Treatment - Baseline Viral Load

[dontworry_behappy1]

Is 7,000,000 a high starting viral load for tx. Has anyone
else cleared with the triple tx with a 7,000,000 or
over baseline viral load?   Anyone with a 7,000,000
or more baseline viral load have to do only 24 weeks?

[working dog]

i cleared in 19 weeks with incivek to 11 weeks and vl at <43 at 4weeks...i had bad symptoms though..had to stop riba at 4.5 weeks for 10 days and then again at i think 8 weeks for 5 days........couldn't stand for more then 15 minutes most of tx...in fact a lot of tx only a couple minutes...i think the nasty symptoms were good in the long run...my doctor had a girl that had to be pulled off triple way earlier then me and cleared the virus...and not that it matters but last vl was over 10 mil.......hang in there.....billy

[willbb]

Sorry.. I didn't know the link would copy like that. If you can't pick it up let me know and I will try something else..
Will

[willbb]

Hi pooh.

I don't know if you had a chance to watch this presentation done to treating HCV physicians by DR. Bob Gish, Dr Ira Jacobson ,Dr. mark Sulkowski and Dr. David Nelson.(these are four heavyweights in Hepatology)

I found it  quite informative with case studies and slides included. It is rather lengthy (about 1Hr. 45 min.) however well worth watching IMO.

There is one part in the presentation where it mentions that VL now plays much less of a factor when it pertain to SVR with the protease's.

I believe approx. only 4% (hence my post above)

You need to register for it ,like CCO however it also is free.

If you have seen it ,then possibly you remember the part where it mentions the 4 %.

Best..
Will

http://www.projectsinknowledge.com/gastroenterology/hepatitis-c/Paradigm-Shift-HCV-Standard-Care-Treatment-DAAs.cfm?jn=2054&utm_medium=email&utm_campaign=CME-CE-showcase-case-most-viewed-email-05-18-2012&utm_source=activity-announcement

[pooh55811]

I had the same questions as you when I started.

7 mil would be considered high according to the classifications, but 7 mil is not anywhere near as high as many of our starting VLs.

My VL was 14,400,000. I was freaked by that number, but then I found out that there are several people with much higher VLs than I had (one over 69,000,000). A few people responded to my questions and told me they had VLs of 22 mil or 30 mil and that they had cleared (SVR).

I would have done 24 weeks if I had cleared at 4 weeks but I did not clear until 8 weeks so I am doing 48 weeks. If you clear at 4 weeks, you can do 24 weeks of Tx. (That is if you are on Incivek).

I do question if the VL affects how fast a person clears the virus. Because mine was high when I started, I do worry about it. I noticed on Frijole's spread sheets that most, but not all, of the people who did not clear at 4 weeks had high viral loads. I don't know if this is a fluke or if it is meaningful.

[willbb]

Actually I thought it makes the information relevant  as the Geno 1's before had this as a pre.-tx. predictor and now it is much less of a factor?

Will

[orphanedhawk]

I noticed this was just for genotype 1 which now is the group using triple tx.
Perhaps this now  makes the information moot  ?

Thanks for digging it up for me~

[willbb]

Baseline HCV RNA of 400,000 Best Predicts SVR and Relapse Rates in Patients Treated with Pegasys plus Ribavirin

http://www.hepcassoc.org/news/article137.html

[willbb]

Maybe  Hi OH  

[willbb]

Ho  OH

There is data that shows high VL for Geno's was a pre-determining factor for success on the old SOC. They have documented it seems to make less difference with the protease.. I believe  4%   less SVR   now with higher VL > 800.000

The percentage was greater than that on the old regime,,however please don't ask me to look for it right now ,,I have got a sinus cold that would drop a bull.. :0)
Will

[orphanedhawk]

I thought viral load wasn't significant in determining SVR even with SOC.
I've always been told viral load is only relevant in determining how well treatment was working. Period.
Am I mistaken ?

[willbb]

VL is not a significant determining factor of SVR with the advent of the protease inhibitors.

Will

[hrsepwrguy]

Follow the link frijole has been tracking stats on people on tx including starting VL and following results

http://www.medhelp.org/user_photos/list/223152?personal_page_id=4523