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Re: Need some help
Aug 2, 2006
[QUOTE=gemmasmommy]I was diagnosed with Hepatitis C in 2004. I have type 1. My viral load was 6.3 mIU or however that unit is written. I was pregnant at the time (that's why it was caught so quickly). I believe I contracted it in 2003 performing CPR. After I gave birth I started on ribavirin and peg-intron. My viral load was down to 5.3 mIU. However, I had the whole list of side effects and was forced to stop treatment for some time. My doctor was ready to hospitalize me if I didn't agree to stop. Now my last bloodwork showed my SGTP levels were eleveted to 58. I'm ready to begin treatment again. My doctors agreed that my low iron levels contributed to the overload of symptoms and i will be receiving intravenous iron weekly to biweekly. My main concerns are 1) My daughter will be tested in 2 months to determine if she has the virus or not. What are her chances of being infected? 2.) I am in a long term relationship. What are his chances of being infected? 3.) I was told my results were promising by my doctor. What are the chances of actually testing negative at the completion of treatment? Has anyone here had success with this combination? 4.) If my treatments are not successful will I need a liver transplant and how long from now might I have? 5.) What other options are out there if this doesn't work? Also could someone please explain to me what the viral load actually measures and what mIU means so that I can better understand how this translates in real numbers and real life. Thank you all for your time in advance.
Sara[/QUOTE]


Hi again,
How long were you on tx last time? a "reduction" of viral load from 6.3 million to 5.3 miil would not be considered a reduction. what is looked for, usually, is one log response within 24 to 48 hours (not that anyone tests this often except in research projects), and two log reduction (reduced by a factor of 100, that is, a 99% reduction) within four weeks, or at worst, 12 weeks. If you were on interferon for weeks, and the viral load went from 6.3. to 5.3, that is a clear NON-response. SGTP levels are likely to vary widely all by themselves--unrelated to the course of the disease--and 58 ain't much, anyway. Third, side effects of interferon can be serious, damaging, and sometimes permanent--and you had bad ones.Taken together, these things lead me to wonder deeply why you are considering treating again????? and why your doc would encourage you in this.

It is also worth considering that supplemental iron is risky for hep cases. Epo or other ways to fight anemia should be considered first, or at least your drs. should be discussing this with you before concluding that iron is the way to go.

there is some chance that your baby got hcv from you, but on the other hand, infants and children are notorious for recovering spontaneously (without treatment that means) from hep c, and often quickly, too. So, it may be that even if she contracted it, it will prove of small consequence. it is not unrealistic to hope so, at least.

Your spouse could conceivably catch hep c from you, if you practice unsafe sex. to say otherwise would be unreal. BUT, the research--and many many anecdotal reports on this board (including my own life story) suggest strongly that sexual transmission between monogamous partners is pretty rare. Also, there is some reason for believing that transmission from the woman to the man is especially uncommon.

the combination treatment is standard now--pegasys considered a shade better than pegintron, but all quite standard--and ''success' is usually sugested to be 50-50. However, a key determinant of your odds is your genotype--that is what sub-type of hep do you have? If it is 1a--the most common in N. America--your odds would be predicted to be somewhat UNDER fifty percent. If you are 2a or 2b, your odds might be as high as 80 percent, other types falling somewhere between. You must knowyour genotype to assess your odds of succeeding in tx.

Even if your treatments are unsuccessful, your chances of needing a liver transplant are small, and for the next few years, probably vanishingly small. People are somtimes confused by factoids like "hep c is the most common reason for liver transplant in the USA." and so on. this may be true, but liver transplant is itself UNcommon, so being a large fraction of a small overall number still means very few of us ever get to that point. and there are millions and millions of hep c folks out there who, like me, have had the disease for decades (yes, lierally decades) without displaying any big deal symptoms, let alone needing transplant.

As to your last question, viral load doesn't mean so much in the case of hep c. In HIV it is a key measure of the seriousness of the disease, but in hcv, it turns out to be a much poorer indicator. A high number (yours is kind of high--just like mine, actually) is very fractionally correlated with less favorable prognosis in tx, but its a pretty weak relationship. Some people with high viral counts (me), go for long periods with no distress, other people not so lucky. The virus lives in the liver, spleen, brain, and elsewhere. the viral load tests measure virus particles in the blood, but this is not primarily a blood disease. so the blood tests are only a distant approximation of what the virus may be doing in the organs. this is also why the only meaningful result to consider successful in tx is to get the viral count to zeor or undetected. no middle ground 'reductions' mean a thing.

I am currently considering pegasys for myself (after years and years of avoiding it), so do not think I am anti-tx when I tell you that you don't seem to me like the obvious candidate for treatment. I am not, of course, a doctor, and am medically entirely unqualified to speak on the issue, so i urge you only to do some more research of your own and on your own. In particular, study interferon and be sure you go into tx with your eyes open, or don't go in at all.


Hope this helps.

sean





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