Hep C Discussion Forum

Hi Hillary,

Interferon was first approved by the FDA for the treatment of HepC in 1991.  Before that, it had been used in treating cancer and HepB, with little effect. It was initially given for 24 weeks, at 3million units/ three times a week. Most patients relapsed after treatment finished. In 1993, treatment length was increased to 48 weeks, again, 3 injections a week.  It was found that about 10% of patients achieved SVR.  However, we did not have Viral Load tests back then. We had the RIBA ( and ELISA) test, which was reported as positive or negative depending on whether HCV RNA was detected or not. The limit of detection was very vague, and could range between 100 and 10,000 viral particles. So, your boss may have become RIBA negative. Did she have 6 monthly or yearly follow-ups? How does she know it came back 'recently'?

I had 48 weeks of monotherapy with the old interferon in 1996. I was RIBA -ve at 12 weeks and stayed that way until 4 months post treatment. However at 6 months post treatment, I was RIBA +ve again. I only mention this, because in the early nineties, 'SVR' was pretty vague.

The results of the early Victrelis Trials were in 2009, so you could say, this is when the first patients achieved SVR with Victrelis.

As we've discussed before on the Forum, SVR does not mean cure in the true sense of the word. There is a tiny chance of relapse which is <1%. Don't worry about it- just get through Rx. Cheers.

Hi Sarah,

Relapse means becoming PCR positive again, after being Undetected at the end of a course of treatment. The aim of treatment is to achieve SVR, which means Undetectable viral RNA in the blood, either at 12 weeks after treatment (SVR 12) or 24 weeks after treatment (SVR 24).  Relapse usually occurs 3-8 weeks after end of treatment, and very rarely, it can occur after SVR.  Most believe relapse is due to reactivation of hidden reserves of virus, in either the blood, the liver, peripheral blood cells ( such as monocytes) or other tissues. Remember that an Undetected patient may have a tiny amount of virus in the blood- it is just too small to be measured on a PCR test. Drug resistant mutations of the virus are often the cause, in patients taking DAA's. These are not a problem with Interferon and Ribavirin.

SVR does not mean cure. Almost every patient with SVR will carry a tiny amount of virus for an unknown number of years. This is controlled by the body's immune system.

The term Breakthrough is used when a patient becomes PCR positive again during treatment, after having become Undetected. This was very rare in the old days of Peg/Riba, but with the DAA's, this means resistant variations (RAV's) have developed.