Aa
Undetected at 12 wk EOT!
I had my bloods drawn yesterday for my 12 week EOT test after sofosbuvir/simeprevir/ribavirin. I am lucky to continue to be undetected!! Of course I'm very pleased with these results, and will next follow up with the test in another 12 weeks to make it official at 24. I hope many more here have good test results, too!!
Mark
Mark
Great news, Mark. Kind of ironic that you get this news just as another poster learns he has relapsed. Goes to show you how each patient is unique with their own particular medical issues and circumstances all of which can impact on their ability to reach SVR.
My husband has three weeks left of 24 weeks total on treatment. He has had to keep his dose of ribavirin at the minimum dosage due to post transplant anemia. Yet his platelets have always remained in the lower normal range since transplant. Though we remain hopeful, because of the low ribavirin dosage, we know that reaching SVR12 is probably unlikely.Nevertheless, as difficult as this treatment has been for him, we believe that the treatment has helped to prevent him from decompensating further. (He has portal hypertension and bouts of hepatic encephalopathy). The HE has recently improved a great deal.
There is something I just can't wrap my head around. Maybe someone can explain it to me. How can a virus that is "undetectable" for 24 weeks return?
So is it that the term "undetectable" actually means ""below the level of quanitification"? Shouldn't they just say that in the results instead of using a term that is misleading test after test?
Personally, I think something that is "undetectable" should be reserved for something that is gone for good, not a virus that can return as soon as you stop the treatment.
Nan
My husband has three weeks left of 24 weeks total on treatment. He has had to keep his dose of ribavirin at the minimum dosage due to post transplant anemia. Yet his platelets have always remained in the lower normal range since transplant. Though we remain hopeful, because of the low ribavirin dosage, we know that reaching SVR12 is probably unlikely.Nevertheless, as difficult as this treatment has been for him, we believe that the treatment has helped to prevent him from decompensating further. (He has portal hypertension and bouts of hepatic encephalopathy). The HE has recently improved a great deal.
There is something I just can't wrap my head around. Maybe someone can explain it to me. How can a virus that is "undetectable" for 24 weeks return?
So is it that the term "undetectable" actually means ""below the level of quanitification"? Shouldn't they just say that in the results instead of using a term that is misleading test after test?
Personally, I think something that is "undetectable" should be reserved for something that is gone for good, not a virus that can return as soon as you stop the treatment.
Nan
Congrats on your EOT-UND12! I'm superstitious and won't be celebrating myself unless its SVR24. Until then, take stock, you're on your way.
Wonderful! Happy to hear this wonderful result! We all share this journey- the good, the bad and the yet to come! Enjoy your report! :)
One the the reasons I brought up the issue of being "undetectable" is that here in San Francisco at the UCSF hepatitis clinic which is treating scores of people with the new oral treatment we have seen some lab results showing "detectable but unquantifiable" with patients during treatment. Since it is known from trial data that once a patient becomes undetectable they stay undetectable as long as they are treating (this is assuming the patient is taking their meds properly) these labs result are an error of the test. In fact we has seen one lab the result as "undetectable" while at another lab the result can be "detectable but unquantifiable" (<15 IU/ml) HCV. Note we haven't seen actual viral load numbers only results that are below the level of quantification.
By understanding how these new treatments work, which is very different than past peg-interferon treatments we realize there is little purpose in performing viral load testing during treatment once a patient is undetectable and I would imagine soon many of these test will be eliminated as part of treatment protocol because they serve no useful purpose related to the treatment. But for now we can be sure that any lab test indicating a detectable viral load during treatment (after becoming undetectable) is only a lab error and that a repeat of the viral load test perhaps at another lab would indicate the proper "undetectable" result. One less thing to have to worry about during treatment.
My main point was the outcome of treatment is dependent not on what happens during treatment but what host factors (genotype, subtype, cirrhosis,etc.) exist prior to treatment and what treatment best addresses these factors which will result in the best outcome. This is why in the future we will see treatments the are for special populations of those infected with HCV. The treatments will be based on these host factors. We are already starting to see some of these early approaches. In the genotype 1, treatment naive people who have a 93% SVR rate with only need 8 weeks of Sovaldi/Ledipasvir. In the simple case of cirrhotics we know that interferon based treatments can be detrimental to the person's liver disease and can cause decompensation or liver failure in some patients. In post transplant patients there are the drug-to-drug issues of the past which are not an issue with the new Sovaldi based treatments. We now are beginning to see which treatments in trials are most effective in co-infected people, in people with genotype 3 and genotype 1b vs 1a.
Cheers!
Hector
By understanding how these new treatments work, which is very different than past peg-interferon treatments we realize there is little purpose in performing viral load testing during treatment once a patient is undetectable and I would imagine soon many of these test will be eliminated as part of treatment protocol because they serve no useful purpose related to the treatment. But for now we can be sure that any lab test indicating a detectable viral load during treatment (after becoming undetectable) is only a lab error and that a repeat of the viral load test perhaps at another lab would indicate the proper "undetectable" result. One less thing to have to worry about during treatment.
My main point was the outcome of treatment is dependent not on what happens during treatment but what host factors (genotype, subtype, cirrhosis,etc.) exist prior to treatment and what treatment best addresses these factors which will result in the best outcome. This is why in the future we will see treatments the are for special populations of those infected with HCV. The treatments will be based on these host factors. We are already starting to see some of these early approaches. In the genotype 1, treatment naive people who have a 93% SVR rate with only need 8 weeks of Sovaldi/Ledipasvir. In the simple case of cirrhotics we know that interferon based treatments can be detrimental to the person's liver disease and can cause decompensation or liver failure in some patients. In post transplant patients there are the drug-to-drug issues of the past which are not an issue with the new Sovaldi based treatments. We now are beginning to see which treatments in trials are most effective in co-infected people, in people with genotype 3 and genotype 1b vs 1a.
Cheers!
Hector
It came back the next day. I was very surprised (although usually it comes back within two days: this is a major medical center in NYC, and they do their own testing). Not complaining!
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