hep c viral load and incivek

[cmac263]

sister had viral load of several million and after four weeks of Incivek it is down to 1,900 but they say she has to stop as she is resistant....she did not hve any side effects until last week.....is it possible she is late bloomer and needs to go on?????

[cmac263]

thank you for your comments and yes we both are ever so disappointed she has tried twice prior to the triple med and she is such a fighter but this one has really got her on the down side of dark.....I just do not understand how viral load can be in the millions and drop to 1900 in 4 weeks and she is out...I get it that if she is not below the 1000 then continuing treatment may result in a more resistant strain... .Damm this stuff is hard to kill....Thanks for the tip regarding Gilead and the she has already registered herself for a clinical triial on clinical trial.gov (Ireland is the name I recall) in Aurura Colorado.....you mentioned a stage three trial... unknown territory what is a state three trial....thank you all so very much for you thoughts and reply  

[Idyllic]

Perhaps a graphic representation makes it more clear. It is the third box about half way down the page under, "Treatment futility rules in all patients"

http://www.incivek.com/hcp/treatment-duration-treatment-history

[hrsepwrguy]

Table 2: Treatment Futility Rules: All Patients

HCV-RNA Week 4 or Week 12: Greater than 1000 IU/mL

Action Discontinue INCIVEK and peginterferon alfa and ribavirin

http://pi.vrtx.com/files/uspi_telaprevir.pdf

[FrontRangeMom]

I notice that there is an "or" between (1) and (2). The way that reads to me there is an option to continue with >1000 at four weeks. But not beyond 24 weeks if detectable.

Mom

[Idyllic]

Hguy is right.  Four weeks is the first key time point for all of us treating with Incivek.  If only your sister's HCV RNA could have been 900 lower since sadly HCV RNA > 1000 is considered an inadequate viral load and further treatment would be considered futile. I am sorry. I know it is a real disappointment.

[Dee1956]

I am so sorry for you and your sister. Hrswspr gave you the answer I just wanted to say I am sorry that it did not work.   There are new drugs to help with Hep C coming out in a few years, I hope one of those will help her.  Perhaps she could ask her doctor about level 3 trials of those drugs.  Gilead has some promising results.
I wish you and your sister the best

[hrsepwrguy]

Discontinuation of Dosing
Patients with inadequate viral response are unlikely to achieve SVR, and may develop treatment-emergent resistance substitutions [see Microbiology (12.4)]. Discontinuation of therapy is recommended in all patients with (1) HCV-RNA levels of greater than or equal to 1000 IU/mL at Treatment Week 4 or 12; or (2) confirmed detectable HCV-RNA levels at Treatment Week 24 (see Table 2).

http://pi.vrtx.com/files/uspi_telaprevir.pdf