Viral load question

[roostermom]

I am now in the middle of week 11 of tx with Incevik. I had to go out on short term disability two weeks ago due to severe anemia. My doc dose reduced the ribo the weekni went on procrit from 800 to 400 and after a week took it to 600 and an half a week later back to 800.

Here is my issue : after week two my doc checked my viral load and I was less than 43. She did not do one at week four (kind of an mistake she meant to), but did one at week 8 and I was undetected. That news has given me the strength to get through some pretty rough sides, my guess made a lot worse by the anemia. The Procrit has made me vomit a lot, so mostly I just get out of bed to stick my head in the toilet. All of this is worth we
Hen I am told I am undetectable. However, I got an email from my doc yesterday saying that my viral load is under 43. This sounds like a back slide to me. She didn't return my email with an answer to this question yet, so I am here imagining the worse.

Could it be that the temporary dose reduction could have caused it to resurface? And if that is the case, what hope do I have I won't relapse again? I did 48 weeks of peg ribo in 2002 and relapsed shortly upon completion.

Not in very good spirits today.

[crossroadsec]

My dr doesn't give me numbers. Just UND . I don't think I could handle that stress.. Sounds like you're doing fine. Hang in there..

[can-do-man]

I agree, wouldn't sweat to much about it until you talk to your doctor, with your 2 week viral load being that good i would guess you were und at week 4,. What stage of liver damage to you have?

[lynda607]

It would make sense if the 2 wk was detected but under the 4 wk would have been undetected.  There are no guarantees, but it's highly likely.

You're right, it's about the omission of the words, detected or not detected on the most recent PCR.   I wouldn't worry either until you speak with the doctor.

Good Luck

[roostermom]

My vl on 7/23/11 was detectable under 43. That was at week 2. By week 8 I was undetected at under 43.

I reread my doc email and she has left out the relevant word, and I haven't seen the actual report. All she said was that I was under 43 - she didn't say detected or undetected. Maybe I am jumping the gun in worrying.

[roostermom]

Thanks for the info. I think my dr was just as shocked that she missed the 4 week as you all are.

[lynda607]

At what week was the last PCR taken to which your doc reported under 43?  Clarification is needed, either you were under 43 HCV RNA not detected or under 43 HCV RNA detected.  If HCV RNA is detected on most current PCR it was probably due to the riba dose reduction.  Under 43 is better than over 43 but you really want to see not detected.

Incivek is a response guided therapy and the patient must be UND at wk 4 and 12 to qualifty for 24 wks.  There is no way of knowing if you were UND at wk 4 and in my opinion negligent of your doctor not to have the 4 wk PCR done because a lot hinges on the results.

If UND at wk 12 your stuck with a decision I wouldn't want to have to make. Perhaps you could press on past 24 wks, maybe do 36 wks and see how well you're tolerating P/R.

BTW, make sure you remind your doctor to have the 12 wk PCR done and you should have completed all doses of Incivek prior to PCR.


    

[roostermom]

I am fairly certain that I just could not do 48 weeks again. This time is really kicking my a$!. I only have another week and a half on the Incevik and I am hoping that I start to feel
L a bit better when that is over. The first time in tx it wiped out my WBC and I was put on neuopgen. This is a big NY hospital w
That was involved in the Incevik trial (which my daughter was in and was cured), so I think their threshold to use neupogen is lower than my last doc. Just as well - I think the procrit is causing the vomiting, so one rescue drug seems to be better than 2!

[can-do-man]

When you say you were undectable at week 8 but now your doctor is saying dectable but under 43, have you had another pcr run since week 8? If yes then i would want them do re-run the last test to check if it was a lab error.

If no then did you see a copy of your week 8 test and did it say undectable or was you just told that? Sounds like some confusion by your doctor, forgetting a 4 week pcr doesn't sound very incouraging on the doctors part..

Good luck sortng this out, theres a lot at stake here, 24 weeks or if really dectable then 48 weeks.

[curiouslady1]

Sounds to me like you have a very busy doc who is quite distracted.  Can you request a nurse educator or coordinator to work with you and ensure you get your labs done timely and results received timely?  Anything is possible but rather than agonize over it, you need to obtain decent information on a regular basis and more frequent lab tests esp. in view of your history.