Dear Dr. Holodniy, 38yo male is diagnosed with HCV according to: PCR >850,000 IU/mL , ALT 109, AST 61, Bilirubin 0.7,albumin 5 and biopsy that showed minimal portal fibrosis, chronic portal inflammation extending into surrounding lobules, no increase in iron stores and no cirrhosis identified. IU versus copies is new to me. It's high but what does it show? How active the virus is? Do we need some more tests to confirm HCV and which? I don't see genotype or CD4 anywhere in his results. I understand the duration of the treatment and choice of of it depends on the accurate and full results. Thanks in advance..

IU stands for international units. It is the current way of expressing copy number. DIfferent viral load tests will have a different correction factor to yield a result in IUs. There is no need to do additional tests to confirm chronic HCV infection. By detecting HCV viral load, by definition confirms chronic HCV infection. The level of HCV does not usually correlate with severity of HCV disease. It does correlate with treatment response (lower levels, better response). A HCV genotype needs to be performed to determine length of treatment and likelihood of response.