Avatar universal

Newby Here. Known I've had hep c since 2001.

I know that I have hep c.  I know that it is genotype 2b.  My viral load has gone up from 1 million to over 15 million since 2009.  I just saw a gastro dr about it.  I was very sick about a month ago and my ammonia level had gone up to twice what is normal.  The dr always tells me that my liver enzymes are good.  I want to know what stage I am in and what damage is done to my liver.  I heard that your enzymes can be fine but damage is still happening.  I asked about a biopsy and he said they don't do that anymore.  This is the Veterans Administration Doctors.  He said it was not just the VA that stopped doing them.  He said it was because of the bleeding risk.  How can they find out what stage I am in.  I want to know if I am end stage because I am always have nausea and am weak and don't feel like eating.  I have lost 8 pounds in a month.  Can they tell what damage is done just by numbers? They did not explain my labs but I have them and it says my It says my viral load is 15048137 and underneath it say HCV, LOG 10 7.8 .  Any advice for the newby.  I am thinking of treatment but am almost 60 and don't know if I should.  I just want to know how to stage my hep c. Help please?
5 Responses
683231 tn?1467323017
Hi those numbers are your viral load or how many copies of the virus are in one ml of your blood.

Viral laod also does not indicate how muck liver damage you have.

The is a score called a MELD score it uses some of your blood test results to stage your liver disease and determine transplant list placement. The MELD score uses your bilirubin creatinine and INR results.

Do you have abdominal ultrasounds every 6 months along with blood testing to include a test called AFP? Have you had an upper endoscopy to check for esophageal varicies?

Having problems with ammonia sounds like a symptom of liver cirrhosis. Have you been diagnosed with liver cirrhosis? What type of Doctor do you see? It sounds like if you are not you should be seeing a hepatologist ( liver specialist)

One test they have now is called a fibroscan which can stage liver disease.

Good luck
Avatar universal
I agree with what Flyinlynn has told you. People with high ammonia levels are most often cirrhotic which is Stage 4. They also have low platelets and that is something you can find in your routine CBC lab work. Your doc is correct. Most are not putting people through biopsy any more. The new direct acting antivirals are so successful and easy to take, it is not necessary to know your stage. However, being that you have signs of cirrhosis, you do need an ultrasound every six months and an upper endoscopy to check for varices. If I were you, I would certainly consider treatment as it will likely stop the progression of your liver disease and lower your risk of liver failure or liver cancer. Disregard what your liver enzymes are doing. Many cirrhotics have normal enzyme levels. Look at your ratio of AST to ALT. If it is more than 1:1, it is also indicative of cirrhosis. You are certainly young enough to treat. Wishing you the best.
683231 tn?1467323017
Just to add you asked about

"viral load is 15048137 and underneath it say HCV, LOG 10 7.8"

Both numbers are your viral load the first is in regular counting numbers the other is the same number but is converted to the logarithmic scale which is a number type researches sometimes use to count virus populations and other natural phenomenon like earthquakes.

Yes your viral load is 15,048,137 or basically 15 million copies of the virus are circulating in each mL of your blood.

I was treated a total of 5 times over the years I finally was cured last year at 57 years 6 months of age.

I am now 58 and have had cirrhosis for over 8 years.

Also you said you were sick from ammonia did they say you have  hepatic encephathalopaty (HE)? Are you being treated with lactulose to treat your high ammonia levels?

If you do have cirrhosis you should be seen by a hepatologist or a gastroenterologist who works with a hepatologist and is associated with a transplant center. They will know best how to help a patient with cirrhosis (ESLD)
Avatar universal
I told the VA when I joined them that I had hep c and they tested me for it and found out the genotype and viral load.  They sent me to a hepc class and that is it.  That was 12 years ago.  I am sick now and they are finally sending me to gastro.  I am having a colonoscopy and the one that goes down your throat in June.  My doctors have been neglectful and even neglected to tell me that my kidneys are having problems.  I found that out myself when I read my lab reports and eFGR has declined from 74 to 60 which is the lowest normal range in 2 years.  My thyroid is also messed up with hyperthyroidism and goiter.  I have no idea if I have cirrhosis. That is why I try to read my own labs.  I worked in the hospital in the military and my best friend was head of the lab and he taught me how to check things.
163305 tn?1333668571
If possible go to a hepatologist instead of a gastro as they specialize in livers.
As Flynn mentioned high ammonia is a sign of cirrhosis and a side effect HE, hepatic encephalopathy.
What can help, is first, do not drink any alcohol. Anyone with hep c needs to quit drinking.
To help alieviate the side effects of HE, restrict your intake do iron, don't eat red meat, and go on a low, or no, salt diet.

I had ESLD, received a transplant at the age of 55, did hep C treatment ( and now am doing great !
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