Thanks for the replies everyone. My doc was positive too, but of course I was thinking "he's just trying to keep my spirits up" as he was talking to me. I'm not in any danger of getting depressed or discouraged - logically I'm just having a hard time with how these meds can annihilate 23 million bugs in 2 weeks then leave a few alone for the next 2 weeks. Maybe they're slowly seeping back into my blood from liver or other tissue? This would make sense with me having such a high viral load - they're probably lodged in all sorts of places. He's going to test me again at 8 weeks. As long as I'm UND then I won't worry. I may ask him what he thinks about tacking on another 4 weeks.
I think you got it right,,, it empty-ed your blood of the virus but the killing is done in the liver, now other tissue is extruding the virus and you are seeing that,, My thoughts.
We are all in this together keep your stick on the ice (Red Green Show)
patiently_waiting said
Jul 11, 2014
Thanks for the replies everyone. My doc was positive too, but of course I was thinking "he's just trying to keep my spirits up" as he was talking to me. I'm not in any danger of getting depressed or discouraged - logically I'm just having a hard time with how these meds can annihilate 23 million bugs in 2 weeks then leave a few alone for the next 2 weeks. Maybe they're slowly seeping back into my blood from liver or other tissue? This would make sense with me having such a high viral load - they're probably lodged in all sorts of places. He's going to test me again at 8 weeks. As long as I'm UND then I won't worry. I may ask him what he thinks about tacking on another 4 weeks.
Gator Man said
Jul 11, 2014
Hi PW,
It appears that no one talks about VL log reductions anymore during tx. The expectation is that anything less than UND at 4 weeks is something to worry about, which is understandable. With your baseline VL at 23 million and some uncertainty regarding your current degree of liver fibrosis, I don't think it is too much of a surprise that you are still "<15 Detected". There have been several members that have had low, but detectable VLs at 4 weeks that still amounted to a 4 or 5 log reduction, which would have been considered good news in the past.
As Tig stated, almost everyone treating with Sovaldi end up UND at EOT, even when the virus was still found at the first VL test. The odds are clearly in your favor at the end of the day. You'll get there!
-- Edited by Gator Man on Friday 11th of July 2014 09:38:47 PM
Isiscat2011 said
Jul 11, 2014
Tig56 wrote:
I think a VL at EOT and EOT +12 to determine SVR are the best testing choices, my opinion of course.
Yeah, regular VL testing during tx does seem to cause a great deal of emotional upheaval. Most everyone will be UND by 8 weeks, however, so that might be a good point for a little morale boost.
Also, no real clinical reason for testing VL before 12 weeks EOT but I would want that done at week 4. Week 4 gives you a pretty good idea, plus the suspense would be killing me, and I would assume others would feel the same way.
Tig said
Jul 11, 2014
Hi PW,
Yep, I'm voting with the rest, you'll get there, but it's going to take a few more weeks to do it. I'm convinced that a 4 week VL is too soon. What it should tell you is it's kicking some serious virus butt and you should be very encouraged that the 6 or 8th week VL will be the one you're waiting for. I think the 4 week VL does more to discourage people than the morale boost most are looking for. I believe that's why so many doctors aren't doing a viral load until the EOT. The rate of success for Sovaldi is so high it's almost unheard of to not be undetectable at EOT. It's the post treatment tests that are what's important. I think a VL at EOT and EOT +12 to determine SVR are the best testing choices, my opinion of course. Anything prior to that seems to be so hit or miss, they can't be relied on for the morale boost people are hoping for. I wish doctors would advise people that the chances for an undetectable VL at week 4 is 50% or less, so they won't get their hopes up too early. Week 6 is plenty early if anyone HAS to have one done. The old Interferon regimens required the frequent VL's to determine doses and lengths of treatment, those days are gone and these new protocols should have an entirely new testing protocol of their own and it will eliminate these emotional highs and lows with the new DAA's. Just my 2 cents...
Tig
Fireman Rob said
Jul 11, 2014
Hi PW,
It'a good to hear from you! I agree with Isiscat, the odds are in your favor. I'm not doing a VL test until six weeks (next Monday) for this very reason. I'm betting by six weeks, you will be UND.
Don't sweat it, we're not even half way through this yet friend. How do your labs look otherwise? Are your AST/ALT's coming down? That's the important thing right now. Keep us posted and stay positive.
- Rob
Isiscat2011 said
Jul 11, 2014
Hi PW:
Based on what I have read and heard pretty much everyone who uses Sovaldi as the backbone of tx will achieve UND. For some it happens within a few weeks and for others it may take a couple of months. There does not appear to be a direct correlation to when UND occurs, however, and whether or not someone will achieve SVR.
No point in worrying about it because you can't control the outcome. All you can do at this point is stop tx which isn't a viable option. Just keep going and hope for the best. The odds are definitely in your favor.
patiently_waiting said
Jul 11, 2014
I'm a little disappointed with the news I got today. At 2 weeks my viral load was <15 DETECTED. At 4 weeks it's the same. Since I had such a quick response I was expecting to see UND this time and now I'm starting to get really concerned that there are some that aren't going to die. I have good reason to have this concern as it's already happened to me twice. Both times I treated before I had a rapid response and stayed undetected (though back then the tests were not as sensitive as they are now) through treatment only to relapse shortly after. I know that overall I've had a good response, but my concern is progress seems to have stopped over the past 2 weeks.
I think you got it right,,, it empty-ed your blood of the virus but the killing is done in the liver, now other tissue is extruding the virus and you are seeing that,, My thoughts.
We are all in this together keep your stick on the ice (Red Green Show)
Hi PW,
It appears that no one talks about VL log reductions anymore during tx. The expectation is that anything less than UND at 4 weeks is something to worry about, which is understandable. With your baseline VL at 23 million and some uncertainty regarding your current degree of liver fibrosis, I don't think it is too much of a surprise that you are still "<15 Detected". There have been several members that have had low, but detectable VLs at 4 weeks that still amounted to a 4 or 5 log reduction, which would have been considered good news in the past.
As Tig stated, almost everyone treating with Sovaldi end up UND at EOT, even when the virus was still found at the first VL test. The odds are clearly in your favor at the end of the day. You'll get there!
-- Edited by Gator Man on Friday 11th of July 2014 09:38:47 PM
Hi PW,
Yep, I'm voting with the rest, you'll get there, but it's going to take a few more weeks to do it. I'm convinced that a 4 week VL is too soon. What it should tell you is it's kicking some serious virus butt and you should be very encouraged that the 6 or 8th week VL will be the one you're waiting for. I think the 4 week VL does more to discourage people than the morale boost most are looking for. I believe that's why so many doctors aren't doing a viral load until the EOT. The rate of success for Sovaldi is so high it's almost unheard of to not be undetectable at EOT. It's the post treatment tests that are what's important. I think a VL at EOT and EOT +12 to determine SVR are the best testing choices, my opinion of course. Anything prior to that seems to be so hit or miss, they can't be relied on for the morale boost people are hoping for. I wish doctors would advise people that the chances for an undetectable VL at week 4 is 50% or less, so they won't get their hopes up too early. Week 6 is plenty early if anyone HAS to have one done. The old Interferon regimens required the frequent VL's to determine doses and lengths of treatment, those days are gone and these new protocols should have an entirely new testing protocol of their own and it will eliminate these emotional highs and lows with the new DAA's. Just my 2 cents...
Tig
Hi PW,
It'a good to hear from you! I agree with Isiscat, the odds are in your favor. I'm not doing a VL test until six weeks (next Monday) for this very reason. I'm betting by six weeks, you will be UND.
Don't sweat it, we're not even half way through this yet friend. How do your labs look otherwise? Are your AST/ALT's coming down? That's the important thing right now. Keep us posted and stay positive.
- Rob
Hi PW:
Based on what I have read and heard pretty much everyone who uses Sovaldi as the backbone of tx will achieve UND. For some it happens within a few weeks and for others it may take a couple of months. There does not appear to be a direct correlation to when UND occurs, however, and whether or not someone will achieve SVR.
No point in worrying about it because you can't control the outcome. All you can do at this point is stop tx which isn't a viable option. Just keep going and hope for the best. The odds are definitely in your favor.
I'm a little disappointed with the news I got today. At 2 weeks my viral load was <15 DETECTED. At 4 weeks it's the same. Since I had such a quick response I was expecting to see UND this time and now I'm starting to get really concerned that there are some that aren't going to die. I have good reason to have this concern as it's already happened to me twice. Both times I treated before I had a rapid response and stayed undetected (though back then the tests were not as sensitive as they are now) through treatment only to relapse shortly after. I know that overall I've had a good response, but my concern is progress seems to have stopped over the past 2 weeks.