Asked in HealthConditions and DiseasesHepatitis
If you have active hepatitis c with a viral load of 189000000 Could you explain the significance of this viral load?
February 28, 2013 11:51AM
There appears to be no significant correlation between HCV RNA levels and ALT values or histological activity in patients untreated by anti-viral therapies (Interferon). Viral load varies between infected individuals but is not a useful prognostic indicator nor does it measure the severity of virus-induced liver disease.
"Our results indicate that the severity of liver disease is independent of serum levels of hepatitis C virus." "Our results indicate that the severity of liver disease is independent of serum levels of hepatitis C virus.
Severity of liver disease is best assessed by liver biopsy. There is in general a poor correlation between serum ALT level and activity of liver disease. More importantly, several recent studies found that significant liver disease can be found in anti-HCV-positive patients despite normal Severity of liver disease is best assessed by liver biopsy. There is in general a poor correlation between serum ALT level and activity of liver disease. More importantly, several recent studies found that significant liver disease can be found in anti-HCV-positive patients despite normal ALT levels. (1-3,5-8) These studies reported that 70 percent of RIBA- positive blood donors who had persistently normal ALT levels have chronic hepatitis or cirrhosis on biopsy. Although most donors (77 percent) who had abnormal liver histology were HCV RNA-positive, significant liver disease was also found in 30 percent of RlBA- positive donors who were HCV RNA- negative and had normal ALT levels on three separate occasions. This may be related to the fluctuating course of chronic HCV infection with intermittently normal ALT levels and undetectable levels of viremia. It may also reflect variations in sensitivities of "home-made" RT-PCR assays for HCV RNA. (9) Several studies reported that patients with more advanced liver disease had higher serum HCV RNA levels. (10-13) However, these findings were not confirmed by other studies. (14,15) It is unlikely that quantitative tests for HCV RNA will replace liver biopsy in the determination of activity or stage of liver disease. HCV genotype I b has been shown to be associated with more advanced liver disease. (16-18) Nevertheless, there is a wide spread in severity of liver disease associated with each genotype. Thus, genotyping cannot be used to determine severity of liver disease….
At the moment, HCV genotyping should be considered a research tool and not a part of the diagnostic algorithm in clinical practice.
Hep C information
Public health guidelines state that treatment should be considered for asymptomatic HIV-infected people who have viral loads higher than 30,000 copies per milliliter of blood using a test known as a branched DNA test, or more than 55,000 copies using an RT-PCR test.
US treatment guidelines (See Fact Sheet 404) suggest that anyone with a viral load over 100,000 should be offered treatment.
Many people are surprised to learn that hepatitis C viral load (the amount of the virus present in the blood) does not affect the course of the disease. In other words viral load does not predict the severity of liver disease, disease progression, or the development of complications due to hepatitis C.
However, HCV viral load level is important in estimating the likelihood of response and the actual response to interferon-based treatment. Overall, people with a low HCV viral load (less than 800,000 IU/mL) are somewhat more likely to respond to treatment than those with a higher viral load.
Hepatitis C viral load is most relevant when someone is undergoing interferon-based therapy as it is used to determine response to therapy.
Fibrosis is scar tissue that forms as a result of chronic inflammation and/or extensive liver cell death. The amount of fibrosis in the liver is one of the measures of hepatitis C-related liver damage that is evaluated with a liver biopsy. The extent of fibrosis is a reflection of liver disease severity.
Fortunately, most patients with hepatitis C have mild or moderate liver damage, and do not have an increased risk of death. Hepatitis C is almost always a slowly progressive disease, giving patients a long window of opportunity to cure their infection. If HCV is successfully eradicated, the liver improves each year instead of worsening. Only the liver and the bone marrow have this ability to regenerate. Over a period of years, the scar tissue in the liver will diminish after HCV is eradicated by successful antiviral therapy. Even biopsy proven cirrhosis has been shown to reverse in some patients. The risk of liver cancer or failure also falls, and with it the risk of premature death.