12 weeks blood test treatm hepC

[justtry]

My 4 weeks viral load hepC drop from 6,000,000 to 360,000.
  12weeks viral load was 390,000, my doctor was talking about stopping treatment (I convinced her continue 1 more month though).
Meanwhile I went to my regular physician office and repeated blood work - it was different
  - 81,000. Now I have to continue treatment until 6 months blood work. I have
an appointment soon but I just can't wait to know was it a lab blood test mistake or
some kind of wild body fluctuation? Is anybody had a similar experience?

Thank you

[justtry]

Thank you so much merryBy,
What week are you now? When is your 6 month test? As you are writting
our viral load can very so much, is your doctor offer for you to take a couple of
blood test instead of just 6months test which might be so critical?
I mean you might be UND 1 day and in 3 weeks- 2000 or so??  

[justtry]

Thank you, Zazza for the good explanation.
I think I might not said it clear, my 81,000 blood work was done just 1 week
after I did 12 weeks test. That why I am so confused for 1 week my viral
change from 390,000 to 81,000.
Especially I am consern if the viral can vary o much may be I should do
a couple tests between my 4 and 6th months

[jmjm530]

You didn't make a two-log drop by week 12 making you a non-responder, and no doubt that is why your doctor told you to quit. Not sure at what week your took the second test with your regular physician, but it's still not a two-log drop, although close. If the two tests were close together, and assuming you're a genotype 1, studies suggest you will have to treat 72 weeks for a decent chance of SVR. If the second test was several weeks out, then the study data suggests stopping because def no two-log drop. Really not sure on geno 2 protocols and stop points, but since most geno 2's are UND by week 4, I'd assume not being UND by week 12 means you should either stop or extend to at least one year, and that probably assumes a two-log drop by week 12 and UND by week 24. Personally, I'd get another opinion from a liver specialist (hepatologist) before committing yourself for a long course of treatment given your results.

-- Jim

[merryBe]

make sure you eat yur RIBA with a little fat in the meal but keep it LOW fiber, as fiber can bind things up and interfere with absorption.

I had same prob and convinced them to let me go 6 months......only got down to 59,000

but that was 95 percent of the virus gone...so you press in.

yes our chances go down but we are not statistics we are people.
so chances are doesn't matter.

besides which, latest studies showed up to 20% who cleared late went on to SRV with extended tx.  So, it depends on you, your health, your doctor.

yes a VL can vary that much...in only a day or 2....which begs the question....at 2800 you might have been at 28 only a day before, or after.....
so again.....hard call (I hate this tx.)   but it would be hard not to go out one more month to see if there's a change (although you may not get insurance to pay for it.

wierdly, in the same clinic my doc said I had to be UND to continue...but the NP said if I was down around 1100 I could continue.......hope I don't have that fight on my hands soon!!!

[zazza]

Looking at your numbers again, I see that even with your latest viral load test, you did not have a 2 log drop from baseline. You had a 1.87 log drop. Close, but a 2 log drop by week 12 is the criteria to continue treatment. The rate of success dwindles too low otherwise.

I have also seen a recommendation to use the same laboratory each time, since the way a laboratory handles tests might affect the outcome. By using the same laboratory, one can expect that the tests were handled the same way. Maybe this has had some influence on your varying test results?

[zazza]

There is a variancy of half-a-log with viral load tests. So to be certain an actual decrease or increase in viral load has taken place between two viral load tests there has to be more than a one-log change, i e allowing for a variancy up or down of half-a-log for each of the two tests. Unfortunately, this might be what has happened to you. But if you can stick it out, continue a bit longer to make certain. You did have a 1.22 log drop between baseline and week 4, so who knows? This virus is unpredictable. Best of luck to you!

Baseline: 6'000'000 IU/ml = log 6.778
Week 4: 360'000 IU/ml = log 5.556
Week 12: 390'000 IU/ml = log 5.591
Week ?: 81'000 IU/ml = log 4.908