Hep C Discussion Forum

Gracie · Guru

RE: Forth Week Viral Load 22

Tig · Admin

So very true! Having tried Tx in 96 and failed, I saw the options for new Tx really stall until the introduction of the anti proteases Incivek and Victrelis. Of course we can't forget to mention our favorite anger management tool, Ribavirin either! The new DAA's have really made an almost overnight change in success rates and Tx lengths. I look forward to both a single dose method as well as the eradication of HBV and HCV altogether! May that day come soon....

Tig

Hep-C Dragon Slayer · Veteran Member

Cant believe I typed HVC, my apologies to all my HCV friends...

Hep-C Dragon Slayer · Veteran Member

Learning lots and wow how complex the different tx can be for any HVC person.

I read the updates from the people on the old tx, the 48 weeks tx, , the Interferon or non interferon, the Incevik, non responders, relapse's, its mind boggling.

As a Genotype 1A, I thank the pharmaceutical companies for coming up with the new 12 week tx, with or without Interferon solution, also the 24 or 48 week tx for other genotype HVCers. The good news and the results seem to be very high percentage of success.

I was told that my tx would expand to 16, 20 or 24 depending on how I responded. On day 20 my VL was less then 15.

Still too early for new tx to give you the SVR stats although I completely understand why you are asking.

Just did a TMA test on day 30 and the usual two business day turn round for results is now 4 days due to the complexity of the TMA test. I will know next week the results.

Gracie · Guru

Either scenario I'm above 15 and detected which is why the 48 weeks. I'm wondering statistically what a difference there is is SVR for those that stop at 24 weeks vs 48 weeks that were detected at week 4? Perhaps it would be worth the risk, given the new 12 week treatments. If I relapsed and retreated, I'd still be 12 weeks less on the new treatment.

Hep-C Dragon Slayer · Veteran Member

Gracie,

Catching up on this post, What test did they run for you, the PCR or the TMA ?

My understanding is the PCR test will measure down to a VL count of 15 and say less then 15 or an actual VL number. Doctors assum less then 15 means UND.

The TMA will measure down to the number 2 and it will say UND or Detected. You do not get a VL number from this test.

That being said, my nurse said they scheduled my blood draws now through Quest Labs so that they run a PCR test first and if the VL count is less then 15 they automatically run the TMA test to say UND or not.

Being new to all of this, can the GURU's tell me if this is correct ?

Gracie · Guru

Well I asked her straight out if I was in for 48 weeks since i was detected at my 4th week test and she said probably. She sent the lab a letter to retest my four week viral load as it was so darn close to undetected and there could have been a lab error. So hoping for a lab error, but preparing to go until November.... Groan!

mindovermatter · Veteran Member

Matt is right, Gracie. A viral load of 22 is very small. This might extend the length of treatment but your chances of being cured are still very good. Take heart and keep on the treatment, one week at a time.

Gracie · Guru

Thanks... I will do the 48 if that's what it takes. Just sucks as I seem to be among the last of the 48 week treatment groups. Every newbie is doing 12. But 22 is nothing to sneeze at. I'm starting week 6 today! That's half way through incevik and I take comfort in those who have said the sx are less when the incevik is stopped. I've not given up fighting the beast!.... Now where did I put that new box of incevik .... Dam brain fog...lol.

Matt Chris · Guru

Hey Gracie

Reaching the viral level of 22 or <22 is considered so small that its hard the quantify.

Its no UND but very close so take courage you will reach UND by the next time you do a viral load.

Pulling for you Gracie to make it all the way.

matt

Tig · Admin

Yes, that's mentioned in the Incivek algorithm. It happens and your VL reduction has been considerable. Your VL level is considered low enough to continue. Here's an explanation describing the issue;

Treatment Duration

Duration of treatment depends on HCV-RNA levels

Triple therapy: telaprevir, peginterferon alfa, and ribavirin

Dual therapy: peginterferon alfa and ribavirin

Treatment-naïve and prior relapse patients

HCV-RNA levels undetectable at weeks 4 and 12: Administer with peginterferon alfa and ribavirin first 12 weeks, then dual therapy an additional 12 weeks
HCV-RNA levels detectable at weeks 4 and 12 (ie, <1000 IU/mL): Administer with peginterferon alfa and ribavirin first 12 weeks, then dual therapy an additional 36 weeks

Prior partial and null responder patients

All patients: Administer triple therapy first 12 weeks, then dual therapy an additional 36 weeks

Treatment futility

Patients with inadequate viral response are unlikely to achieve sustained virologic response, and may develop treatment-emergent resistance substitutions
Discontinuation of therapy is recommended in all patients with either of the following circumstances:
HCV-RNA levels >1000 IU/mL at treatment weeks 4 or 12, OR
HCV-RNA levels detectable at treatment week 24

Gracie · Guru

Disappointed but my doctor said this means it's working and I should definitely be clear by 8 weeks. Does this mean I'm in for 48 weeks? I asked and he said it depends on 8 week viral load, but I'm thinking the worst.

I just found this... Could this mean a chance for 6 months?

Incivek (Telaprevir)

In a sub analysis it was found that:

Note: The on-treatment response was guided by the following rules:

People who were HCV RNA (viral load) undetectable (<25 IU/mL) at week 4 and week 12 were treated for a total of 24 weeks
Patients who were not HCV RNA undetectable at week 4 or week 12, but who were undetectable by week 24 were treated for a total of 48 weeks

-- Edited by Gracie on Saturday 1st of February 2014 02:27:19 AM

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