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Hep C Discussion Forum -> On Treatment -> Week 4 only 1/2 log drop
Post Info TOPIC: Week 4 only 1/2 log drop
mallani


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RE: Week 4 only 1/2 log drop
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Hi Jack,

Are you sure that's correct? Whenever there is an E in the result, that's Scientific Notation which is peculiar to some Canadian labs.

When the VL is expressed in S.N., it will be e.g. 3.23E + 2 i.u./ml. The number following the + must be a whole number. The example I gave is equal to 323 i.u./ml.

VL expressed in Log. units is different.



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Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
TeddyTrout


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mallani wrote:

Hi Jack,

Are you sure that's correct? Whenever there is an E in the result, that's Scientific Notation which is peculiar to some Canadian labs.

When the VL is expressed in S.N., it will be e.g. 3.23E + 2 i.u./ml. The number following the + must be a whole number. The example I gave is equal to 323 i.u./ml.

VL expressed in Log. units is different.

 Offical lab results  states the results asHepatitis C Virus RNA {Quantitative RT-PCR ]      3.23E+(2.51) IU/mL.   Using the Roche Diagnostic Taqman Real Time HCV qualititative assay has  a lower limit of detection of 15 IU/mL and a linear range of 43-G 9E& IU/ml.  The log drop was indicated by a arrow down 3.64 * an is written by hand, this is vebatim so what does this all mean to me? good /bad?



-- Edited by TeddyTrout on Saturday 26th of January 2013 08:56:20 AM

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TeddyTrout


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mallani wrote:

Hi Jack,

Your 8 week VL is 2.51 log, which is equivalent to 320 i.u./ml. That's a good drop. Now you need to be below 100 i.u./ml at week 12. It's confusing using log units, and I wish Labs could agree to only use i.u./ml.  Here's another link for you.  Good luck.

 

http://www.natap.org/2011/HCV/stopping.htm

 I guess The Canadian results are quoted diffrent as the Offical lab results  states the results as 3.23E+(2.51) IU/mL 3.64, most likly a combined report from baseline. Using the Roche Diagnostic Taqman Real Time HCV qualititative assay has  a lower limit of detection of 15 IU/mL and a linear range of 43-G 9E& IU/ml. {what ever that means LOL} My HGB has dropped to 103 so there having me do 1 less Riba pill per day for the next little while. 



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Don't sweat the small stuff, it will only give you hair loss.
mallani


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Hi Jack,

Your 8 week VL is 2.51 log, which is equivalent to 320 i.u./ml. That's a good drop. Now you need to be below 100 i.u./ml at week 12. It's confusing using log units, and I wish Labs could agree to only use i.u./ml.  Here's another link for you.  Good luck.

 

http://www.natap.org/2011/HCV/stopping.htm



__________________

Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
TeddyTrout


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Hi all sorry for not dropping by and saying hi and being supportive for all of you but I'ts been a rough time this 3 time around. I have just got my week 8 PCR and am not very encuraged buy the results but then I don't really know much about the information I now have and maybe you can weigh in and let me know. VL at the start was 6.15 and a week 4 leadin it dropped 1/2 log to 5.75 and at week 8 pcr it has rdropped tro 2.51 or a 3.64 log drop from base line.



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mallani


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Hi Jack, not a great result. The link gives the SVR chances based on the leadin. Strange things can happen.

 

http://www.victrelis.com/boceprevir/victrelis/hcp/dosing/lead-in-phase.jsp



__________________

Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
Uval951


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The influence of lead-in period for the SVR is contradictory in different studies. For example, the following report forecasts SVR basing 8 weeks response:

 

http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/AntiviralDrugsAdvisoryCommittee/UCM252341.pdf     page 9:

 

Table 6. SVR by Virologic Response on Treatment (P05216) Cohorts 1 and 2 Combined

Virologic Response

Arm 2 (RGT)

SVR

n/N (%)

Arm 3 Boc/PR48

SVR

n/N (%)

Treatment Difference

Arm 2-Arm 3

[95% CI two sided]

Overall

233/368 (63.3)

242/366 (66.1)

2.8 [-9.8, 4.1]

*Early Responders

156/161 (96.9)

155/161 (96.3)

0.6 [-3.8, 5.2]

#Late Responders

45/68 (66)

55/73 (75)

-9.2 [-24.4, 6.3]

 

*Early Responders: Undetectable HCV RNA treatment Week 8 through 24 (In RGT arm, early responders received BOC/PR through Week treatment Week 28).

#Late Responders: Detectable HCV RNA Week 8, but undetectable by Week 24 (In RGT arm, late responders received 28 weeks BOC/PR, followed by 20 weeks of PR for total of 48 weeks. Subjects were discontinued for futility at Week 24 in all treatment arms if HCV RNA was detectable.

I discussed the issue with the two experienced hepatologists and both are guided by an 8 week response (after 4 weeks Victrelis). Poor response in lead-in period only increases the duration of therapy (until 36 or 48 weeks), but less important for final SVR with Victrelis.



-- Edited by Uval951 on Sunday 23rd of December 2012 01:15:13 PM

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Gen. 1b. 1st Tx in 2003 Rib/Peg. Biopsy F3-F4; 2nd Tx started 2/28/12, Pegasys+RibaPak+Victrelis for 48 weeks. VL: 260,000 (starting), 125,600 (4 weeks), UND-weeks 6-45.EOT 1/7/13 after 45 full weeks. Post Tx 4,12,24 weeks -UND  SVR!
Daook


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Also Jack,

I didn't know fish ride bicycles!! hahaha!

Funny avatar.

:)

 



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Geno 1a, second time around, stable viral load since 1973, timing is right for new therapy
Daook


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It took me until week 6 to be undetected. Give it alittle time, it will work.

You might have a tough immune system fighting off the initial start of treatment. That happened to me back in 1980 the first time around for me.

Best of luck!!

:)

 



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Geno 1a, second time around, stable viral load since 1973, timing is right for new therapy
Uval951


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Jack, don't worry yet. Wife's response was even worse after 4 weeks lead-in period. But Victrelis changes the results a lot and after 6th week (2 weeks of Victrelis only) she got UND.

I suggest to make PCR test after 6 weeks ( don't wait for standard 8 weeks) for better Tx duration schedule.



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Gen. 1b. 1st Tx in 2003 Rib/Peg. Biopsy F3-F4; 2nd Tx started 2/28/12, Pegasys+RibaPak+Victrelis for 48 weeks. VL: 260,000 (starting), 125,600 (4 weeks), UND-weeks 6-45.EOT 1/7/13 after 45 full weeks. Post Tx 4,12,24 weeks -UND  SVR!
JoAnneh


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There are a lot of smart people on this forum
What is your doctors opinion?

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JoAnne

Genotype 1a, Triple therapy w/Invicek started May 19, 2012

DET 4 wk. UND 2,6,12,24 48 treatment. Achieved SVR 2013!
TeddyTrout


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Just got the news about my first PCR into the treatment. After 4 weeks of Interferon and riba I only had a 1/2 log drop. I'm into my 2 week of Victrelis Boceprvir and will have my second PCR in January, It's not looking good. I was a slow responder last time and had break through in a 72 week trial the last try in 05 but I had 2 log drops right up to week 24 was still positive but not able to do a count. I'm thinking I just might quit and wait and see if anything eles comes up. I'm a stage 3/2 back in 07.



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