PCRs, when and how many

[springfever]

When do hepatologists order pcr during tx these days.  I received pre-tx, 2 wk, 4 wk, 6 wk, and am going for 8 wk today.  I had to request the 2 wk and throw my 100 lbs around to get the 6 wk.
I know that 12 wk and 24 are standard but not sure after that.  
One of my concerns is that the number of pcr's drops off after 12 wks.  If und, and god forbid the virus breaks through,  without frequent monitoring, a person could be taking months of interferon unnecesarily.
What are your doctors doing?

[springfever]

Thank you for your responses.  I just like knowing what effect the tx is having, but I don't want to be too much of a pain for dr. and staff.  At 6 wks I am 14K - down from 250mill at beginning of tx.

I did, and do, have elevated AST/ALT.  118/133 pre tx - 61/88 at 6 wks.
So, if I am not und at 12 wks, I will request more pcr after that.  

I'm still hopeful though that 12 wk will be und.  Based on the rate of decline so far, I expect my 8 wk will be around 1200; 10 wk - 100; and 12 wk und. god willing.

Thanks again!!

[eureka254]

My husband's doc scheduled PCRs at:
4 weeks pre-tx, wk 0 (baseline), wk 4, wk 8, wk 12, wk 24, wk 36, and wk 48.  
(He also allowed an extra PCR when asked at week 13 because wk 12 was <50 detected.)  Hope that helps, and good luck -- keep us posted. ~eureka

[charm27]

YES i THOUGHT 8 WEEKS WAS REAL IMPORTANT. i WASNT IN A TRIAL..BUT NEVER THE LESS....I was able to determine more that way then if I were to wait 12 weeks,

Take good care.

[newleaf09]

Good points, charm.  Clearing by 8 weeks is a marker of early positive response used in the trials and may add some needed encouragement during TX.

[charm27]

I was tested a 4, 8, 12 and 24.
Then again at EOT which was 55.

The only PCR I had an issue with was the 8 week Hepatologist wouldnt test me at 8 weeks...however I thought that was an important one so I insisted,.

I had the insurance why not??
So I was able to find out I cleared somewhere between week 6 and seven, rather than him telling me I cleared at 12 weeks.
Take care
Charm27

[nygirl7]

Ditto to the testing above I was tested at 4, 12, 24, 48 and 72. I was one of the rare people who was not UND at week 12 but was before week 24 and still yet as you can see once I did get UND my doctor didn't worry too much about breakthrough.

I do know that some specialists (like Dr. Jacobson) do PCRs every single month all during treatment but I believe that is extremely rare.  Especially if you had an early UND and were considered RVR I don't think you'd have enough of the odds against you to warrant more testing.

[Bill1954]

I’d guess that you’ve had sufficient viral assays to determine response; now you’re concern would be breakthrough. My understanding is that this is relatively rare; I don’t have supporting statistics handy, but I believe breakthrough occurs in <5% of patients. I’d hope that biochemical markers (such as ALT/AST) would detect reemergence of the disease, but as we know, these aren’t completely fool proof. Did you have elevated enzymes prior to treatment? If so, these might wave a flag for you. I treated with a large liver clinic in California, and they did VL testing monthly throughout the treatment period. I think this is unusual; although I had significant liver damage, and they said I had a greater chance of breakthrough because of this.

Good luck,

Bill

[HCA]

Breakthrough is quite rare and is usually found in slow responders.
People who have a strong virological response don't get breakthrough.
If you become undetectable by week 12 (geno 1) breakthrough is extremely unlikely to be an issue as it tends to occur when viral suppression has been excruciatingly slow.

[jdwithhcv]

My doctor did PCRs at weeks 4, 12, and 24, then 48 (EOT) and post tx at weeks 4, 12, and 24.  We will do another at 1 year post tx, and another at 2 years.

jd