Viral Load

[debbiemac40]

I took quite of few of yours advice and stayed away from Medhelp for awhile.   Yes, it has helped and now I am back.  Finally had my 6mth followup to be told that I will be starting my classes in a couple weeks then I will FINALLY get started on treatment.   Those of you that dont know me it has been almost a year since I found out I have Hep C and now getting treatment.   One of the questions I ask the doc today was what is my VL and he said 83,860 but said they dont go by that.  Also doing a fibrosure blood test and if it comes out abnormal then he will do a biopsy.  Is this normal procedure?   They also ran a TSH, liver biochemical test today.  So for those of you that understand what all this is I would greatly appreciate any help.  

Debbie

[IAmTheWalrus]

Sounds like you are headed the right way to me. The fibrosure is just a noninvasive way to get an idea about liver health before going with the more invasive biopsy. It weems more an more that many go on treatment regardless of whether or not the fibrosssis has progressed significantly. It used to be wise to wait because the treatments were not very effective. Now that PI drugs are approved and being uses, I think there is less reason to do this "wait and see" approach. That said, there are even newer drugs currently in trial that promise more effective treatments, amd more importantly, treatment without interferon, that could raise this question again. I know I am waiting for a new TX, but that is because I am a TP patient and using the current PI regimens is ill advised and even dangerous because of drug interaction with immune supressant drugs.

[Susan_1a_CC]

I was told by my hepatologist that the fibrosure is most accurate on either end of the scale of damage i.e. very little liver damage or quite progressed damage; less accurate in the middle of the scale.  HTH.

[GrammyA]

Something else I discovered.  STAY out of the sun PRIOR to treatment too.  I am starting my 2nd week and have now acquired all the standard side effects.  One of them being the awful rash.  But, the worst areas where this rash has the largest welps is where I got sunburned about 3 months ago and it then peeled that skin.  It is like the delicate tissue is impacted by the drugs in a much stronger way.  My rash is already from the neck down.  Put that with the nausea, headaches, chills, fever, dizzyness and fatigue.....everything but the anal fire..... and it has been a week to remember.
Good Luck on your journey.

[Dawn703]

Idyllic is right, I had a full metabolic panel done as well as all complete for the thyroid, CBC, etc... I understand the nervouness you must feel;heck I'm still nervous. a positive attitude is oh so important, so you are starting off right. You have to go into this with the attitude that you will be healthier; you're doing this for your life. And everyone on this forum is here to help when do you start treatment. And def check out what OH pasted.

[BoceprevirGal]

  Well, the FibroSure test will show some pertinent imfo, most definitely.
   Make sure to get a copy of it, and then, if something is "out of range" (in the labs), you can refer to it.
  My FibroSure test indicated I had cirrhosis. So I wnet and had a biopsy, which had me at Stage 2 (Stage 4 is cirrhosis) so, I think the biopsy was more accurate.
   But if your FibroSure test is normal, then I guess it woul dbe a personal choice, of wether you wanted a biopsy or not.
  

[orphanedhawk]

I made a list of questions for the doctor that you might want to look at:
http://www.medhelp.org/user_journals/show/360204/guestions-for-doctor-for-newbies-to-tx?personal_page_id=17823

Good luck in going forward.

[1swimmer]

Hi there,
I had the fibrosure test; I did not do a biopsy. At the time, from what I had read, if I knew I was going to treat, didn't really need to do biopsy. The more I have learned makes me curious, and, starting over I would get a biopsy.

With the fibrosure test, like a biopsy, there are degrees of error. If you score lo or high, these are the more accurate areas of fibrosure. If you fall in the middle, it's less accurate. I was a F0 with lots of viral activity.

The test itself is a blood test that measures 6 aspects of your blood, spins it through an algorithm and this suggests a likely state of your liver.

Good luck,
C

[Idyllic]

I think your doc may have meant that your VL is not a reliable prognosticator of the state of your liver. As Dawn says, your VL is an indicator of how you are responding to the HCV meds. I would have loved to have a Fibrosure but I only had a biopsy. I will let others share pro/con of these.

So far it sounds as if you are on track. If you have not done so you may want to get vaccinated for Hepatitis A & B. The the closer you get to treating you have a series of baseline labs. It is a comprehensive set of labs for comparison to future results such as lipid panel, iron panel, AFP,  TSH, Free T4, Free T3, thyroid antibodies, autoimmune and a boat load of other ones that you will probably never in your life need again :) Plus you may want to schedule a visit with an ophthalmologist for an eye exam, dilation & a retinal scan.

I think there is a thread on somewhere that mentions all the pre-treatment labs & health check ups. I remember at the time thinking many of the labs were unnecessary but I was glad for the thyroid one since my TSH skyrocketed a few weeks ago. I had an Endo look at them and to him there is no reason why my thyroid function should not return to normal when I am finished treating. I am not sure how accurate he will be but it was encouraging to hear and I guess we shall find out soon enough.

[debbiemac40]

Thanks Dawn for the info.  the more I read on here the more I learn each time.  I have started a notebook with side affects and what to take.  meds tracker and emergency numbers for my family members and myself to help me remember.  My memory just isnt what it used to be and I havent even started treatment ..lol
Am I nervous about treatment.. heck yea but right now I have a positive attitude about it and some really great support from family and friends and every one on here.

[Dawn703]

Well welcome back. They should go by the viral load to monitor your response to treatment, otherwise it means nothing. The fibrosure,  don't know too much about. But it is non-invasive, but I think not as accurate as a biopsy. Someone will correct me if I'm wrong. TSH is for thyroid (treatment can cause thyroid issues and I think also people with HCV in general can have issues) and the liver test is for increased enzymes, mainly AST and ALT (gives an indication of liver damage but NOT how much).