New to this Hep C

[RonniePATWebb]

Hello all, I am a (soon to be) 57 yr old female and worried about if I have Hep C. My reasoning behind this is My hubby and I applied for life insurance in Feb. I pushed this because for the last yr I have been feeling ill and fatigued.
When the life insurance blood work came back (I requested a copy of the test) it stated POS for HCV.  In March I wet to see my Family DR.  who took another test just to verify the life ins test.. It also came back POS for HCV.
I was then referred to a  GI specialist.... Who requested a Hepatitis C RNA, QUANT by PCR blood test. The results for this just came back and my next appt is not til 5/7.  Far to long for me to wait.... I'm sure some of you can Identify.  I do not know enough to read the results and was wondering if I could get a little help before my appt date, because if I do have HCV, I want to go to Duke Medical for help/tx.

Hep C RNA RT by PCR             7.1   (2)
HCV RNA RT PCR INTP            Detected * 3


Viral load results for HCV RNA is 13,600,000 iu/ml
The log 10 value of HCV RNA is 7.1

Test Information Hepatitis C Virus RNA Quantitive
        Real time PCR (log IU/ml)

The quantitive range of this assay is 2.3 logIU/ml and
greater. Results between 1.9 and 2.3 log IU/ml
(75 to 200 IU/ml) will be reported as "HCV RNA detected
below the limit of quantitation."
An interpretation of "Not Detected" does not rule out the
presence of PCR inhibitors in the patient  specimen or
hepatitis C virus RNA concentrations below the level of
detection of the assay. Care should be taken when
interpreting any single viral load determination.
This Assay should not be use for blood donor screening,
associated re-entry prococols, or for screening Human
Cell, Tissues and Cellular Tissue-Based Products (HCT/P).



OK now I see detected and understand that.  Does this test show the severity, as you see it?
What would be my next step other than seeing a specialist?
I am a smoker and know I need to quit. I am really trying to now and Have reduced my tabacco use to
less than 1/2 pack a day... from about a pack and 1/2 per day...


Thank you all for any and all help you can supply.
I have been a forum lurker for a few weeks and needed this test to ask these questions ( from what I did pick up previously.  


RonniePatWebb      

[RonniePATWebb]

ok received my blood test back from Duke University  I have an appt with Dr Patel on the 7th of July.. Just wondering if anyone would be able to help me decypher these in the meantime,,,,,here are my test also did hep  a/b  results were negative,


GENLAB Hematology      drawn May 19th 2009   AUTO BLOOD CT WITH AUTO DIFF

HEMOGLOBIN                       14.1         g/dL         [12.0-15.5]      
HEMATOCRIT                        0.43        L/L           [0.35-0.45]      
RED BLOOD CELL COUNT       5.05        X10^12   [3.77-5.16]      
MCH                                     27.9         pg           [26.5-34.0]      
MCHC                                   32.6          %          [31.4-36.0]      
RDW-CV                                13.5          %           [11.5-14.5]      
MCV                                     86             fL           [80-98]        
NUCLEATED RBC %               0.0            /100WC                      
NUCLEATED RBC COUNT      0.00        X10^9       [0.00-0.00]      
PLATELET COUNT /L              204        X10^9       [150-450]        
WHITE BLOOD CELL COUNT  8.0         X10^9       [3.2-9.8]        
NEUTROPHIL %                    56.2         %             [37.0-80.0]      
LYMPHOCYTE %                   34.5         %             [10.0-50.0]      
MONOCYTE %                       7.2         %             [0.0-12.0]      
EOSINOPHIL %                       2.0         %             [0.0-7.0]        
BASOPHIL%                            0.1         %              [0.0-2.0]        
NEUTROPHIL COUNT             4.5         X10^9       [2.0-8.6]        
LYMPHOCYTE COUNT             2.8        X10^9        [0.6-4.2]        
MONOCYTE COUNT               0.6        X10^9        [0.0-0.9]        
EOSINOPHIL COUNT               0.16       X10^9       [0.00-0.70]      
BASOPHIL COUNT                   0.01       X10^9       [0.00-0.20]              
                              BLOOD FILM REVIEWED




COMPREHENSIVE METABOLIC PANEL                                                            
Reference  SODIUM                      139         mmol/L      [135-145]        
POTASSIUM                                 3.9         mmol/L      [3.5-5.0]        
CHLORIDE                                   104         mmol/L      [98-108]        
CARBON DIOXIDE                         29         mmol/L      [21-30]          
UREA NITROGEN                           11          mg/dL       [7-20]          
CREATININE                                 0.7        mg/dL        [0.4-1.0]        
CALCIUM                                     9.2        mg/dL        [8.7-10.2]      
PROTEIN TOTAL                          *8.2         g/dL        [5.8-7.8]        
ALBUMIN                                      3.7         g/dL        [3.5-4.8]        
BILIRUBIN,TOTAL                           0.6       mg/dL       [0.4-1.5]        
ALKALINE PHOSPHATASE                83          U/L         [24-110]        
ASPARTATE AMINOTRANSFERASE   31           U/L         [15-41]          
ALANINE AMINOTRANSFERASE      34           U/L         [14-54]          
GLUCOSE                                      88          mg/dL       [70-140]




PROTHROMBIN TIME                                                            
Reference  PROTHROMBIN- PATIENT               11.1        sec         [9.5-13.1]      
PROTHROMBIN- RATIO                                  1.0                     [0.8-1.1]        
PROTHROMBIN- INR                                      1.0                     [0.8-1.1]                  
Reference Ranges:                  DVT/PE/PVD =                         INR 2.0 - 3.0            
Mechanical Heart Valve =       INR 2.5 - 3.5              
NOTE: The INR is not a PT Ratio and is valid only for Coumadin patients

appreciate any help
Thanx
Pat

[Jakied]

One thing no one has mentioned and this is good news for you.   Women, as a general

rule, have an easier time with hep c than men.  Estrogen is a natural defense so that is

a good for you.

[IMstacie]

thanks for following thru with your experiences.

[RonniePATWebb]

Duke University Medical Center yesterday 05/19.
My Dr. Patel ordered bloods test which I took b4 I left the clinic and has me scheduled for a sonagram(sp)  on July 7th.  They also referred me to a mental health professional because the medications I will be taking (they say) will leave me more depressed than I am now and they want me started on antidepressants before I start the medications for HCV.  So I got that started today.

I understand that some people do not understand what Hepatitis is and do not understand how this disease spreads ,, But this was toooo much
I went to the mental health office today and the LPN that was doing my intake evaluation wanted to know why I wasn't wearing a mask because hep. was an airbourne disease... well I educated her real fast(thanks to this forum and you guys)
I informed her that it was blood to blood contact only.  As far as I know I didn't need a mask for my blood ..she asked me if I was sure....omg
I started thinking back & when I was 16 yrs old (41 yrs ago) I did have a blood transfussion and could have very well contracted it that way.

[RonniePATWebb]

ty   everyone      I received a call from Duke and have an appt with Dr. Patel on 05/19


oneatenuff            ty  I will post updates as they come in...




Pat

[RonniePATWebb]

thank you so very much, You have all been helpful and given great advice... of course you all know what I am going thru which is the best part of this... I have no idea (well maybe) how I got it but in 2000 I was an American Red Cross blood donor so I'm sure if I had it then... that it would have been detected... right?   My X husband was cheating on me and I found out in 2004 his girlfriend died from complications of HCV..  so I am assuming that was probably it  but I also got a Tatoo in 2001  so none the less   Bottom line  I HAVE IT.. and it's not the END of my life.  I guess a liver Biopsy will tell more so I will wait til then and let ya'll know.   I really am glad you all are here XOXOXOXOX
Thanx Pat

[hopeful51]

You got some great advice already.
I just want to add now that you know don't let it make you crazy.Learn all that you can but don't forget to live your life.
Stay active and connected get support from family and friends.
You have probley had hep-c for a long time it is a slow progresive disease.
Everything is gonna sound scarry at first....like liver biopsy really not thay big a deal...
Now that you have found this forum you have hit the jack pot. At least thats how I felt.
The knowledge and friendship you have found here will help get you through it.
Good Luck
Hopeful51

[GSDgirl]

Welcome to the forum!!!  You already got great advice and are headed into the best of hands so good luck to you & keep us posted

[RonniePATWebb]

TYSVM for all your replies... I have contacted DUKE to see about getting into their Liver department and seeing a Hepotoligist(sp)  will continue to attend the forums... any further help is greatly appreciated.

Thanx
Pat

[oneatenuff]

Sorry about that  (I had my screen up for a long time and didn't see the responses before I posted my comment.)   Great advice from all.    Janice's is good site.

[oneatenuff]

Hi RPW (short).   As far as "severity" from the information you've got so far   (I see a viral load - which is in the 13 millions which would mean you do have it)   the answer is no - that does not tell anything about the "severity" of your condition, it doesn't say how your liver is doing.   (the viral load is a measure of the amount of virus in a sample of blood.)    

My suggestion is  (as far as trying to help you figure out now what you need to do now or how to prepare to deal with a diagnosis of hep C and your treatment options or if you even need to treat now)  is   .....  don't worry right now about how that particular test or even another one (at this point - since you are so new to this.)   Sure, it's nice to know, but for practical purposes now  (since you've just found out you have hep C)  don't get too bogged down now by labs and what they mean.  

Having an appointment in May seems like a long time, but it's not long to wait at all.  If it's any comfort, it's very soon compared to most. Try to be OK with that appointment date and not get worried that's it seems a long time off.

Fatigue is common with hep C, but the intensity of the fatigue does not correlate with "severity".  In other words, you can be extremely fatigued but that does not mean you are real sick from the hep C virus or that your liver is "bad off" or that you need treatment immediately.

If you can quit smoking altogether, you would be doing your liver a huge favor.  My hep doc says cig and pot smoking (in his opinion)  are as bad if not worse for the liver than alcohol.

Duke Liver Clinic is rated one of the best.   Dr. K. Patel, J. Mchutchinson  (all of them at the clinic)  are great.  The staff there is helpful and kind.   When you get seen by the GI doc again, talk to him about wanting to be seen at Duke Liver Clinic - ask if you need a referral from him to get there.   (Some do, some don't.)    If he does refer you, it might be a few months before they can see you at Duke  (but that is par for course.)  

You can also call Duke Liver Clinic  (Hepatology / Gastroenterology Division)  and tell the you are under the care of a GI doc (give name)  and that you want your care transferred to Duke.  They will ask you questions and then point you in the right direction and tell you what you  need to do.    

Ask your GI doc if he is going to do a liver biopsy on you.   Ask what Geno type you are.   Ask what your liver enzymes are and how your CBC looks.

If you drink alcohol (any)  stop drinking it.  If you're on prescription drugs, find out if they are OK for you to continue in the doses prescribed.  Ask how much Tylenol you can take (if you take it.)   Unless you're on a special diet prescribed by a doc, continue eating sensibly  (eat a good diet, veggies, fruits, cut out junk food, fast food, fats, sugar, try to eat lean meats, eat a variety.)     If overweight, try to lose some weight.   Take a nap if you need to but also get exercise.     Start walking and getting exercise if you don't do so now.   Staying busy and exercising daily  - or at least walking  (believe it or not)  will help your level of fatigue.   But clear it with your doc.   Ask doc if you have any health conditions that are a concern now with respect to hep C.   (cardiac, metabolic, pulmonary, etc.)  

Ask what your platelets are.   Ask what labs they will be monitoring and how often you will need to be seen.    

Others on the board will give your some good advice.   That's what I can think of right now.  

Good luck.

[Bill1954]

According to the results you posted, you have active HCV virus. Your viral load (the amount of virus in your blood is 13,600,000; while this is fairly high, it does not tell you how ‘severe’ your disease is. This is usually determined by liver biopsy; this is a fairly painless procedure that removes a little segment of your liver with a long syringe to study under a microscope. The results of this procedure determine the severity of your disease.

One of the first questions you want to ask the specialist is whether they have determined your HCV ‘genotype’; this is the particular strain of HCV you have been infected with, and will help determine the duration of treatment, if necessary; as well as the efficacy of the treatment drugs. Genotype 1 is the most prevalent in the U.S. as well as the most difficult to treat. Genotype 2 and 3 are more responsive to treatment drugs, and generally require less time to treat as well.

Take a look at the following site:

http://janis7hepc.com/

You might begin by opening the section “newly diagnosed” near the top of the page, or by clicking on “other HCV information” found in the right-hand margin. They have all kinds of info including help interpreting biopsy results, genotype info, etc.

Good luck going forward, and welcome to the discussion group—

Bill

[IMstacie]

I agree with copyman regarding the hepatologist - they seem to be the very best doctor for HCV.  I'm seeing a GI and have had problems.  

I think you may want to educate yourself before you see the doctor.  A couple of good sites:  http://www.hcvadvocate.org/hepatitis/hepC/hcvinformation_2009.html and http://janis7hepc.com.

Welcome to the forum and wishing you the very best.

[copyman]

sorry to say you do indeed have hepatitis C. The PCR test confirms this. If you can get in with the Duke doctors that would be your best bet. There is the best chance of seeing a "hepatologist" at a teaching hospital. They most likely do a liver biopsy to see the condition of your liver, If little damage then waiting for the new drugs in a few years is an option.
You should stop all alcohol if you drink. This is probably the worse thing you can do if you have hepatitis. Best of luck