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Tig


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I remember having had the PCR testing in 96 as well. I don't have that information because the group controlling those records had them destroyed and the lab hasn't been determined, long story. Regardless, my doctor at the time said he was disappointed but gave me the reason that I wasn't responding as quickly to treatment as he had hoped. That's the only explanation I was given. I'll never know if I was +\- ve. He also mentioned that my CBC was dropping lower than he was comfortable with. I recall a low WBC but don't know those numbers. Lots of unknowns from that period of treatment.

My VL this go around started at 5M. It dropped to 16264  <43IU/mL at week 4, which was the lead in completion date. No VL was performed at week 8 (4). My next VL was done at week 12 (8th week of Vic) and was UND <43/IU/mL. It would be nice if there was a set of standards that all results were measured by instead of what many use and that's a "feeling" or a "hunch". Strict adherence to a lab schedule would also be uniformly informative. Oh well, I'm glad at any rate the tests say UND now and with some "luck" will stay that way! Thanks again--



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

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Hi Tig,

Back in 1996, Viral Loads were not done here. I'm not sure whether you had VL's available in the USA then.  Here, if you tested +ve to HCV antibodies using the ELISA test, you then had a RIBA test to confirm the presence of circulating HCV RNA. You were simply called +ve or -ve. The PCR test was available at a huge cost and from my notes, this was available in 1997 and called the Cobas Amplicor PCR test, and could supposedly detect down to 2000 viral copies. For my previous treatments (before 2000), I had the RIBA test and was only reported as +ve or -ve. So, I'm not sure what diagnostic tools you had, but I wonder why your doc was 'disappointed'. When I started my 1st course of monotherapy with interferon( on 23.12.96), I was RIBA -ve at week 8, week 24 and at week 48. I became RIBA +ve again 6 weeks after EOT.  So I was called a relapser.

Re my doc: He wants you to be Undet. at week 8. i.e. after 4 weeks of Victrelis ( as well as having a > 2log drop after the leadin), and to stay Undet. at week 16 (after 12 weeks of Victrelis). He said I had an eRVR but that didn't affect my Rx time as I was doing 48 weeks anyway (cirrhotic). It's just one guys opinion, so be guided by your own Hepatologist. Cheers.



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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

Tig


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Thanks Malcolm, but that also brings a question to mind if I may indulge please? I responded to mono therapy but my doc in 96 said he would've liked seeing a stronger response and decided to stop treatment. It was new to him and I don't think he was on top of what was expected. Now I believe he thought I should've been UND by then and was disappointed when I wasn't. So who knows what would've happened had I continued Rx. Most likely like everyone else my chances of SVR were small. So my question is why would your doctor class me as an EVR when I was UND by week 12 P/R and week 8 of Victrelis? Also why would he consider me a candidate for 48 weeks? I'm not cirrhotic. Wouldn't I, according to these figures, be eRVR versus EVR? (Remember I was UND at week 8 of Vic and hoping that week 16 is similar) You're right, it's confusing at the very least. Thanks for your time, I truly appreciate your help!



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

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Hi Tig,

Previous Interferon +/- Riba treatments are useful, if you can decide whether you were a non-responder, partial responder or relapser. It gives an indication of how you are going to react to triple Rx. If you do the Victrelis triple, you have a better idea of this after the 4 week leadin ( ideally you want at least a 2 log drop). However, not everyone gets a 4 week VL (Insurance or Doctor problems). Also not everyone gets a 8 week VL. Some Insurance Co's only allow a preRx VL, then a VL at 12 weeks and 24 weeks and EOT (if needed).

Regarding your question: this is what I was told by my doc.

RVR: No detectable HCV RNA  at week 4 after SOT with Peg/ Riba/ Incivek, or after week 8 with Peg/Riba/Victrelis.

eRVR: No detectable HCV RNA at weeks 4 and 12 (Incivek triple) or weeks 8 and 16 (Victrelis triple).

EVR: No detectable HCV RNA at week 12 (Incivek) or week 16 (Victrelis). Obviously that means <1000 at week 12 (Victrelis).

vRVR (very early virological response) is no detectable HCV RNA at 2 weeks after SOT. This is used in Trials for the newer DAA's.

So, it's confusing if you don't get VL's done at 4, 8, 12 and 16 weeks.

My doc's opinion is that only eRVR patients are eligible for RGT. He would class you as an EVR, and make you do 48 weeks. That's only his strategy, and he may be wrong, so be guided by your own doc. Cheers mate.



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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

Tig


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Thanks Matt I appreciate the information. You're so right about nothing being cut and dry regarding our treatment and expectations! How nice that would be! Maybe next week, eh? JK! I do try to keep my eyes and ears open for the various opinions out there but I honestly find better and more reliable information from the membership here! It's always my go to place for data. I believe from the forum use statistics that a lot of people search these pages for information. I believe that's a testament of excellence for the job you and the other admin members do here! You provide a no BS, factual and trustworthy environment where people come to with questions and concerns about their health and welfare. Its a place where any of us has the ability to help another individual with a question or a problem. I hope everyone that reads these pages values the importance and accuracy of the information provided like I do. It's a treasure trove of HCV data and people with the willingness to make a positive difference! I encourage everyone to become a member here and DONATE!! 



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

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Hey Tig56 

As you are well aware things with HCV treatment are never quite that  black & white or cut & dry.

I don't think your previous treatment in 96 would have much impact on your current triple therapy. Because you have achieved RVR I would think you would be a candidate for the shorter duration  especially not being cirrhotic.

Best advice is to study all the pertinent assays on shorter treatments versus longer treatments and see if you personally would in anyway benefit from a longer treatment.

Hoping the best for you Tig56 you have been a steady contributor and great addition to the forum keep up the good work.

Matt 



-- Edited by Matt Chris on Saturday 7th of September 2013 08:42:37 PM

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61 year old Geno type A1, F4 Cirrhotic, started 24 weeks on Harvoni 12-17-14 ,EOT-5 week = UND, 8-31-15 =UND , SVR-24 Baby YES! 

Tig


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Thanks for the update! I do have a question regarding something I read there. Regarding the RVR, is the biggest difference or treatment change as a result of RVR, eRVR, or sRVR generally treatment duration? I was UND at week 12 P/R and week 8 of Victrelis. Do I consider that as RVR or eRVR? I'm wondering with my results and having had 12 weeks of mono therapy in 96, just where do I sit in the big picture? I've heard my doc tell me that I may be able to end treatment at week 24 or 28, but see different ideas all the time. That makes it confusing and hard to be sure when my EOT date might be. I've already seen confusion coming from more than one Hepa's office and I'd like to have that knowledge going in next time. I would appreciate your input, thanks!



-- Edited by Tig56 on Saturday 7th of September 2013 02:46:30 PM

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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

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Hi guys,

I've updated the Forum Abbreviations in the New Members Area. If anyone has any additional ones, please let me know. Cheers.



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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

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