VL Climbing

[michelehen]

Evening everyone - went to the Doctors today to get 4 weeks result and got alittle bad news,
my Viral Load went up over another 100+K, my Docotr didn't like the idea of the Hep C still attacking
my Liver.  He order my lab work and will get those results back by Friday - has anyone had any
problems like that?  Oh and my platetes went back down again to 44.  I have a great Doctor that has been treating Hep C for along time and attends every seminar there is.  I've been pretty lucky on not having alot of side effects
I've had the chills a few times and ran a fever a few times and thats about it.  I'm kinda of bummed out with this news and praying the meds are working in other ways.  Any answers woul,d be very helpful.....

Thank You,
Michele

[michelehen]

Hi Advocate - no I did what everyone suggested and take the lab work on Friday the day I was to take my 5th shot that night, so hopefully today I will get results back.  Crossing fingers...:)  Thank you for asking

[Advocate1955]

Hi Michele,
Did you get your PCR results back from the re-draw yet?
Hoping for good results.
Advocate1955

[srw920]

So for now on I am going to schedule labs on Friday mornings.  Thanks so much.  The nurse was loose in her direction for the labs.  Basically said anytime after every second shot.  I love this forum.  Thanks again.

[hrsepwrguy]

The full 8 weeks would be june 29 before your 9th injection, that is assuming you do your injection in the evening.

[srw920]

Hi pooh and everyone,

My 4wk vl was still detectable and just shy of a one log drop.  after reading this dialogue I realized I had my blood draw 2 days early.  I am coming up on my 8th shot and realized my scheduled lab work is 4 days premature of the full 8 wk.  I just moved my appt to Thursday since my peg days are Friday.  I started Friday May 4th so 8 wks would be the 28th correct?  Thx everyone.  I am so nervous about these tests. Gulp!

[pooh55811]

It would not matter if it came back Undetectable, but it may matter if you are showing Virus tomorrow but would have been UND on Friday.

We never know when we clear the virus. It might be detectable one day and undetectable the next day.

If I had my 4 week VL drawn 2 days early and it came back detectable, that would affect how long I treat and/or if I could continue treating. If I had to do 48 weeks based on an early VL, then I would not be happy. If I had to stop treatment based on an early VL, I would be even more unhappy and I would always wonder if I had had the VL drawn at exactly 4 weeks, would the outcome have been the same.

[michelehen]

Ok so I will wait til friday morning and get it done then, would it really make that big  of a difference?  Wonder why he didn't tell me that, strange....thank you pooh very much!!

[pooh55811]

I did not do the math like hrsepwrguy did so I did not realize it has not even been 4 weeks since you started treatment. The 4 week VL should be drawn on the day of your 5th injection before you take the injection (that is a full 4 weeks of treatment). As hrsepwrguy pointed out, your 4 weeks VL should be drawn this Friday, June 22, not before. The  4 week VL is so crucial in terms of determining if you continue treatment or stop treatment that it should be drawn right after 4 full weeks of treatment (not before and not after, but at 4 full weeks). So you should have a VL drawn this coming Fri. on June 22nd.

Once you see what the 4 week VL shows, then you will know if you can continue or have to stop treatment.

IF you have to stop, there are many trials going on and some have great success. You may be able to get into a trial at some point before any new drugs are on the market. This is only if you have to stop treatment.

Wishing you the best.

[michelehen]

That blood work was done on the 8th and tomorrow I will have a new PCR Quantitative and also for the platetes he is running a media citrate?  hope that is right....lol

[michelehen]

I didn't ask for the numbers but he did say it went up 100k more than when I started,  We are hoping it's a lab error also, so if not then I have to stop treatment and then wait for the next one that could be maybe in 2014?

Thank you both for answering, I pray I don't have to stop..........what and wait for my Liver to get worst.....oh brother....lol

Michele

[hrsepwrguy]

My mistake sorry, you started tx on may 25 so your 4 wk VL should be taken on june 22 but by your post it looks like it was drawn today and that this will be the one that tells you whether or not you should stop due to futility rules. Again I apologize, hopefully this PCR will reveal a great response.

[hrsepwrguy]

I hate to be the bearer of bad news and really hope that your PCR was a lab error of some sort but according to incivek futility rules you should stop all treatment.

2.3 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).

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

[pooh55811]

What was your starting VL?

Do you know the exact numbers for the 4 week VL?

Are you saying that the VL is higher than when you started?

If you can tell us this information it will help us respond more accurately.

Hopefully another VL was drawn just to be sure it is not a lab error.

Hoping it is a lab error.