lungs, test for leukemia, vitamin deficiencies, thyroid, epstein barr and other auto immune diseases, colon cancer!  I changed doctors for a 2nd opinion and this time they decided to test me for Hep C and confirmed it.

genotype is 1b.
AST=43.
ALT=75


Actually I am a little surprised at the low viral count since I have F1-F2 stage fibrosis.
Fibrosis score is 0.47 and Necroinflammit Activity score is 0.55  both high.

[Bill1954]

Yeah, it can be somewhat challenging at times, but most of us manage one way or another, and get through it.

Have you had a biopsy yet? Do you know your genotype, or strain of HCV? With a viral load, you should already have genotype; or they should be working on it right now.

Biopsy can help you determine how much, if any damage has occurred to your liver as well as how urgent the need is to treat your disease.

How long do you suppose you might have had HCV?

Depending on a number of factors, there are new meds in clinical trial that are pretty exciting; be sure to discuss these with the doc. Ask about ‘STAT-C’ class drugs, when they might be available, and if you would benefit from them and should wait for their release.

Bill

[Trinity4]

I think it's the Logarithmic format and to be quite honest I'm not sure exactly how it works.  The  25,960 IU/mL is really all you need because that's the number we use and doctors use when assessing PCR test results.

I'm sure someone will chime in and explain how the 4.414  log10 IU/mL converts to 25,960 IU/mL.

Trinity

[Jay_555]

Thanks Bill.  I have not started any treatment.  My GI doctor mentioned antiviral treatment and suggested I attend a seminar to learn more about the treatment first.  I am not sure if I want to take that course and wanted to find out my viral load first.  
Am 50 years old.  Had jaundice as a child, my sibling has hep C as well.  Never had any symptoms until a year ago - fevers, tired, etc.
Not sure what to do next.  I heard the treatment can be debilitating.

[Bill1954]

Hi,

As Trinity mentioned, your viral load is remarkably low, if you’re not currently undergoing antiviral therapy. There are many people with results in excess of 50,000,000 IU/mL.

The ‘log 4.414’ is the same number, expressed with a different scale using logarithms.

Have you started or are you considering treatment for your HCV?

Bill

[Jay_555]

thank you Trinity.  What does  HCV log10         4.414    log10  IU/ml   mean?  Should I be concerned about this?

[Trinity4]

Your viral load is 25,960 IU/mL which is considered a very low viral load.

Most viral loads are in the hundred thousands or millions unless you are treating and that is your latest PCR results.  

Trinity