The issue of low neutrophil counts is complex.  Neutropenia is defined as an absolute neutrophil count < 1500.  However, significant increased risk of infection does not occur until ANC < 500 and goes way up with ANC < 100.  Duration of neutropenia is also a risk factor.  So one day at 100 is lower risk then 5 days at 100.  Neupogen (filgrastim) can be used to raise the ANC.

thats the prolly mixup between LLOD and LLOQ terms...i remember she said log 1.2 (that shoudl be 16ui/ml) what they consider limit for UND.

just got back from my doc. As i thought, only UND counts for RVR, but still she said my result is still good and that if i am really keen on getting less interferon than supposed to, couple of shots less than 24 won't make a difference (she had patinets who took 22shots instead 24 with no difference in SVR rates). So i might go for 21shot if i am UND @ week 8 and 12 of course. If there will be still some viral load on week 8th i wont say a word anymore about shots reduction.

my blood is getting worse tho (neutrophiles espec)

WBCC 3,0
Neutrophiles 1,2 (not sure when it gets really serious, at 0,9? i already have constant infections in mouth and throat)
RBCC, Hgb is low but still got room to fall more

liver enzymes are great tho!
AST 23 (11-38 ref)
ALT 21 (12-48)
GGT - 21 (11-55)
ALP - 74 (60-142)

she told me start taking strong Vit B12 dose (2x500mg), and that there are options with meds to force neutrophiles production when it gets really bad. I have also asked now that i lost so much weight, shall i receive less dosage of Interferon according to my new weight, but thats really not advisable, even if i loose more weight. I must stick to initial dose (tho it was higher dosage for my initial weight). I don't get this around dosing PEGylated interferon alpha 2b vs PEGylated interferon alpha 2b

i talked with her in case i relapse. I am ready to save money to obtain sofosbuvir from USA on my own when it hits USA market in 2014. (or daclatasvir or Abbot's meds, but seems Sofosbuvir will be first on market) and she will gladly be my doc with it. She is also very excited about it's potential, but jokes we will get it here in 2057 year. Still no Boceprevir or Telaprevir here and no sign where will it be available, so situation with new meds arriving here is really bad ;/

Hi Zlikster,

Just a quick one. The previous Abbott PCR tests quoted a LLOQ (Lower Limit of Quantification) which was higher than the LLOD. The newer tests, from both Abbott and Roche, have the same LLOQ and LLOD. The older Abbott tests quoted a LLOQ of 43, 25 or 15. All of these then quoted a LLOD of 10. This is why I was confused- I am so used to the newer tests with the same values that I forgot there was often a marked difference in the older versions. Cheers.

Hi Zlikster,

See what your doc. says. To me, 51 i.u./ml positive means Detected, but it's still a great result.

I have a special interest in the different VL tests, and Abbott have received approval for their latest HCV PCR test, which has a LLOD of 12 i.u./ml. Abbott claim this is there most accurate version ever. If Bosnia has an Abbott PCR with a LLOD of 10 i.u./ml, I'm confused. Perhaps I should find another hobby. Anyway, you're doing very well and be guided by your doc. Cheers mate.

Good News!

RVR = undetectable at 4 weeks

EVR = at least a 2 log reduction at 12 weeks

The lower limit of detection depends on the method used by the lab

Hi Zlikster,

1 log unit is 10 i.u. It's really odd (and inaccurate) to report such a low number in Log. format. You'll need to wait to see your doc to get the full result.    In Bosnia I would expect that the Lab is using an assay with a LLOD of 50. Your result should say ' <50 Undetected'.  Try to find out the exact wording. For an RVR, you need to be Undetected at week 4- the log drop is not relevant. Sounds good. Cheers.

funny thing was, when i called microbiology dep @ hospital to check is my VL test done...they called main doc there to tell me result, since they thought i was not on riba/peg therapy. I've paid for test, so they thought i was healing myself with some alt therapy or something ;-D silly

Hi Zlikster, sorry I`m not Malcolm!    But yes you`re right, RVR means that there`s no detectable virus @ 4wks.  I can understand you being so anxious, but you haven`t seen a copy of your results or spoken to your hepatologist yet, so try not to panic.  The main thing is the meds are working, and that`s a huge drop in viral load!  Hang on in there...Jill

just called hospital to check is my PCR done (4th week VL check). Technician didn't said how much in UI or copies,  she just said  less than/log 1. My VL base was 25k UI (Log 4.4), so does that makes 3.4 Log drop? I am glad to see drop like this, on other hand i am not that happy since this means i am not RVR which i hoped for so that at least i get few shots less of interferon (and spare my audiotory system more damage).

I will prolly do VL check again on my own on 8th week (insurance covers only 1 VL check @ 12th week)...hoping for UND ;/

Hi Bouba

yeah log 1 is from 10 UI/ml to 90 UI/ml...Not sure whats the treshold or type of VL test they use @ hosptal. I still dont get RVR definition, somewhere it says <50UI/ml, then again <20UI/ml or UND @ 4th week...

i'll try to subdue my anxiety until Tue apt


cheers!

log 1 is is very very low. nothing to worry about.

I dont even know how low. 100'000 IU is log 5, 75'000 - log 4.875.

1 should be the same as undetectable.

my labs show < 15 IU, which my liver doctor said was negative.

15 IU is a threshold of a detectable limit here.

It`s very confusing when they give out the viral load result in log numbers, I wish it would be standardised.  Treatment certainly is a roller coaster ride, and I know you`re concerned about the duration with your tinnitus problem.  That`s a good result at this stage anyway.

ps - I can understand what you`re saying ok, no prob!   

Hi Jill i know, i just can't wait for Tue's apt with my hepa to arrive )...they said over phone i am log 1, that could be somewhere 10-90UI/ml, i was too dumb not to ask in UI...and i find when i look for RVR defintion as UND or <50UI/ml

sorry for typos and bad grammar, i am just in weird combination of excitement and anxiety )

can anyone explain me is RVR defined as UND @ 4th week VL check or <50UI/ml? Malcolm help! anxiety is killing me (i got hepatologist apt on Tue! until then i am uberanxious about results)