4 week PCR results in

Hello everyone,

Just got my 4 week PCR.  Am not sure if I should be sad, happy or indifferent.  I had talked e few weeks ago about changing docs if I was not UND at week 4 since my current doc said if I was not UND at 12 weeks tx would not work.  So am wondering if I should go on with my plan.

4 week V/L 720 IU/ml   log10 =  2.857

Before starting tx 1,930,000 IU/mL and log10 = 6.286

Female, Age 51, Geno 3.

Comments welcome and needed!  I was so hoping for UND.

Linda

[copyman]

i think that is a great drop and bet you will be unde between now and 12 weeks. dont get down on this news. i would test at 8 and then 12 weeks. you most likely will be unde both tests. most docs still use the 12 weeks as the true test on tx working or not, seems alot of talk has been the 4 week test showing if you will svr or not and this is not always true. all the stats and precentages that are used are still based on the 12 week pcr. hang in there and you will see that you will be unde next test.

[returntosender]

That's a terrific reduction - 3.4 logs in 4 weeks - those are genotype 2 and 3 numbers!  There are a some folks who treat who really get no significant viral reduction until AFTER the 4 week mark, seen by some as the onset of the reactivation of a dormant immune system.  The other thing to consider is that you achieved this reduction even before your Riba had a chance to reach peak serum levels.  So somehow your immune system is kicking some virus butt. Once Riba connects in you should be really good to go!

[returntosender]

Oh, you are geno 3! See told you they were geno 3 numbers.  If I were you I wouldnt give another thought to viral loads until you have reached your 6 month post tx milepost. At that point you will surely be SVR!  Congrats.

[Kalio1]

That is a good, solid log drop, you are headed in the right direction. What is being said in some studies is if you do not clear the virus in the first 4 weeks then you might consider extending treatment. Are you on a 24 week plan? Usually geno 3 are put on a 24 week plan initially. If you were, I might consider treating for 48 weeks.
This is not to say you couldn't still acheive SVR in 24 weeks but the odds are lower fpr clearing if not UND by week 4. I am geno 3, I didnt clear it by week 4 but did clear it by week 12, I relapsed after the first 24 weeks of treating, so from my POV I'd consider extending to 48.
Don't get discouraged! You ARE responding and knocking the virus down. See if you can get another PCR sooner than week 12 if you can.

[LindyK]

I'm glad you responded because I knew you had a similar situation.  My doc is straight SOC - he wouldn't order a 4 week PCR, only 12 week and he will not extend treatment.  That is why I had my PCP order the PCR.  I wrote a lot in another post a while back about changing Hep docs.  You were the one who suggested I get my PCP to order the 4 week PCR.  There is a good doc in Atlanta who evidently is less rigid about tx protocol so I think I'm going to go ahead and get a referral to see him.  I see my PCP on Monday and he has already agreed to re-refer me if that's what I wanted.  Like you, I'd rather go ahead and extend now rather than do the 24 then relapse, wait six months and start over with 48.  I hate the thought of 48 weeks.  I was desperately hoping for UND at 4 weeks.  But I'll do what I have to do to get rid of this horrible monster.

Thanks so much for all the support and info you've given me!

Let me know what you think about changing docs.

[jmjm530]

You had over a 3 log drop in four weeks. Personally, I'd test again at week five, and week six if necessary, before making any plans on extending. Of course, the amount of liver damage might play into the decision to extend -- the more damage, the more benefits of extending IMO. As to the numerical significance regarding SVR of a geno 3 still being detectible at week 4, this is something that I would research out if I were in your position. Consulting with another liver specialist also a very good option.

All the best,

-- Jim

[LindyK]

Thank you both for your encouraging words.  I was a little bummed when I picked up the results today.  I feel much better now.

[Kalio1]

I would consult with someone else if your doctor has made it clear he won't extend. You still have a chance of clearing it in 24 weeks, all is not lost on tht regard. We do now know your chances are much improved by clearing by 4 weeks though, so you can use that to clue you to needing longer tx but the fact yo didn't clear by then doesn't rule out you clearing in 24 weeks, which is why your doctors feels 24 will be enough. He could be right. but if it doesn't work out that way, YOU are the one that does the extra time on tx!
Try not to view tx overall, look at it day by day. Right now you need a doctor who will help you extend if that is what you feel is best. Try not to focus on the weeks left.
Did you try showing your doc the studies or articles you have seen on the subject? It seems easier on you to get him to be more open minded than having to change doctors. If he just wont agree, I'd see someone more agressive. Geno 3 has it's own special quirks.

[scubadiver30]

I was wondering. Can a patient switch from Pegasys to Pegintron right in the middle of TX?
Lindy, TX is working. Hang in there. As JIM said I hink u should do a 6 wk and 8 week PCR to know exactly when you become UND and how many weeks should extend after 24 without having to go the full 48. Sorta like Aiuta is doing.

luv
scuba

[Cindy10]

I know exactly how you feel. I am gt3 on week 13 of 24 weeks.
I was detected at week 4, I went from 1.3 million to <615 but greater than <10 and although the numbers are good I was still bummed. You read so many that are UND at week 4 and you just want to be one of them. Because I did not clear at week 4 my doc is alreay talking about extending to 48 weeks. I just had my 12 week test so we will see what happens, but it does seem now if you dont clear at week 4 you may need to extend.

I wish I had done this so I am going to sugest to you. Try to get another test at 6 weeks or even 8 weeks, dont wait if you dont have to. The sooner you clear (or know you have clear) the better, you may not have to extend that long. I may have cleared at 5 or 6 weeks and now I will never know.

Hang in there, we are still on track!