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TOPIC: Pre-Treatment VL and Bloodwork

Pre-Treatment VL and Bloodwork 2 months 2 weeks ago #28403

  • joy2world
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Hello! I’m new to the forum and wanted to introduce myself and give a little background, post my VL and LFTs. I’m a 33 year old female, in the US.

I was first alerted to the possibility of infection 5 years ago. I had some routine bloodwork done during a yearly well woman’s exam. My ALT was around 42 at the time, and the nurse practitioner (bless her) said that I should look into getting a Hep panel done. Even though it was only slightly elevated.

I looked at her in astonishment and said “well didn’t they do that during my pregnancies (2)?” She shook her head no, and told me not unless I gave them reason to believe that they should.

I didn’t divulge to my OBGYN that I had used drugs when I was 17 years old. It was embarrassing. I figured if anything was wrong, surely they’d catch it. Wrong.

I went on to have the antibody test, and sure enough... tested positive. I was devastated. I had been living on the straight and narrow... moved away, turned my life around, got married, and had two beautiful children. My children!!! I panicked. Got them tested immediately and by the grace of God they were negative. My husband still hasn’t been tested, which scares me. Even though I know the odds are low, there were 5+ years of me NOT knowing and us sharing razors, and just not even thinking of the possible risks.

I didn’t have insurance at the time, and couldn’t afford the RNA... so 5 years later, here I am.

I am now fully insured (after being uninsured for 10 years) and told my brand new doctor EVERYTHING. He ran a full metabolic panel, CBC, and Quant RNA on me. Sadly, I am indeed infected with HCV and I have been living with this for 15 years at the minimum.

Strangely, my bloodwork is perfect. From all appearances, everything looks good. Except for the viral load of over 3 million!!!! I wasn’t expecting that. I’ll go ahead and post the bloodwork and let you be the judge, because I’m freaking out at this point and would love any positive words:


WBC
Your Value
5.76 K/uL
Standard Range
3.90 - 12.70 K/uL

RBC
Your Value
4.19 M/uL
Standard Range
4.00 - 5.40 M/uL

Hemoglobin
Your Value
12.3 g/dL
Standard Range
12.0 - 16.0 g/dL

Hematocrit
Your Value
40.4 %
Standard Range
37.0 - 48.5 %

Mean Corpuscular Volume
Your Value
96 fL
Standard Range
82 - 98 fL

Mean Corpuscular Hemoglobin
Your Value
29.4 pg
Standard Range
27.0 - 31.0 pg

Mean Corpuscular Hemoglobin Conc
Your Value
30.4 g/dL
Standard Range
32.0 - 36.0 g/dL

RDW
Your Value
12.2 %
Standard Range
11.5 - 14.5 %

Platelets
Your Value
288 K/uL
Standard Range
150 - 350 K/uL

MPV
Your Value
10.9 fL
Standard Range
9.2 - 12.9 fL

Immature Granulocytes
Your Value
0.2 %
Standard Range
0.0 - 0.5 %

Gran # (ANC)
Your Value
3.9 K/uL
Standard Range
1.8 - 7.7 K/uL

Immature Grans (Abs)
Your Value
0.01 K/uL
Standard Range
0.00 - 0.04 K/uL

Lymph #
Your Value
1.5 K/uL
Standard Range
1.0 - 4.8 K/uL

Mono #
Your Value
0.3 K/uL
Standard Range
0.3 - 1.0 K/uL

Eos #
Your Value
0.0 K/uL
Standard Range
0.0 - 0.5 K/uL

Baso #
Your Value
0.03 K/uL
Standard Range
0.00 - 0.20 K/uL

nRBC
Your Value
0 /100 WBC
Standard Range
0 /100 WBC

Gran%
Your Value
68.1 %
Standard Range
38.0 - 73.0 %

Lymph%
Your Value
25.3 %
Standard Range
18.0 - 48.0 %

Mono%
Your Value
5.7 %
Standard Range
4.0 - 15.0 %

Eosinophil%
Your Value
0.2 %
Standard Range
0.0 - 8.0 %

Basophil%
Your Value
0.5 %
Standard Range
0.0 - 1.9 %

Sodium
Your Value
136 mmol/L
Standard Range
136 - 145 mmol/L

Potassium
Your Value
3.9 mmol/L
Standard Range
3.5 - 5.1 mmol/L

Chloride
Your Value
101 mmol/L
Standard Range
95 - 110 mmol/L

CO2
Your Value
25 mmol/L
Standard Range
23 - 29 mmol/L

Glucose
Your Value
77 mg/dL
Standard Range
70 - 110 mg/dL

BUN, Bld
Your Value
10 mg/dL
Standard Range
6 - 20 mg/dL

Creatinine
Your Value
0.8 mg/dL
Standard Range
0.5 - 1.4 mg/dL

Calcium
Your Value
8.9 mg/dL
Standard Range
8.7 - 10.5 mg/dL

Total Protein
Your Value
7.9 g/dL
Standard Range
6.0 - 8.4 g/dL

Albumin
Your Value
3.6 g/dL
Standard Range
3.5 - 5.2 g/dL

Total Bilirubin
Your Value
0.4 mg/dL
Standard Range
0.1 - 1.0 mg/dL

Alkaline Phosphatase
Your Value
67 U/L
Standard Range
55 - 135 U/L

AST
Your Value
20 U/L
Standard Range
10 - 40 U/L

ALT
Your Value
28 U/L
Standard Range
10 - 44 U/L

Anion Gap
Your Value
10 mmol/L
Standard Range
8 - 16 mmol/L

eGFR if African American
Your Value
>60.0 mL/min/1.73 m^2
Standard Range
>60 mL/min/1.73 m^2

eGFR if non African American
Your Value
>60.0 mL/min/1.73 m^2
Standard Range
>60 mL/min/1.73 m^2

Here’s where it gets a little hairy...

HCV RNA Quant PCR
Your Value
3,148,265 IU/mL
Standard Range
<12 IU/mL

Yikes.

So there it is, folks. I’m awaiting an appointment with gastroenterologist on the 19th and hope to celebrate 2020 on treatment. I have no idea what genotype, or what damage has been done over the past 15 years.

I’m hopeful, and I’m forever grateful to have this forum to read success stories, and understand more about my new journey.

Thank you for reading!
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Pre-Treatment VL and Bloodwork 2 months 2 weeks ago #28405

  • DrJames
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Hello joy2world,

Welcome to the forum.

Don’t sweat it. You are still early stage, there is no damage evident yet, and you will probably get 8 weeks Mavyret which is an awesome treatment.

Your husband should get tested. Sexual transmission is just about impossible but the razor sharing is a real risk. If he’s infected he just needs treating. Either he is or he isn’t. Not testing won’t change that but will probably just remove the worry.

Great news that the kids are fine.
YMMV
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Pre-Treatment VL and Bloodwork 2 months 2 weeks ago #28406

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Thank you so much! I appreciate your insight Dr. James. Will update once I know more.
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Pre-Treatment VL and Bloodwork 1 month 4 weeks ago #28455

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Quick update!

Just had genotyping blood work come in, and prothrombin time labs. Results are as follows:

Genotype 1a

Viral load went down from 3 mill to 2.2 mill... I’m assuming it fluctuates.

Prothrombin Time
Your Value
9.7 sec
Standard Range
9.0 - 12.5 sec

INR
Your Value
0.9
Standard Range
0.8 - 1.2

Have liver ultrasound scheduled on January 10th and am praying and hoping for the green light for treatment after that.
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Pre-Treatment VL and Bloodwork 1 month 4 weeks ago #28458

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Hello joy2world,

1a is the commonest genotype and 2-3 million is the average viral load...

Yes viral load fluctuates a bit.
YMMV
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Pre-Treatment VL and Bloodwork 1 month 2 weeks ago #28484

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More updates:

Liver Ultrasound

Study Result
Impression
Dilation of the common bile duct measuring up to 7.9 mm without intrahepatic biliary dilation. Etiology for this is unclear. No obstructing stone or other abnormality is seen. Please correlate with biliary indices. Further imaging can be performed as clinically indicated.


Electronically signed by: Anshu Duggal, MD
Date: 01/10/2020
Time: 10:01
Narrative
EXAMINATION:
US ABDOMEN LIMITED

CLINICAL HISTORY:
Chronic HCV, r/o liver cirrhosis; Chronic viral hepatitis C

TECHNIQUE:
Limited ultrasound of the right upper quadrant of the abdomen (including pancreas, liver, gallbladder, common bile duct, and spleen) was performed.

COMPARISON:
None.

FINDINGS:
Liver: Slightly increased in size, measuring 15.9 cm. Homogeneous echotexture. No focal hepatic lesions.

Gallbladder: No calculi, wall thickening, or pericholecystic fluid. No sonographic Murphy's sign.

Biliary system: The common measures 7.9 mm. No intrahepatic ductal dilatation.

Spleen: Normal in size and echotexture, measuring 10.8 cm.

Miscellaneous: No upper abdominal ascites.

I’m assuming this is ok news? I’m unsure of what the common bile duct is... and homogeneous echotexture. Will be able to speak with my doctor this week hopefully!
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Pre-Treatment VL and Bloodwork 1 month 2 weeks ago #28485

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Hello joy2world

The homogonous echo texture means your liver looks uniform (ie not very fibrotic/cirrhotic)




Your liver makes bile which is a mixture of detergent to help digestion and waste products that end up in your stool. The hepatic ducts are in the liver and are joined by the cystic duct from the gall bladder (a storage reserviour for bile) to form the common bile duct. The common bile duct goes through your pancreas to get to your duodenum which is part of your gut tube.

Anyway, your common bile duct is slightly larger than the usual 6 mm and this has been commented on. The reasons can include being born that way, having a stone in the duct blocking it, some medications, or a tumour. The "etiology (reason) for this is unclear" means that a stone can't be seen, a tumour can't be seen ie there is no obvious reason for it.

The further imaging can be performed as clinically indicated is a standard clause so that the radiologist can blame the ordering doctor for not ordering more tests if it turns out that the cause was serious.

It's probably nothing, but should be looked into/kept an eye on by your doctor.
YMMV
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Pre-Treatment VL and Bloodwork 1 month 2 weeks ago #28486

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Thank you so much for your thorough answers!!! It definitely puts my mind at ease that my liver is not cirrhotic or damaged greatly. That was my greatest concern since finding out that have this virus.

The next step is treatment, and I’m hopeful that insurance will cover a portion and hopefully can qualify for a copayment card through Mavyret. That’s been another fear is not being able to afford the treatment even with insurance.

I’m grateful to have found this forum and know I will always have a backup option for treatment as well. You’ve been most helpful!
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