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TOPIC: Pre-Treatment VL and Bloodwork

Pre-Treatment VL and Bloodwork 2 years 5 months 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 years 5 months 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 2 years 4 months 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 2 years 4 months 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 2 years 4 months 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 2 years 4 months 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 2 years 4 months 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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Pre-Treatment VL and Bloodwork 2 years 2 months ago #28574

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Today is my first day of treatment! Insurance approved 8 weeks of Mavyret and my copay was only $5 thankfully.

I’m so ready to tackle this beast and will be reading about the side effects on the forum! I’m so nervous.

Thank you so much for your help, Dr. James!
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Pre-Treatment VL and Bloodwork 2 years 2 months ago #28581

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That's fantastic news joy2world.

Maviret is great with very little in the way of side effects so don't sweat it too much. Get a glass of water, swallow the first 3 pills, do that every day and it will be over almost before you notice.
YMMV
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Pre-Treatment VL and Bloodwork 2 years 2 months ago #28595

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Three weeks into treatment and I feel great! No side effects whatsoever!

I am a little worried with covid-19 going around. My family and I have done our part by staying home, and only leaving when absolutely necessary to buy food or supplies.

I have an appointment April 2nd to check viral load, but am unsure if that is even possible with the onslaught of serious respiratory cases.

Am I considered high risk due to HCV status? Would Mavyret make me more or less susceptible to acquiring this virus? So many unknowns at the moment, and I don’t expect a response... just thinking out loud.
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Pre-Treatment VL and Bloodwork 2 years 1 month ago #28609

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Hi joy2world,

Congratulations on starting your treatment. It's great to hear that you have no side effects. I have just started 14 days isolation after arriving back from Europe yesterday so I understand the worry of it all. I suspect when my 14 days is up everyone will be on tighter restrictions. I feel well and after getting rid of Hep C a few years ago (through fixHepC) I would be pretty unhappy about picking up another virus.

I'm not sure about the increased risk factor but sounds like you are doing your best to isolate yourself and your family to keep yourself well. Good luck with the rest of your treatment.

Coral
G1a probably early 1980's, Biopsy F1(2010), F2-F3(2015). VL 5+mill; 2+mill (2014) Tx naive. Accessed Sof/Led through Dr Freeman at GP2U and Buyers Club (lifesavers!!!)
Commenced tx 12/11/15. 9 wk: VL <15 Detected but LFT = Normal 12 week results: UND (Yay!) Due to slow response commenced Sof/Dac 4 Feb for 12 weeks. EOT @ 24 weeks 27 April 2016. (With thanks to Dr Freeman et al). SVR11 result: VL 1,950,000. It's back!
New tx 030916 (Viekira Pak, Solvadi, Ribavirin UND @ 111116. EOT 170217.
SVR12 and SVR 24...
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Pre-Treatment VL and Bloodwork 2 years 1 month ago #28611

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Thank you, Coral! We are all in this together. You are correct, we have been self isolating and only leave the house once per week to make the daunting trip for supplies. I’ll be happy to not be afraid anymore to run simple errands!

I’m taking this threat very seriously, as we all should! We all know how tricky viruses are.

I received word from my gastroenterologist that they are not doing bloodwork at this time so all labs have to be postponed! I was due for bloodwork on April 2nd (1 month into treatment) and will complete treatment on April 28th! My only concern is not knowing if the treatment is working or not. I can’t do anything other than just continue and hope that it is working!

I hope everyone is taking care of themselves during this crazy time. We will get through this together. ❤️
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Pre-Treatment VL and Bloodwork 2 years 1 month ago #28619

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Hi Joy2world, you can be 97% certain that the medication is doing its job, that's the cure rate for Mavyret. In your case since you don't have severe liver damage, that certainty is almost 100%. The tests done during treatment are not essential, the only important test is done 12 weeks after finishing treatment. Of course it would be nice to learn that you're responding well to the medication during treatment, but if that's not possible due to the current circumstances, don't sweat it.
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Pre-Treatment VL and Bloodwork 2 years 1 week ago #28692

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I’m a little discouraged today. I finally was able to get my EOT labs drawn and am still showing DETECTED. Viral load is under <12 and unable to be measured but the qualitative still shows detected.

I ended treatment April 28th and had labs drawn May 5th, so was only a week after EOT.

I’m thrilled to see my viral load go from 3 million to <12... but man. I was so hoping for it to be completely undetected.

Any advice or help would be greatly appreciated, as I feel so defeated at the moment.
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Pre-Treatment VL and Bloodwork 2 years 1 week ago #28693

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Don't be discouraged Joy. You may still have bits of dead virus floating around. As I recall, it can take some time
Failed Interferon 96', G1a, VL = 9 - 5.5 Million, F3/A3, AST 111, ALT 190, Generic DAA treatment Sof/Led (Mylan - India MYHEP LVIR) - 8 June, 2016
2 Week Results 20 June, 2016 AST 19, ALT 32
4 Week Results 06 July, 2016 AST 22, ALT 30, VL = 35
6 Week Results 20, July 2016 VL only = HCV RNA Detected, Non-Quantifiable <15
8 Week Results 04 August 2016, Labs, LFTs Normal, VL = UND
12 Week Results 31 August, 2016 LFTs Normal, VL = UND
EOT + 4 Weeks, LFTs Normal, VL = UND, "SVR4"
SVR12, 21 Nov 2016. CURED!!!
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