Are we cured at SVR 12, SVR 24, or SVR 48?

[FreedomMK]

At what point can we say we are "cured" of Hep C and the virus is gone (except for the antibodies)?

Some sources say it's 12 weeks, some say it's 24 weeks.

Would I be correct in thinking there's a greater than 99% chance of it being gone at SVR 12, but no one is really 100% "cured" until SVR 24? Or are we not really 100% "cured" until SVR 48?

Is the very small number of "relapses" after SVR 24 explained by a very small number of people becoming re-infected?

[FreedomMK]

Thank you for clarifying that. I thought he meant 47 weeks after the end of treatment.

So since I'm SVR 12 now, the chances are very high that I'm cured.

Like yourself, I failed previous treatments (once with interferon/ribivirin and once with peg-interferon/ribivirin) and I'm stage 4.

But these new drugs (I had 16 weeks of grazoprevir, MK8408, MK3682 + ribavirin) are not only more effective, the side effects are virtually non-existent, at least for me.

[hepcandme]

That is such wonderful news freedom! I wouldn't wish interferon OR Ribavirin on anybody

[flyinlynn]

Yes your odds of cure are very good with SVR 12 and many doctors would say you are officially cured now. I had some trouble with anemia from Ribavirin glad you had an easy go with the riba.

Anyway I will just say congratulations on being cured since I do believe SVR 12= cured

[FreedomMK]

Thanks.

I see that according to one source says, only 2 of 779 people who were SVR 12 failed to achieve SVR 24.  That works out to 99.7%.

http://www.ncbi.nlm.nih.gov/pubmed/25314116

The nurse at the center where I've been treated says they've had just one person (out of hundreds they've treated) relapse after SVR 12.

But I read here at medhelp several people saying they've relapsed after SVR 12. Hector said he relapsed after 47 weeks.

http://www.medhelp.org/personal_pages/user/446474

[flyinlynn]

On what treatment? Hector was cured with the new medicines Sovaldi Olysio and Ribavirin. Where do you see he relapsed?

I was treated with Sov Oly but only for 12 weeks which the doctors later decided for a patient like myself with cirrhosis and multiple treatment failures with the old interferon ribavirin the 24 weeks of Sov/Oly and possible ribavirin as Hector was treated is the preferred treatment but we did not know that at the time. So when I retested at 12 weeks post I was found to have relapsed.

Two months after I relapsed I treated again but this time with 24 weeks of Harvoni and part way in we added ribavirin so 24 weeks of Harvoni and 15 weeks of ribavirin. I was clear at 4 weeks, 12 weeks 24 weeks, and 44 weeks. I only got tested that many times as I had 5 failures buy that time so I asked to test just to make really, really sure.

Like I said I have not seen anyone who relapsed for these new medicines after achieving SVR 12 but could have missed it can you site a case?

The ones most likely to have a hard time being cured are like me prior interferon NULL responders who are multiple treatment failures especially if they relapsed like I did on one of the new medicines and with cirrhosis.

I only recall seeing a couple of people who were treatment naive without liver damage fail treatment and they had relapsed by the 12 week post test.

[flyinlynn]

And yeah 99.7% 99.8 % different but similar data from different studies so yes relapse at post SVR 12 is rare at so far around 0.2 to 0.3 % note sample size 779 not a lot of data really and what was the pool like? Prior treatment status, fibrosis status?

[flyinlynn]

OK I see now where hector said he relapsed after he was not detected for 47 weeks but I am fairly sure that included his weeks on treatment. I would need to dig through hih posts during that time for more information. Also when he treated with sovaldi back in 2012 it was as part of a clinical trial for patients with liver cancer. Hector was very ill when he treated in that trial.

But after his liver transplant he did successfully treat as I mentioned and was finally cured of hep c.

[flyinlynn]

OK found Hectors post. He failed a treatment with Sovaldi & Ribavirin which was nit that effective for someone like him with advanced liver disease or really even anyone even without liver damage who is genotype 1.

Here is his post from Sept 01 2013:

I got a call from my hepatologist tonight notifying me that my HCV has returned one month after stopping 48 weeks of Gilead's Sofosbuvir + Ribavirin treatment.

So he was found to have relapsed by his 4 week post treatment test.

My assumption is he was not detected at 4 weeks on treatment and stayed that way until 4 weeks after his 48 weeks of treatment had ended is what he meant when he said he was not detected for 47 weeks not that he was a late relapse.

[hepcandme]

I was going to explain what Hector's situation was but you have done some incredible research Lynn and beat me to it. Because of Hector and a tiny handful of people who were given permission to use the new round of Hep C drugs with success, the rules changed to include folks with advanced liver disease, like me and Lynn and many others. One more thing to be thankful to Hector for

[flyinlynn]

I have read that the odds of cure at 12 weeks SVR are 99.8% From the old interferon days that some doctors hang on to was 24 weeks was needed to say cured but many doctors today do agree with the current published information and feel SVR 12 is cured.

What small number of relapses at 24 weeks post have you seen? I have not seen any except one person whose lab it turned out had made an error.

Also from what I have read the belief of the medical community at present time is that a patient SVR 12 who later again tests positive for the hep c virus that would not be a relapse but rather a new infection.