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TOPIC: Viral load

Viral load 1 year 4 months ago #26785

  • Nedgemmer
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Hi is a hep c viral load of 33 million curable ?
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Viral load 1 year 4 months ago #26786

  • DrJames
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Hello Nedgemmer,

Welcome to FixHepC and the forum.

Yes, strange as it may seem, your viral load has no impact on cure rate.

You have a high viral load because your body (immune system) is not really trying to do much. The upside is that your immune system is not destroying your liver in its attempts to kill the virus. The downside is that... well, actually there is not a downside besides the extra ink to print the extra zero after 3 million (this is the average viral load).

33 million viruses don't eat much - maybe 1/2 a hamburger a year (they are very small) so you can afford to feed them.

No reason not to get cured and your chances are as good as anyone else. Not 100% on the first pass, but about 95% for GT1,2,4,5,6 and 90% for GT3.

Back in 2015, when we were doing RVR testing on a new drug we saw a guy with a 16 million viral load go to 16 in the first week. These drugs are remarkably effective.
YMMV
Last Edit: 1 year 4 months ago by DrJames.
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Viral load 1 year 4 months ago #26789

  • sabrecat
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"Computed Tomography) uses Xrays to look at the liver. Triple phase contrast scans are usually conducted to look cancer. Doing one from time to time is low risk, but CT is not ideal for regular follow up in cirrhotic patients at high risk of liver cancer."

They have really backed off with the CT scans with me and I now get by with ultrasounds. I understand that CT produces up to 200 times radiation of normal x-rays?

Risk benefit wise how do doctors weigh up whether another one is worth it?

Is having a large gap between them mean a reduction in risk, but there still is a cumulative effect?


J.

P.S.

for anyone reading this and still considering starting treatment, include these calculations in your thoughts - don't wait for your liver to become cirrhotic.
GT3a 1990 Failed Inter 1998, comb in 2000. HCC 2012
Started 24/52 Sof/Dac 27th October 2015.
1. Bloods 2 October 2015: AST - 165 (20-40), ALT - 265 (5-40), GGT 189 (5-50)
2, Bloods 20 November 2015: ALT etc normal; VL 19
3. Bloods 8 January 2016: AST - 40, ALT - 59, GGT 48 VL RNA UND
4. EOT 12 April 2016 - blood tests: all is well, CT scan: okay
5. AFP 11 June 2016: 4 ref< 11
6. VL July 2016: DET
7. Oct16 start treat - June17 UND
8. Jun 18, lfts okay, platelets a bit low.
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Viral load 1 year 4 months ago #26793

  • Vororo
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Hi Sabrecat,

I don't know about the difference in dosage of X-rays, but the speed at which those things spin is impressive. For a given dosage, faster should mean better 3D images. Here is a cool little video that explains that better than me:

Diagnosed Jan 2015: GT3, A0+F0/F1. Fatigue + Brain-Fog.
Started Sof+Dac from fixHepC 10-Nov-2015. NO sides.
Pre-Tx: AST 82, ALT 133, Viral Load 1 900 000.
Week4: AST 47, ALT 58. VL < 15 (unquantifiable).
Week12 (EOT): AST 30, ALT 26, VL UND
Week16 (EOT+4): AST 32, ALT 28, GGT 24, VL UND
Week28 (EOT+16): AST 26, ALT 22, GGT 24, VL UND
Ever grateful to Dr James.

Relapsed somewhere after all that... Bummer!

Jan 2018: VL 63 000 (still GT3).
Last Edit: 1 year 4 months ago by Vororo. Reason: removed duplicate video link
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Viral load 1 year 4 months ago #26797

  • DrJames
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Hello sabrecat,

Yes there is a small, but real risk that having a CT will give you cancer.

For an adult the risk is roughly 1:10,000 per year post exposure with the risk being cumulative so more scans (say 10) might make this 1:1000. This was the results of a really large Australian study into the risks:

www.bmj.com/content/346/bmj.f2360

This compares to a 3% 3:100 per annum risk of a cirrhotic patient getting cancer.

So the risk benefit analysis that HCC is relatively likely (for cirrhotics) and the chances of the scan doing harm are small. So we do the scan.

For a child, who has a CT of their brain there is a 1:500 risk of that giving them brain cancer, so, it is very rare that we would take that risk (we would MRI).

Patients don't typically have the small risk of CT explained, but their doctor (if they are any good) will have considered the risk/benefit - it's basically what we do all the time.
YMMV
Last Edit: 1 year 4 months ago by DrJames.
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