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72 weeks rock!

I got my 13 weeks post tx viral load result back today. I am - brace yourselves - U N D E T E C T A B L E!!! Yes! I am so happy! More than 95% chance of a cure according to dr. Dieterich.

I did feel this coming as my liver enzyme values have been excellent both 6 and 12 weeks post tx. I had normal liver enzymes in the upper normal range all those years before tx (diagnosed in 1995), so I did some research to be able to evaluate my post tx liver enzyme results. This is what I came up with:

Women with a BMI less than 25 should have ALT levels below 19.2 units/L.
Men with a BMI less than 25 should have ALT levels below 30 units/L.

My ALT is now 10.8! The only time I have ever been below 19 before without tx was when I was pregnant (and they say your liver enzymes normalize then).

I have also read that if the AST/ALT ratio is less than 1 (that is AST is lower than ALT) - it indicates chronic liver disease, such as HCV.
If the AST/ALT ratio is greater than 2 (that is AST is more than twice ALT) - it indicates alcohol induced liver disease or chronic liver disease once cirrhosis is established.
It was more difficult to find what the normal AST/ALT ratio should be, but I did find one place where it said 1.5. My ratio is now 1.55!

Well, you can all see, that I am still making HCV into a math problem. Hope you bear with me and join me in celebration! Thank you all for your support! It truly has been invaluable. You all carried me through each of my 504 days of tx!

Za
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173975 tn?1216257775
HOORAY, zazza!

jUST IN TIME FOR NEW ROMANCES, NEW EXPERIENCES NEW EVERYTHING!  :-)

(sorry about the caps)

I just did  the 3 month bloodwork yesterday and am anxiously awaiting the results but I'm hoping some of your great luck comes my way,

I will post as soon as I see the reports.

Hooray again, ZA and many happy hugs for you.

wyntre
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Avatar universal
Dear friends, old and new, I am so happy you are celebrating with me! You all have your own special place in my heart!

Za
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548668 tn?1394187222
Way 2 Go Zazza - in the short time I've been here your posts have been an inspiration;  I'm soooo celebrating for you and can't get the smile off my face.. F A N T A S T I C!!!
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264121 tn?1313029456
That is WONDERFUL!!!! seeing a lot of good SVR news lately.  so awesome!
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Avatar universal
I just saw your post and I'm SO HAPPY for you!!!!!!!!!!!!!!!!!!!11

Congratulations!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
and as you can see, thyroid problems can be reversible!!!!!!

and yes, you took a very scientific approach to your treatment plan and helped other people with well researched advice and support!!!

All the best to you, my friend!!

Hugs
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Avatar universal
Congratulations to you!!!!

Haven't been on much lately so I just got the great news...Miracles are a happening!  

72 weeks do rock - rock on with your bad a$$ self ;-)

Peace & Love <<

TV
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Avatar universal
Oh, my goodness!!!!  I just now saw your post.  Beautiful, beautiful news... Best to you Zazza.
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412832 tn?1219075345
Hey, we got our results about the same time!  I just found out on Thursday that my 12-week was UND.  I know you had 72 weeks of tx which is just thee most amazing yet grueling feat I can even think of!!  Well, Bill1954 may have you beat on that :-)  Nevertheless, I'm sooo thrilled that your perseverance paid off for you!!!!!

pK

PS  Here's an article I found to back up Dr. Dieterich's claim:  It's a small study, but gives us lots of hope anyway!  Also, added the link at the bottom in case the table gets messed up when I post.)

HIV and Hepatitis.com Coverage of
Digestive Disease Week 2007
May 19 - 24, 2007, Washington DC
  
"A Follow-up Week 12 Viral Count Is Useful in Predicting SVR and Is 100% Accurate in Patients without Cirrhosis"

The primary goal of HCV treatment is a sustained virologic response (SVR) determined by a negative HCV RNA at 24 weeks after discontinuation of therapy. One report on early relapse rate in patients treated with standard interferon (IFN) or pegylated interferon (Peg IFN) monotherapy noted only 2% of patients became HCV RNA positive between 12 and 24 weeks after discontinuation of therapy.

No data have been reported on early relapse rates following response to Peg IFN plus ribavirin therapy. Therefore this study was designed to assess the predictive value of the 12 week follow-up viral load in determining SVR.

This was a cohort study of HCV patients treated from 2003 to present. All patients who were HCV RNA undetected (<29 IU/mL) at the end of treatment with viral counts done at follow-up week 12 and 24 were included.

Results

154 patients qualified for inclusion (89 men, 65 women). Age range was 18-79 (mean 48.7  +/-  8.8). Race distribution was White 119 (77%), Black 12 (8%), Hispanic 16 (10%), and other 7 (5%).

Fibrosis was stage 0-1 in 23, stage 2 in 38, stage 3 in 35, and stage 4 in 44 patients.

Genotype distribution was 87 (56%) with 1, 43 (28%) with 2, 18 (12%) with 3, 4 (3%) with other.

Duration of treatment in genotype 1 was 44-72 weeks (mean 49.1  +/-  4.9) and genotype 2/3 was 12-60 weeks (mean 27.1  +/-  11.6).

This was the first treatment in 114 (74%) patients, 16 (10%) were relapser and 22 (14%) were nonresponders.

Treatment was with Peg IFN alfa-2a (Pegasys) in 58 (38%), Peg IFN alfa-2b (PegIntron) in 70 (45%), and CIFN (Infergen) in 26 (17%).

In predicting SVR (Table 1), the follow-up week 12 viral counts had a sensitivity of 99%, specificity of 94%, PPV of 97%, and NPV of 98%.

Follow-up 12 week viral count did not predict the SVR status in 4 patients all of whom had cirrhosis and were in their first treatment course.

One patient positive at follow-up week 12 (HCV RNA 9000 IU/mL) later achieved an SVR.

Table 1: Post Treatment HCV Viral Counts in Patients with EOT Response

                                                                     SVR
                                                                Yes      No         Total
12-Week Follow-up HCV RNA     Negative    99        3           102
                                                 Positive      1       51            52

Total                                                         100     54            154

The authors conclude, “A follow-up week 12 viral count is useful in predicting attainment of SVR and is 100% accurate in patients without cirrhosis. In this sample, 9% of patients with cirrhosis were misclassified by the follow-up week 12 viral count.”

In addition, they write, “Use of an earlier viral count in patients without cirrhosis would allow earlier retreatment for those with relapse and allow earlier confirmation of successful treatment.”

05/25/07

Reference
D Friedman, S Rashdan, C D Levine, and others. Predictive Value of a 12 Week Follow-up HCV RNA on SVR in Chronic HCV Patients Treated with Peg/RBV. DDW 2007. May 19-25, 2007. Washington, D.C. Abstract # 1859.

hivandhepatitis.com/2007icr/ddw/docs/060107_a.html




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Avatar universal
Congrats on your wonderful news!!!!! I am seriously thinking of talking to my doc about doing 72 weeks also.

But anyhow I am glad that "72 Rocked for you"!!!!
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Avatar universal
I just love everyone for sharing my joy!
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167203 tn?1280692080
I am soooo happy for you!!!! yea!!!
This is such good news!!! I don't get the chance to check in as much as usual since I've moved and still not in my own place yet. I loved reading your post!!!
Congrats!!!
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338734 tn?1377160168
I put the root of a negative number in there just in case you were trying to work it out. Figured that would raise some suspicion.   If you worked it out with that, congratulation on being a total math nerd! :)))   ... and welcome to the club.

Congratulations again. You give a slow responder like me hope!
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Avatar universal
Congratulations!
I am so glad for you. It is especially encouraging news for all slow responders.
Good luck and good healthy life to you!
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Avatar universal
I just love these mathematical congratulations!
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Avatar universal
Hahaha, Walrus! I actually tried to decipher that before I saw it was a joke!
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338734 tn?1377160168
I found the following:

AST/ALT * LOG(GGT/AlkPhos) + SIN(WBC-RBC) - SQRT(-2LOG(RDW))/PCR = Forgetaboutit! You did it! Way to Gooooo!

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446474 tn?1446347682
GGGGGOOOOOOOOOOOOOOOAAAAAAAAAAALLLLLLLLL!!!!

ZAZZA = 1
HCV = 0




(No Root Beer in Sweden???)
Hector
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Avatar universal
very encouraging, congrats, jerry
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92903 tn?1309904711
The last sentence in previous post (under my name) should have been deleted as is was from Zazza's original post and was only for my reference.

The first sentence in my post should have been deleted as it was copied from Jim's post, but if I did that then second sentence wouldn't make sense and would need to deleted too. That said, I wouldn't have a post. And don't let the 'that said' fool you, it's from my post not JIm's post.
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Avatar universal
The last sentence in previous post (under my name) should have been deleted as is was from Zazza's original post and was only for my reference.
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Avatar universal
Congratulations on your well deserved SVR!

As to the the AST/ALT ration, you don't have it right. It's an *elevated* AST/ALT ration that associated with fibrotic progression, i.e. where the AST is higher than ALT.
http://ndt.oxfordjournals.org/cgi/content/full/15/10/1716?ck=nck

That said, the AST/ALT ratio is only relevant when enzymes are elevated as in HCV. If both your liver enzymes are normal, as in SVR, then it doesn't matter if your AST is higher than your ALT. In this case it does not suggest anything negative.

-- Jim



I have also read that if the AST/ALT ratio is less than 1 (that is AST is lower than ALT) - it indicates chronic liver disease, such as HCV.
Helpful - 0
113932 tn?1189755824
Congratulations to you!! When I heard that news myself, it made treatment seem like a breeze, and definately worth it. Way to go!!
Kathy
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476246 tn?1418870914
I want to wish you a HUUUUUGE Congratulations. I am so very happy for you. The sound of SVR approaching is soooo sweeeeet.

Hugs, Marcia
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Avatar universal
What wonderful news!
Good For You!
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