I run a support group for inmates and one individual was wondering What is the deal with the viral load concerning hep C? whats good and bad? with Hiv T-CELL COUNT BELOW 200 IS aIDS IS THEIR AN EQUVALENT DANGER ZONE FOR HEP C PATIENTS. wHAT NUMBERS SHOULD HE BE CONCERNED WITH, ALSO WITH HIS LIMITED ACCESS TO ANYTHING SHOULD HE BE ON A CERTAIN DIET OR EXERCISE PLAN?

Excellent question. There is no good correlate of CD4 cells and fibrosis in Hepatitis C. For example, the height of the virus does not tell you anything about the severity of disease.

There are some non-invasive blood markers for fibrosis. These markers are best to identify persons with minimal disease and those with advanced disease, but they are not as good in identifying people in between.

I often will order a liver biopsy to determine the degree of disease in patients with genotype 1 infection, which is a bit less responsive to treatment. However, in patients with genotypes 2 or 3, which are easier to treat, I simply treat if the patient is interested in trying therapy. After 4 to 12 weeks of viral load monitoring, I will have a good idea if the treatment is going to work or not. If not, I stop the therapy. If the patient is responding very well, all the more reason to complete the course, which is only six months max.

Hope this is helpful.