Hep C Discussion Forum

Your labs look fine, Mike.  Your Hgb hasn't changed since last time which means you are tolerating the Riba well.  You are UND!  

Btw, if you have a few platelets to spare send them over.  Yours look better than most cirrhotics who are not on tx including mine.  Time to stop worrying.  :)

Not sure why you are so concerned, the labs are very good Mike, the "Undetected" is great those are the words you want to hear, if there was anything present it would state that.

Take it as good news and do a couple happy dances for each time it says that word!

Happy to see such a good report for you !

Duane

I agree, the labs look pretty acceptable. However, you're right, there is information like the LLOQ missing from the report. Is this from the same lab you were tested at before? Might have it on another report.

Tig

Thanks for the positive reassurance everybody. I certainly am feeling good. I've been getting plenty of light exercise increasing some each morning, now that I have my former digestive issues solved, I'm eating healthy foods with an appetite that exceeds the ole pot 'munchies'  , and my mental state is really positive which has even shown to passing strangers at times lately.

I have decided to move from this rural town 53 miles away from the liver transplant center to a location in midtown Memphis TN, 1.2 miles from the transplant center. I was in Memphis today for 2 group meetings with my Tx nurse and HCV nurse and several other of the patients currently on Tx or post Tx, Those were at 8am & 3pm, so I viewed some rental properties in the interim time that I had researched the ads online and found one that I could not live without. So I paid 1st months rent and deposit on a very nice little apartment that looks to be taylor made for my needs. I have accumulated a lot of material things that will need to be moved and I have nobody to help me. But I feel so good that I'm confident I can't get everything moved by myself, with my van and small trailer provided I work at a slow pace and don't overdo it.

 LOL... previously I had mentioned to my Dr that I thought Sov/Riba and also my new HIV meds agreed well with me and even may be helping me to feel 'better than normal'. His reply was that I likely was feeling so good because I'm no longer putting all that alcohol, drugs, nicotine, and other poisons into my body. Of course, as usual, I know he is right. 

Those are good numbers Mike! Congrats on the continued UND! Good luck...

Tig

Got my UND, so I can finally not worry about VL until after 1-7-2015.

mallani wrote:

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Don't worry about it.

---

 I agree. I don't need the confusion and we also, thankfully, have you to explain results in simple terms. So I'll have the changes made in order to have all future labs done at the liver transplant center, and I'll post results here when they are available.

As always, thanks for your help Malcolm!!!

The blood for this latest result 8-19 and on 8-6, was tested @ LeBonheur Childrens Medical Center Laboratory using Roche TaqMan HCV v2.0 Real Time RT-PCR in vitro diagnostics reagents for quantitative detection of HCV RNA copies in IU/mL of plasma.

So I know that's not what we want.

___________________________

The blood drawn 5-2-14 (results attached) and yesterday was at the transplant center where my Dr's office is. And tested @ Clinical Pathology Laboratory in Austin TX USA using Real-time PCR, Roche COBAS Ampliprep/Taqman v2.0.

This result printout reads: Range of Quantitation 15-100,000,000 IU/ML. If this is what we want, then yes, I can arrange to have all my labs done at this lab location.

______________________________

mallani wrote:

1.5E +01 is the same number as 15. Any VL >15 will be reported as Positive and any VL <15 will be reported as Negative.

The result attached from 5-2-14 says "Positive" "722916". I understand that result - no problem.

But I'm still confused: The results on this last test says "Positive HCV by PNR < 1.50 E+1 (<1.18) IU/mL  (or as you stated <15 iu/ml)

So if it's < 15 iu/ml then why does it say "Positive"?

Thanks Malcolm. I'm truckin' on.

 This lab does something different every time. Last time the lower limit of quantification was not even given, although you assured me at that time that it was likely < 1.5 iu/ml.

And they took more blood today, which will be tested at a different lab (the one used for my 5-2-14 lab work, which I use as pre-SOT reference). I'm glad we have you because all this inconsistency makes my head spin.

I hope it will accept JPEG attached:

Isiscat2011 wrote:

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This is very common for HCV tx.  I was completely shocked by it then but now I realize that it is what it is.  

---

 I'm increasingly learning that this is true by the day. It's a good thing I have you and all the others on this forum to learn from so I can watch out for mistakes in my Tx. Also, for me it's even more of a challenge since my long time girlfriend died from HIV related complications, my recent lady friend across the street has now moved away and my only family is in FL. So that leaves just me to negotiate all this by myself with nobody who can go to appointments with me and be educated about it in order to fend for me if the time comes when I can't.

With the no-help deal it's always some detail that needs to be addressed such as when I went for an endoscopy, and they would not do it unless I had someone to drive me home. So I hired a young man who lived down the street to go with me that day. Now that young man has moved away so, in case of a colonoscopy, I was planning to rent a motel room close to the hospital, leave my car there, take a cab to the hospital, then take a cab back to motel after the procedure. Then the problem starts to be where am I going to get the $ for hiring a driver or motel, cabs etc on a small disability check? I am on a waiting list in a medicaid waiver program to receive help for this transportation thing but that won't be finalized for several months.

But all-in-all, obstacles included, this whole deal will be so worth it if I kick the dragons butt!!!

Mike:  I have to share one of my unpleasant tx stories with you.  

My platelets really took a hit.  Pre-tx they were 200 but within a short time they began to plummet.  My doc had ordered weekly blood tests.  Here was my routine:  On Friday eve at about 7pm I went to the hospital lab (open 24/7) and then waited for the results.  I took my Interferon shot as soon as I got home.  

So, my platelets had dropped to around 70 the previous week.  It was a Friday evening so I got my lab results and saw that my platelets were now at about 60.  I didn't want to skip my Interferon shot but was afraid to take it because my platelets seemed to be in freefall.  I didn't know much but I knew there was some connection between platelets and Interferon. 

I get home from the lab and page my doc.  His partner, who was on call for him, took the call.  When I asked him what to do about my dilemma he responded that he "did not know how to advise me because he does not treat HepC."  I told him that he needed to find out because he and his partner were responsible for my medical care.  He replied that I could stop taking the Interferon.  I told him that I was concerned about doing this because it might impact my SVR odds.  He then responded  "Take it, don't take it, I don't know. I can't advise you." Long story short, I took it and my platelets fell about another 10,000.  I was barely hanging on when my doc finally got back in town.

This is very common for HCV tx.  I was completely shocked by it then but now I realize that it is what it is.  

results

Just prior to starting Tx, I got the two for one special, a colonoscopy and endoscopic exam at the same time. Even though there seem to be little concern with having esophageal varices, my doctor thought it would be a good idea to rule it out. Went back to the same gastro who did a colonoscopy in 2005. He reviewed his notes from the 2005 exam when we met in January. He told me I got a "C" for prep, so he gave me the "grenade", a bottle of magnesium sulfate to take the day before the regular prep kit. Good advice (actually mandatory for obvious reasons) to stay close to the loo, but otherwise it wasn't that bad. I was on the exam table laughing with the nurses and the next thing I was waking up in recovery 2 hours later. Results were fine and I got a B+ for prep this go around! Hooray!

Well, I certainly have no anesthesia problem after all the surgeries I've been through and even if something about it is painful, I'll bet it's not as painful as me rolling on the bathroom floor with abdominal pain @ 3am this morning.

So I hope they get this scheduled and done, ASAP.

wmlj1960 wrote:

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 The nurse called this morning (imagine that) to check if any change with my constipation/diarrhea deal. There is no change for the better so she said they may do a colonoscopy next Tuesday. So that gives me something to research.

---

My PCP has tried to get me to have a routine colonoscopy a couple of times but so far I have been able to negotiate him down to stool samples instead.  I'm sure it is annoying to have me for a patient.  

The procedure itself shouldn't be too bad but the preparation can be a bit rough.  I wonder if they couldn't accomplish the same thing through imaging.  Not that it is something to fear; I just prefer the least invasive methods whenever possible.  

I expect a few people here have had colonoscopies and can give you the low down.  

Thanks Isis.

 I wouldn't say amazing but rather 'no alternative choice, coupled with the will to live'. What's amazing is how stupid I was to abuse my body for so many years, and put myself in situations that I knew were risky, and always going to do better 'tomorrow' and tomorrow never came. Well, today is that tomorrow and I have nobody to blame but myself, and that gets tough some days, but I've never quit anything, even when it would have been wise to do so. And I won't quit this battle either regardless of HCV, HIV, HSV-2, emphysema, peripheral neuropathy, arthritis, spondylosis, or aches and pains from car/motorcycle wrecks, lost fights, gunshot wounds, etc. The good news = all  this makes me think that I've finally found a constructive use for my extreme 'hard headedness'. LOL

Huey wrote:

 Pot  is not good for everyone,In your case Mike you have too much scaring.

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 Not to mention I smoked it like a freight train in the 70's and got to the point of only getting a case of paranoia from it. I have not wanted any for many years. I think I'll stick with the pharmaceutical, healthy foods approach on this one. Thanks anyway Huey. 

Thanks Isis. That's good news. I just feel a little weak but not too bad. As you know, with my HIV, I'm accustom too this feeling so no-problem. My main problem likely has very little to do with HCV Tx - constipation, then, diarrhea. Back and forth, that I think is caused by my new HIV Rx's. The nurse said that the Dr may do a lower GI if it continues until I see him on 8-26. I suppose I'll be able to make it until then without creating too many more new 4 letter words. LOL

 Here are some of the results from my 4 wk post SOT labs done yesterday. I suppose I'll have to wait until 8-26-14, when I see my Hepatologist, to get the VL, AST, ALT etc.

WBC's sure dropped, and RBC's/platelets too, as expected. But Hb is still 10.0 so how low is my Dr going to let platelets drop before putting me on Procrit or reducing Riba ?

Protein, Total

Result
    7.2 g/dL (8-6-14 6.7)

Normal: 6.4 g/dL - 8.2 g/dL
__________________________________
CREATININE

Result
    1.20 mg/dL (8-6-14 1.18)

Normal: 00.60 mg/dL - 1.30 mg/dL
__________________________________
WBC

Result
    5.7 thou/mcL (8-6-14 7.2)

Normal: 4.2 thou/mcL - 10.2 thou/mcL
____________________________________
Sodium

Result
    135 mmol/L (8-6-14 133)

Normal: 136 mmol/L - 145 mmol/L
___________________________________
RBC

Result
    2.75 x10(6)/mcL (8-6-14 2.81)

Normal: 4.20 x10(6)/mcL - 5.60 x10(6)/mcL
_________________________________________
Potassium

Result
    4.3 mmol/L (8-6-14 4.8)

Normal: 3.5 mmol/L - 5.1 mmol/L
__________________________________
Platelet Count

Result
    130 thou/mcL (8-6-14 143)

Normal: 150 thou/mcL - 400 thou/mcL
___________________________________
Hemoglobin

Result
    10.0 g/dL (8-6-14 10.0)

Normal: 12.8 g/dL - 16.4 g/dL
____________________________________
Hematocrit

Result
    30.1 % (8-6-14 28.9)

Normal: 38.8 % - 48.1 %
___________________________________
Glucose, Serum

Result
    94 mg/dL (8-6-14 85)

Normal: 65 mg/dL - 99 mg/dL
_______________________________
Chloride

Result
    102 mmol/L (8-6-14 98)

Normal: 98 mmol/L - 107 mmol/L

-- Edited by wmlj1960 on Thursday 21st of August 2014 06:36:25 AM

Hi Mike,

Here's my take on your labs:

You are still Detected for the HCV, with a reading of 23.3 iu/ml. This is very low, and although the report doesn't mention the LLOQ, it is probably 15 iu/ml.

You have the Ribavirin anaemia, with decreased RBC, Hb and increased MCV. With a Hb of 10, you should be OK for a while. The platelets are just a bit low, but this is probably cirrhosis-related. The white cells are good, with plenty of neutrophils.

Your liver results show a typical cirrhosis pattern, with decreased albumin and increased bilirubin. Your AST and ALT are quite low, which suggests you don't have much liver inflammation at the moment.

Looks good buddy. Lets hope for Undetected at the next one. Cheers.

Huey wrote:

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Improvement is good,  My thoughts on your situation is I wonder if the HIV somehow competes with the HCV and if you attack one without getting just as much of the other, the imbalance will tip the scale in favour of the one not getting attacked? Or Not,  If I were you I would try to somehow keep the treatment balanced and kill a little of both so you lower the VL without raising the competition level. It will take a vary strict protocol to do this.

---

 Thanks Huey,

 That has crossed my mind. The Rx's for fighting both infections even sound similar - ribavarin, sofosbuvir, darunavir, etravirine and tenofovir (Viread), one of my HIV Rx's, is also used in treating Hepatitis B. I know each Rx has it's specific job for fighting specific infections, but it seems like there should be some advantage to having all these virus killing Rx's working all at once. I have no idea of a way to "balance" the mix though.

I'm certainly more interested in curing the HCV virus than the HIV since, with proper antiretroviral therapy these days, an HIV+ individual can live a full, healthy, Sx free life. Without a SVR the HCV will always continue to attack the liver.
HCV drugs are getting much better, but in some cases, such as decompensated cirrhosis and HCV/HIV co-infected individuals, the HCV cure rates are still not very impressive.

So eating liver friendly foods and not eating liver unfriendly foods, taking 'ALL' of my Rx's on time, exercise within reason, and becoming educated with the facts of my illnesses is about as "strict" of a protocol as I know how to get.

These labs were done 7-17-14 ordered by my HIV Dr. CD-4 338, HIV VL <20 copies/mL. That's the best results I've seen in several years. But I suspect the HCV Tx will trash my HIV #'s once again, but hopefully not too bad.

Hi Mike,

Looking good, apart from the Hb and RBC level. As Isiscat said, the haematocrit is just a volume % of red cells in blood, so it will be low when the red cells are low. That's all due to Ribavirin. Your doctor will decide whether to drop the Riba dose or add procrit.

Your platelets and WCC are OK, and shouldn't be affected by Sovaldi/Riba. Let us know your ALT when you find it. All the best.