Lullabie:
I went to my first doctors appt today for my HEP C. This is the information I received: Genotype: 1A Viral Load: 7,120,000 Degree of Liver Damage: Unknown at this time
I have several appointments for blood and a liver scan before I return to the Doctor on July 31, for evaluation and a treatment plan.
Can anyone explain to me what the viral load and genotype means?
Thank you
Mugwump:
Genotype 1a was in the past the most difficult to treat. Today your treatment options are so good that your chances of a cure with just one treatment are well over 95 percent. The different Genotypes of HCV differ in that they have very slightly different sequences of RNA. HCV is a retro-virus and as such is a very tiny block of RNA that encapsulates itself to become active. The virus is not living in the sense that it does not propagate in the same way that organisms with DNA does. It requires complex proteins and proto- proteins that are only created in liver cells to transcribe the genetic information contained with in the viral code.
HCV has a structure which creates a unique shape that allows it to enter hepatocytes (liver cells). This shape is like a skeleton key that allows the encapsulated virus to inject the RNA particle intact into the liver cell at a specific area in the membrane surrounding the human hepatocyte.
The new treatment take advantage of the same structural shape that HCV uses to inject RNA into cells. The new drugs use the same structural shape to inject antivirals directly into liver cells. A very smart biochemical scientist Dr. Micheal Sofia did not listen to the detractors who said it was impossible. So he invented the first drug that used the chemical shape associated with the same key that HCV uses to infect cells called sofosbuvir. Since then many other drugs have become available and are getting better at treating HCV all the time.
The best way forward is to learn as much as you can about the different treatment options open to you and prepare yourself both mentally and physically for being cure quickly. Most importantly keep active and involved with the treatment process and you will do great.
All my best Eric
Lynn K:
Or another way to think of genotype is like there are many varieties of the flu like bird flu swine flu etc. but they are all the flu. For hep c we have genotypes so just not as fancy names. There are I believe 16 different genotypes with the exciting names of genotypes 1a, 1b, 2a, 2b, etc... the genotype you have will determine which treatment for hep c would be best for you. The other number is your viral load the number of copies of virus circulating in 1 mL of your blood. The viral load doesn’t matter much except they will test you at the end of treatment (EOT) and 12 weeks after treatment has ended to make sure you are Not Detected 12 weeks after finishing treatment to know you are cured. They may test you at 4 weeks into treatment. You should have a huge drop in viral load and will likely be Not Detected at that point but the test that says you are cured is the one at 12 weeks after finishing treatment.
Best of luck
Lullabie:
My second appointment with the Doctor is Monday July 29, 2019. Not July 31. I believe I will start medication at that time. Lynn, can you advise me of what questions I should ask? As you might imagine, at this point I'm still having sleepless nights and high anxiety with my concerns over my situation.
Lynn K:
You may still have to wait to start. Do you have a prescription yet? Has it been approved by your insurance?
As far as your doctor appointment have they evaluated you for liver damage you could ask about that. I doubt you have any as it takes many years of infection for that to happen. How are your lab tests any out of normal? Likely your ALT and AST are slightly elevated due to hep c infection but probably just those.
Also, what time of day should I take these meds should I take with food or does it matter. Any foods to avoid or other medicines to avoid on treatment? What should I do if I miss a dose? If I want to change the time of day I take my meds can I do it all at once or shift the time over several days? What are the most common side effects of this medicine anything I should look out for?
As far as sides most people tolerate treatment very well worrying can actually create its own symptoms so try not to talk yourself into thinking you are having a symptom when it could just be your worry working overtime to make you feel unwell.
Which med will I be taking and for how long? Will I need to come for any testing while treating? When will I be tested for the virus post treatment to know I’m free of hep c?