Help! so confused VL came back

[Effiedanna]

I was undected at 12 weeks using Quantitative HCV RNA <50 IU/ml and <1.70 log IU/mL, my 16 week labs show a viral load again at 23,5000 and my log at 4.37. Can anybody explain whats happening this has really upset me.

[Effiedanna]

I did and he said he wants me to just continue with my meds and we will see what happens that he is not even thinking of quiting yet. I do respect his word he is one of the top hepatologist in Ks.
Thanks Effie

[Bill1954]

Hi Effie,

Have you had a chance to discuss this with your doctor yet? If so, what was his take on it?

Bill

[Effiedanna]

I am a geno type 1a stage 0 to 2, when this blood work came back as deteectable my ALT and AST were lower since beginningf treatment also, my T3 and T4 cells are now normal for the first time thats why i am so confussed. i weight 164 lbs and am 5"8 i haven't missed any dose and take 1800 of pegagus oncee a week and 1200 of riba daily my Vl consistently has gone down since beginning treatment an at 12 weeeks undectable then 16 week labs show Vl at 23,500 i wonder if this could be a mistake what do u think. Thanks for your support. Effie

[Trinity4]

I don't know Red, I'm grateful for the advice I've been given so far.  It's made a huge difference in how I'm approaching my treatment.  You may have been talking about me, and that's OK.  I just take the advice or commentary, or dialogue, whatever one wants to refer to it as -  under consideration - and if it doesn't appear to me as a logical or viable option I toss it out.  Someone always chimes in with a different approach to things if they disagree as well -  I like the advise.  
Trin

[dointime]

The PCR test used which showed UND  was sensitive to 15 IU.

dointime

[redrodeo]

I vote for a 2nd test. While I was on tx I was neg until wk 22 and all of a sudden the test came back positive w/ viral load of +18mil!!!! It was never that high before tx. So we did a retest and it was neg, Thank God. PCR testing has a reputation of false positives. But I'll tell you I've been reading these posts for a awhile now and there are a lot of people giving advice and sharing their knowledge that have no business doing so. I don't know what their credentials are but they ought to be careful, I don't think they are MDs
Red

[comeagain]

So sorry to here about the virus up again thank God there are new meds coming soon.
given us better odds.
I wonder if you have done any dosereduction or if you have missed any dose.

Also wonder what geotype are you and what is your weight and what is your doses?

I´m a relapser on my second tx right now if i fail this time aswell I only have the new meds to hope for.
Take care .

ca

[nygirl7]

Agree - that's a huge jump and most likely does mean breathrough.  If that is indeed the case I couldn't really imagine a doctor telling you to continue with the medications because they have ceased to work - however if he does think that you might possibly become UND again, you are going to need WEEKLY PCRs to find out in fact if you do WHEN and if it sticks. Then you really will have to consider extending treatment - I was found to be UND somewhere between 12 and 24 weeks (meaning it "stuck" for me then) and I had to do 72. I didn't even have a breakthrough but still really had no choice.

The medications don't just "kill" the virus like you kind of imagine. They teach your bodies IMMUNE system how to do it. SO if they have come back again it means somwhere inside your immune system (not really your liver) something failed. That is why we continue treatment for so long AFTER we become UND - our bodies have to be taught to wipe them and and make sure it gets any that are lingering.

I don't know if I said that correctly or clearly but - it's not just a matter of getting rid of them and becoming UND - as you have seen first hand those creeps REALLY want to come back and you have to have the amount of time to train your immune system to push them down and kill them ALL.

So if you are a geno1 by all accounts you need to consider it like you have NEVER been UND at all - that means IF you can get rid of them again....you really have to do 72 weeks to have any odds of staying permanently UND at all.

[Trinity4]

That's about a 3 log jump up from UND -  please somebody correct me if I'm wrong.  If you are still detectable at 24 wks, not good.  Usually, they will discontinue tx.  Breakthroughs do happen -  the body reacts well to the medications and then suddenly no longer fights as hard - don't know the exact science behind it - not common but happens.  The same principal applies to those of us that do not clear at 24 wks -  even when we are responding so well.  Just can get rid of those last little virons.  In any event, I would go along with what you doctor has recommended and it's is entirely possible you will reach UND again.  However, if you continue with tx and are UND by 24 wks, you should talk with your doctor about extending tx to 72 wks.
Good Luck
Trin  

[Effiedanna]

my positive is 23,500 not 23,5000 i typed that wrong the first time do u think that is still high from a jump of undetectable? also, talked to my Hpatologist this morning he said that to continue what i am doing that their is a fight going on in my liver with the pegaus and riba and that lets wait and see what happens that he is not ready to stop treatmeent that it could become undetectable again, what do u think?

[nygirl7]

I had a false positive but the count was 63.  Once you get a count that is that high the chances of it being false are very very low but I would insist on a second PCR myself just to make sure.

Unfortunately these things can happen.  We don't know what dosages you are on or anything like that but if it is real you will need to stop treatment and then decide later to retreat with more meds or try using one of the trial meds that are out there or try infergen.  Many options so it's not hopeless so don't give up.

It does totally s*ck but I would make sure with that second PCR using a good sensitive test.

[comeagain]

May i ask  what test was used ( how sensetiv ) showing UND after 8 weeks.

ca

[Bobby1952]

   Get a second Viral Load just to be sure. Dr Dieterich told me that 5 % of PCR's are false positives. Not to get your hopes up too much but you never know.

Bobby

[dointime]

Same thing happened to me.  It really s*cks I know.  I was UND at 8 weeks and over 200,000 at 16 weeks.  Viral breakthrough Iºm afraid.  You should get a 2nd PCR taken 2 weeks after your 16 week one, just to confirm.  

Your doc and you will decide on what next, ofcourse, but usually you just have to stop tx and accept that it hasn´t worked.  Iºm waiting on the new drugs.  I´ll tx next time with SOC and at least 2 other active agents.  All is not lost, although it feels like it at the time.  I hate waiting but Iºm lucky that I can.  I hopeyour liver damage is mild and you can too.

Good luck,
dointime        

[merryBe]

It happened to me...so sorry to hear this for you...

but it isn't uncommon. Mine was I think caused by my body trying to fight of a severely inflammed infected gall bladder.  As soon as they took that out my VL went to UND and has stayed there for 5 months now.
But my docs were ready to take me off of treatment the second it went up as they didn't beleive it could be caused by the gall bladder as I'd been telling them for months..
Read my journal on this, and be sure and get tested if you may have a secondary infection.  (my surgeon said my GB was shaped like a corkscrew...the worst he'd seen.)
There's no doubt in my mind this sick thing attached to my liver was hampering my tx response.
mb

[Bill1954]

I should have closed by saying that this really should be discussed with your doctor; he’ll need to address this and come up with a plan. If this were me, I’d specifically ask to see the doctor rather than an NP if at all possible.

Good luck—

Bill

[Bill1954]

You just might have encountered viral breakthrough. It’s rare, but it can happen. Breakthrough is defined by achieving undetectable status, then encountering viral re-emergence *while remaining on treatment*. This compares to relapse where the virus reappears after the course of treatment has been completed. Have you spoken with your doctor? What is his take on the situation?

Bill