Hep C and DLBCL

I believe you have asked about this before - maybe even in the first thread you started on this forum.

Chemotherapy means hard work for the liver, metabolizing all those "poisons" necessary to kill the cancer cells. Liver enzymes, therefore, are likely to become elevated during treatment.

Hepatitis C is caused by a virus. If Terry has tested negative for this infection, how could his treatment reactivate a virus that is no longer there?

I never had any form of hepatitis, and tested negative for those prior to my first R-CHOP. Nevertheless, my liver enzymes, like Terry's, crept up steadily during treatment. As a matter of fact, they shot up to FIVE TIMES the upper limit of "normal" a couple of months after chemo was over. The hematologist did raise an eyebrow then, and ordered a sonogram, which was perfectly normal, and weekly blood tests, which showed those worrisome values subsiding after two or three weeks. That episode was very likely due to a ten-day round of anti inflammatory prescribed by my PCP for acute back pain. My liver enzymes have since returned almost exactly to their pre-chemo levels - well within normal.

Terry's doctors are certainly well aware of his past history of Hepatitis C and keeping an eye on his blood test results. It cannot hurt to make sure they see anything that is not looking normal, of course. It might also serve the purpose of reassuring you if you ask them what they think of those values in Terry's particular case.

PBL

I, too, had normal bilirubin and elevated LFT's throughout my chemo.  All back to normal now, so don't take these results as an indication of anything more than what PBL and Max have said.  As long has his viral burden by PCR stays at zero, it's at zero. No reason to expect re-emergence of this particular virus/disease.  

unknown said:

Thanks, everybody.  Sorry if

Thanks, everybody.  Sorry if I repeated myself . . . not unusual for me these days.  I mentioned it again only because we were told that there is one of the RCHOP drugs that can reactivate viruses.  I think it's the Vincristine.  We were also told that the screening test for Hep C will always show Hep C antibodies; but that when the PCR test comes back negative for viral load, we can assume the Hep C has been "cured".  With the liver enzyme tests rising, and that dang Vincristine stirring things up, as we were told, I felt it deserved another "ask".  The PA for our oncologist, back before we started chemo . . . asked Terry if he had ever had chickep pox . . . as THAT virus/antibody history could trigger shingles.  I know I'm probably worried for nothing . . . yet, to see those liver tests rise again with him . . . just triggers the obvious concerns that, yes, all this stuff (I realize) can cause permanent liver damage.  I wouldn't necessarily worry as much as I do about that if he hadn't had the Hep C, but given his history I would think it only increases his chances with that.  I know.  I know.  One worry at a time with all this.  But with each day . . . and each abnormal anything . . . it's a different worry/concern with any of these abnormal results.  We're hoping and feel confident that he will make a full recovery; but, I'm sure you can understand and wonder, Is the cure worse than the disease?  Obviously, we're confident we made the right choice in going this route to try and nip this all in the bud; yet, with that choice, obviously, comes added concern for what it can do to a person, long-term.  Trying to focus on the remission we hope is ours; but that doesn't stop all the concerns we each have, right?

Thanks for listenig and for the reminders that this junk plays with every system in a person's body and that what we're seeing is "normal" "abnormal.  It helps.

On the port issue . . . things seem to be much improved; so, I think we're on schedule for Hit #3 this Thursday.  

Take care all . . . 

Til nex time . . . 

Over and out.

Some viruses integrate into our DNA and remain there, essentially becoming "part of us" for life.  The one we are all most familiar with is Varicella zoster, which causes chickenpox. If reactivated later in life due to immunosuppression, etc., it manifests as shingles.  HCV is not known for doing this; it is a different kind of virus.  Can a person have undectable levels of virus still infecting them?  Of course that is possible.  But generally speaking, no virus = no virus.