Reactive hep test, pls help

[Els1234]

Hey! I recently had blood work done in order to start Accutane.  The nurse called and told me I had a reactive hep test and my liver enzymes are elevated.  Let me preface my question by saying I'm a recovering heroin addict.  I used for 7 or 8 years and have been sober no drugs, no alcohol for 3 years.  I obviously shared needles often and reused my own needles.  I know you can test positive for hep but not have the active virus and the wait on the second test to see if I have the active virus is driving me crazy.  Is having elevated liver enzymes a pretty indicative of having the active virus? I know no one can tell me I do or don't have it, I guess I'm just looking for a probably or probably not.  Obviously I'm not surprised by these test results, so I promise I can take any feedback I get. and if I do have the active virus, what then will be done? Will a doctor automatically want to treat it no matter what stage it is?

[lporterrn]

The answer is probably. Great that you have been alcohol-free for a few years (as well as drug-free!) and assuming that your drug use is your risk factor, then you haven't had it for long. (Long is more than 20-30 years) The really great news is that hep C is curable and the cure is fairly easy to tolerate. As for treatment, it depends on the doc. I believe the earlier the better.

So, wait for the results, then let us know. In the meantime, do yourself a huge favor and don't freak out about this if you can. If you are in recovery, stay close to your posse and us, and together we'll get you through this. Assume you are positive and learn about transmission prevention. https://www.hepmag.com/basics/hepatitis-c-basics/hepatitis-c-transmission-risks

[Els1234]

OK I definitely will! Should find out for sure if I have the active virus next week. Thank you so much!

[Mugwump]

If you are confirmed to have a viral load then it is time well spent learning about how the liver reacts to HCV.

Some people show very slow progress and the disease can take many years to progress to significant liver impairment and the onset of cirrhosis.

Other people can react quickly to the disease and have it very quickly damage the liver. But these cases are in the minority. Over 70% of individuals that have chronic HCV infection live relatively normal lives and the disease progresses very slowly.

Most importantly if you have a viral load that seems very high do not think that this means that you are close to having cirrhosis. Over the years my viral load went from the low hundred thousands all the way to over 15 million.

What happens is that if you have chronic active HCV you need to have regular liver panel tests done usually on a six month basis if you are not undergoing treatment immediately. It is not important to have viral load tests done every time you check your liver function. A good GI will test for viral load only if you have elevated liver enzymes for a sustained period of time.

There are very good references in this forum to what the test results all mean. But here is a general reference about the most important ones.

As well as a Complete Blood Count these liver function tests are the ones used to make the critical clinical decisions

ALT
AST
 AST (SGOT) and ALT (SGPT) are reasonably sensitive indicators of liver damage or injury from different types of diseases or conditions, and collectively they are termed liver tests or liver blood tests

Bilirubin
Bilirubin testing checks for levels of bilirubin in your blood. Bilirubin (bil-ih-ROO-bin) is an orange-yellow substance made during the normal breakdown of red blood cells

GGT
The gamma-glutamyl transferase (GGT) test may be used to determine the cause of elevated alkaline phosphatase (ALP). Both ALP and GGT are elevated in disease of the bile ducts and in some liver diseases, but only ALP will be elevated in bone disease

ALP
The alkaline phosphatase is the most frequently used test to detect obstruction in the biliary system.

During treatment the testing is more frequent and the viral load is usually checked at commencement, at four weeks into treatment to ascertain that the drug(s) is/are working, at end of treatment and post treatment to ascertain if you have achieved a virus free status and the treatment was a success.

I sincerely hope you get treatment early if you are HCV active.

All the best however things turn out, most here have been through a lot and the stress of not knowing what tests mean is a common problem for many. You will fight the fear and other stressful effects better if you are well informed and are not afraid of what the specialists tell you.

Eric

[Els1234]

Thank you for all of the info. I've seen so much on here about test results questions. I gather HCV is one of those things the patient also has to do a lot of research on. So from here on out I will be asking for copies of my results. Thank you for all of the insight and support. I should have an update to post next week!

[Raney]

@ELS1234...   Welcome.. I too, am a recovering addict after 20 years in the lifestyle, I was an iv user (meth) for 10 years. I am now almost 4 years clean. Here is my experience:

On a routine blood test in Dec 2014, they found the HCV in my blood. In Mar 2015, they did further testing and found my viral load (20,000) , and my genotype (2b). In April 2015, I did a prometheus liver scan and was (F1-F2), so I was still unqualified through my insurance to get the treatment but my gastro kept tabs. In Nov 2015, my VL was 306. My mother had hep c and her body rid itself f it, so I was hoping. In Mar 2016, my VL was 40,000 via my primary Dr labs. In April, with my gastro Dr, my VL was 1546.  I finally got approved for 12 weeks of Sovaldi & Ribavarin. ** the reason I share all this is to answer your question: "will my dr want to treat me where ever it is?" My counts are very low and my liver function is completely normal, so I would assume, YES. They would rather treat it now, versus down the road when more serious situations can (notice I said, can, NOT will) occur (i.e. cirrhosis, liver disease, etc..)

Was freaked out after reading the side effects. Was supposed to start tx May, was going to put it off until July, but let me tell you... these forums have helped me tremendously. After reaching out here and getting feedback, I decided to start the tx this past Saturday. So far, so good.

Please stay connected to these forums and you will find all of your answers and the feedback is amazing. I hope all goes well for you.. I am sure it will, since, as with anything else, there is a solution that leads to the cure.