Welcome, Guest
Username: Password: Remember me

TOPIC: Huge Viral Load Fluctuation

Huge Viral Load Fluctuation 1 year 10 months ago #17912

  • hepCat
  • hepCat's Avatar
  • Offline
  • New Member
  • Posts: 7
  • Thank you received: 18
  • Karma: 0
So… I understand that any given VL test is simply a reflection of that precise moment in time and that VLs fluctuate daily, weekly, monthly, over time. I think I also read somewhere that VL gives an indication of how well a person’s immune system is fighting off the virus. I’m sure there are other factors. And I get that whatever the VL the most important thing is getting the appropriate medication and taking it - hence my signing up for 24 wks of Redemption 2, (first 12 wks just delivered; second 12 wks already in transit).

However, at my last consult with the Dr. who will be monitoring treatment locally we decided to order another VL test since I’ve only ever had one.

On 4/14/16 my VL was 824,000

On 5/31/16 my VL was 14,413,000

So, a fairly significant jump in 6 weeks time. At the time of the second test I was just at the tail end of about a week and a half of … I dunno, flu? Some sickness … my best guess would be laryngitis because it started at my vocal cords and pretty much stayed there. Is it possible my immune system sort of diverted resources to fight the acute infection leaving the chronic HCV to proliferate with abandon?

Of course, one or even both tests could be wrong but I doubt there’s a way to test that.

So, what’s up with that massive increase in VL? More importantly, does this alter the calculus for my treatment plan? Specifically, does a high VL increase the likelihood of RAV?

(I have a blood specimen stored to test for RAV. The test is available to me. I chose not to do it prior to treatment because my VL was low and I was F2, both of which are in question now)

Thanks in advance for any help or insight.
GT 3a, tx naive, dx 4/12/16
4/12/16 V/L 824,000
2/03/16 AST 119 ALT 239 platelets 109
4/12/16 AST 87 ALT 164 platelets 118 (different lab)
5/5/16 FibroScan 8.9 kPa F2
5/16/16 AST 86 ALT 157
5/16/16 Fibrotest 0.6 F3 Actitest 0.79
5/31/16 VL 14,413,000 (uh... YIKES)
Y93H @ baseline
6/20/16 Started Redemption 2 Sof + Dac
7/516 QUANT VL: NOT DETECTED
7/5/16 AST 34 ALT 60 Platelets 128 (diff lab though)

12/06/16 EOT VL UNDETECTED
1/03/17 EOT+4 VL 12,222,000
no new RAVs; IL28B = CC
The administrator has disabled public write access.
The following user(s) said Thank You: Meg

Huge Viral Load Fluctuation 1 year 10 months ago #17918

  • mgalbrai
  • mgalbrai's Avatar
  • Offline
  • Moderator
  • Posts: 1326
  • Thank you received: 2696
  • Karma: 27
Did they measure your ALT/AST both times?
If so, how did the results compare?
m
This email address is being protected from spambots. You need JavaScript enabled to view it.
forums.delphiforums.com/generichcvtx

G 1a F-1
Started tx 10/23/15 (Meso sof & led) ALT 48 AST 28 v/l 1.6 mil
11/17/15 4 wk lab ALT 17 AST 16 <15
11/18/15 Started Harvoni
12/16/15 8 wk lab ALT: 15 AST: 13 V/l UND
1/14/16 Fin. Tx
7/07/16 UND SVR 24
The administrator has disabled public write access.
The following user(s) said Thank You: Meg

Huge Viral Load Fluctuation 1 year 10 months ago #17921

  • hepCat
  • hepCat's Avatar
  • Offline
  • New Member
  • Posts: 7
  • Thank you received: 18
  • Karma: 0
No, we didn't do them at the time of the second VL test because I'd been ill.
GT 3a, tx naive, dx 4/12/16
4/12/16 V/L 824,000
2/03/16 AST 119 ALT 239 platelets 109
4/12/16 AST 87 ALT 164 platelets 118 (different lab)
5/5/16 FibroScan 8.9 kPa F2
5/16/16 AST 86 ALT 157
5/16/16 Fibrotest 0.6 F3 Actitest 0.79
5/31/16 VL 14,413,000 (uh... YIKES)
Y93H @ baseline
6/20/16 Started Redemption 2 Sof + Dac
7/516 QUANT VL: NOT DETECTED
7/5/16 AST 34 ALT 60 Platelets 128 (diff lab though)

12/06/16 EOT VL UNDETECTED
1/03/17 EOT+4 VL 12,222,000
no new RAVs; IL28B = CC
The administrator has disabled public write access.
The following user(s) said Thank You: Meg

Huge Viral Load Fluctuation 1 year 10 months ago #17925

  • mgalbrai
  • mgalbrai's Avatar
  • Offline
  • Moderator
  • Posts: 1326
  • Thank you received: 2696
  • Karma: 27
If it were me, I would have a liver panel. My v/l went from 4.9 million to 1.6 million in the year before I started treatment. I attribute to not drinking alcohol. During that same time period, my ALT went from 225 to 48.
We probably need an expert in this corner...
m
This email address is being protected from spambots. You need JavaScript enabled to view it.
forums.delphiforums.com/generichcvtx

G 1a F-1
Started tx 10/23/15 (Meso sof & led) ALT 48 AST 28 v/l 1.6 mil
11/17/15 4 wk lab ALT 17 AST 16 <15
11/18/15 Started Harvoni
12/16/15 8 wk lab ALT: 15 AST: 13 V/l UND
1/14/16 Fin. Tx
7/07/16 UND SVR 24
The administrator has disabled public write access.
The following user(s) said Thank You: LondonGirl, Ariel, Meg

Huge Viral Load Fluctuation 1 year 10 months ago #17931

  • DrJames
  • DrJames's Avatar
  • Offline
  • Platinum Member
  • Posts: 1511
  • Thank you received: 5769
  • Karma: 90
Viral loads go up and down, but yes that's a large change. You can't directly compare different quantitative tests so this might have something do with it.

Viral load has very little correlation to either liver damage or SVR rate.

The best viral load to have is undetected at SVR so rather than fussing about what it is currently I would be actively seeking to make it 0
YMMV
The administrator has disabled public write access.
The following user(s) said Thank You: LondonGirl, mgalbrai, Meg, fitz

Huge Viral Load Fluctuation 1 year 10 months ago #17971

  • Meg
  • Meg's Avatar
  • Offline
  • Premium Member
  • Posts: 100
  • Thank you received: 327
  • Karma: 12
What are the best correlation "variables/factors" with SVR known besides length of tx? Perhaps there is a file with such a data in the forum I am missing. Thank you so much in advance.
Blood transfusion in 1992 - Diagnosed in 2007
Tx naive -G1b - F1
VL 2.270.000
ALT 40
Start tx June 4th/2016 with DAAs - Sof/Led from India
Bloods on two weeks of tx (June 18th)
AST 17 - ALT 10 - GGT 19
Virus UND
Bloods on six weeks of tx (July 16th)
AST 17 - ALT 8 - GGT 12
Virus UND
EOT on August 8th (did 9 weeks and 3 days)

SVR 4 Virus UND (September 7th)
AST 13 - ALT 5

SVR 14 Virus UND (November 12th)
The administrator has disabled public write access.
The following user(s) said Thank You: Ariel, fitz

Huge Viral Load Fluctuation 1 year 10 months ago #17973

  • sonix
  • sonix's Avatar
  • Offline
  • Elite Member
  • Music is life
  • Posts: 160
  • Thank you received: 343
  • Karma: 2
IIC the main factors are fibrosis level (F1-F4), genotype, previous treatment experience and presence of RAVs. I'm sure relevant data is somewhere here in the forums but can't remember where.
M 61yo HCV+ ~ 30 yrs Gt1a F2 VL 223,000 ALT 54 AST 42 Tx start Sof/Dac 17Dec15.
SVR4 at 7Apr16 ALT 22 AST 22
SVR12 at 9Jun16 ALT 23 AST 25
Melbourne, Australia
The administrator has disabled public write access.
The following user(s) said Thank You: DrJames, Ariel, Meg, fitz

Huge Viral Load Fluctuation 1 year 10 months ago #18038

  • DrJames
  • DrJames's Avatar
  • Offline
  • Platinum Member
  • Posts: 1511
  • Thank you received: 5769
  • Karma: 90
Past treatment (failure) is probably just another way of identifying poor levels of innate immune response to HCV - ie it picks up people with IL28 TT and probably other genes we don't know about.

It makes sense to me that patients with high viral loads X many years = more replication cycles capable of generating resistant mutants.

Diabetes and insulin resistance is probably bad, and genotype/fibrosis.

With genotype 2 is best, 1b, 1a, then 3 last. Data for 4,5,6 is lacking. GT3 remains the problem child.
YMMV
The administrator has disabled public write access.
The following user(s) said Thank You: mgalbrai, Ariel, katy8katy0, Meg, GT2, fitz

Huge Viral Load Fluctuation 1 year 10 months ago #18045

  • Price
  • Price's Avatar
  • Offline
  • Elite Member
  • Posts: 237
  • Thank you received: 343
  • Karma: -5
Having untreated infections during interferon treatment made it more difficult to clear HCV. So maybe having two infections raises the viral load.
The administrator has disabled public write access.
The following user(s) said Thank You: mgalbrai, Meg, fitz
Time to create page: 0.209 seconds

Copyright © 2015-2017 FixHepC

Back to Top