What day counts as the day you are cured?

Question

Is it:
1) 12 weeks after your last day of treatment?
2) 24 weeks after the end of treatment?
3) The day you get a letter from your med team that says you are cured?

hepcandme · Answer

What do you think of this?

My last labs showed a perfectly normal ALT but they didn't test for AST. My doc's explanation was that once those 2 liver enzymes become stable, they don't really look at them much but concentrate on Bilirubin levels

Which is normal now as well

"Stable" is the word they use to describe my condition now. So, from now on, just call me Stable

Which is better than being Unstable but sounds so bland

hepcandme · Answer

Lynn, Congrats on your 1 year anniversary!

flyinlynn · Answer

I am going with the 12 weeks SVR to say cured but I did get tested at 24 weeks and for my annual testing which was 44 weeks post since with my history I wanted to be really sure.

Do doctors write letters saying someone is cured?

Dee1956 · Answer

Yes, Sandi, I was the same back then. In fact I was even tested two years later. Now that it has been over 4 years I count my first UND as far as my liver health is concerned. I know, I am as clear as mud. :)

Dee1956 · Answer

Oh, very good about the ALT and the AST. Mine were lower than they had been in 30 years.

hepc4Sandi · Answer

For me it was 24 weeks, but I really didn't feel assured I was cured until a year after treatment.

Dee1956 · Answer

At first, for me it was 24 weeks because I did the old insidious (Incivek) tx, groan.  At the one year mark I was very happy. Now that it has been 4 years, I count the first day that I was UND. I figured, it didn't come back so why not?  Good question :)

hepcandme · Answer

Or the day that Hector said to use?  Here's his message that includes a little trick to discern without a VL test whether you are cured or not:  From Hector:

I saw your post on my Cirrhosis Community so I thought I would respond since there is no reason to be in doubt about SVR 12 weeks after EOT. 

You are now 12 weeks since EOT. So if you are still undetectable you are cured. SVR is SVR12 not SVR24 weeks and has been that way for years now. So all you really need is SVR12 and you are cured for good. SVR24 went away with interferon based treatments, viral breakthroughs, early/late responders and other terminology of old obsolete treatments. 

There are two options to learn if you are cured: 

1. You can pay for a PCR test and know 100% you are cured. 
Have your primary doc give you a lab order for a HCV RNA test. You can take it to a local Quest Lab or LabCorp lab and 

2. Look at your most recent blood labs with ALT and AST levels taken at least 12 weeks since EOT. 
When a person starts treatment and becomes undetectable there are other labs levels that also change. For example ALT and AST. These enzyme levels inflammation of the liver caused by the virus. So if you look are your ALT and AST labs before you started treatment and then while you are on treatment you will notice that the ALT and AST levels drop as you become undetectable and they stay low (sometimes in the teens) as long as you are on treatment. Then when you stop treatment they will continue to stay low as long as the virus doesn't come back to cause inflammation to your liver again. 

The Bottom Live is... 
If your ALT and AST have remained about the same levels as they were when you were treating (low 20s or in the teens) then you have not relapsed and since you are more than 12 weeks since EOT you are cured. 
The SVR24 lab will only confirm that you are cured. 

People typically relapse within 4 weeks after stopping treatment. After being undetectable at week 4 after EOT you have about a 98% chance of being cured. In other words only a 2% chance of relapsing between week 4 and 12. There is 0% of relapsing between week 12 and 24 so that is why SVR is SRV12 not 24. 

So there is really no reason to wait 3 months to know if you are SVR. 

Looks like your cured (assuming good ALT and AST levels). 

Congratulations!