12 wk results --> 20 VL (stubborn virus !)

I just got my 12 wk viral load results --->  the VL # is 20 using Lab Corp Quantasure Plus which goes down to 10.
My previous VL results are:
Pre tx VL =   2.8 million IU =   6.453 log
2 wk post tx VL =  136,000 IU = 5.134 log.
4 wk post tx VL =    10,900 IU = 4.037 log.
8 wk post tx VL =        270 IU  = 2.43 log.
I am Genotype 1a with bx of  Grade 2 Stage 2.  
This is my first time tx for Hep C - started tx Jan 8, 2008 taking pegasys 180 mcg weekly and Ribavirin 1000 mg daily.  
Just wondering if anyone else has had such a low VL result.  
If I become UND at  24 week, I think that gives me about 50% SVR chance.  Does anyone know if this 50% sounds correct, and if it is based on tx for 48 wk or 72 wks?
Just trying to get an idea of what to expect.
Thanks.  GingerB.

[nygirl7]

Stinkers! Man I had them too a very few left that just would NOT go away until somewhere between week 12 and 24 (4 week went straight down to 400 and I thought I was doing GREAT until it stayed at that number until week 24).

Because I did not get to UND I opted to do extend to week 72.  It wasn't any fun but I have been UND and SVR for 15 months now.

That made it all worth it.

Has your doctor talked to you about this?  Has he read the Berg and Sanchez Tapias studies?

[zazza]

Sorry to have to welcome you to the slow responders' club. At least you are not alone. I was detectable at week 12 with a viral load too low to quantify with a test of the sensitivity of 15 IU/ml. My doctor said this meant I had between 5 and 20 IU/ml. I was UND at the next viral load test at week 15. I have been on the lookout for other people with low viral loads at week 12, and unfortunately I have noticed that they tend to relapse if they only do 48 weeks.

So my choice has been to extend to 72 weeks. I do not know if it will help me, but I want to give it my best shot this first tx. Roughly speaking, I think with a low viral load at week 12 you can reduce the relapse rate to half by extending to 72 weeks. I know your doctor has already spoken to you about extending. I would grab the chance if I were you.

Since we know that you are responding to the tx, I think it is more interesting to look at relapse rates than SVR rates.

I quote the Berg study "Extended Treatment Duration for Hepatitis C Virus Type 1: Comparing 48 Versus 72 Weeks of Peginterferon-Alfa-2a Plus Ribavirin" from 2006:

"Mainly patients with low-level viremia at week 12 achieved a benefit from extended treatment duration. In the group of patients with HCV-RNA concentrations less than 6000 IU/ml at week 12 the relapse rates were 57% (20 of 35 patients) vs 32 % (12 of 37 patients) in groups A (48 weeks) and B (72 weeks), respectively. In contrast, relapse rates were 91% (10 of 11 patients) and 87.5% (7 of 8 patients) in group A and group B slow responder patients with HCV-RNA levels of 6000 IU/ml or greater at week 12."

Have you read the Berg study? If you don't have it, send me your email address in a PM and I will send it to you.

Don't forget that the good news is that you are a responder, so if you don't beat the virus this time I am certain you will do it in the future with a PI in the mix.

[zazza]

Can you get your doctor to give you viral load tests before week 24? It will be encouraging for you to know when you become UND. I don't believe it will take another 12 weeks for you to get there. See if you can get tests done at week 16 and 20 for example. It is such a nice feeling the first time you read UND on your test result.