Aa
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
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
Oh, my goodness!!!! I just now saw your post. Beautiful, beautiful news... Best to you Zazza.
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
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
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"!!!!
But anyhow I am glad that "72 Rocked for you"!!!!
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!!!
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!!!
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!
Congratulations again. You give a slow responder like me hope!
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