Borderline 4 Week PCR - Advice/Inspiration

I got the results today from my 4 week PCR. Pre tx viral load was 9,123,148. VL on 4 week PCR is 1,064,229. That comes out to about a .94 log drop. The studies I have read indicate that if not a 1 log drop by week 4, one should discontinue treatment. Looking for thoughts /inspiration from others to keep going to week 12? I am a geno 1.

[Trinity4]

My Stats - Barely a 1 log drop at six weeks, probably was the same place at 4 wks too but didn't have a 4 wk PCR.  Went UND somewhere around 15 wks probably. I am extending tx but I did respond and so are you.   Keep going!!!!!

Baseline vl 1,300,000
6 wk vl         100,000
12 wk vl             793
24 wk vl            UND

[Isobella]

I know you are disappointed right now....but I gotta say, if it were me-I'd keep going.  See where you are at by week 12 and make another decision then.  Below is a geno 1 timeline I copied when I first came here....I didn't save the link tho, but I think the information will still help.

As a geno 1, this is our expected response to treatment:

20% are rapid responders (UND by week 4) and have a 90% SVR ("cured") rate.

40% are complete early responders (UND by week 12) and have a 70-80% SVR rate.

20% are slow responders (UND by week 24) and have a 20-30% SVR rate with 48 weeks of treatment. If they extend to 72 weeks tx, they will increase their SVR rate.

20% are non-responders, i e null-responders, breakthrough, partial responders.

Maybe you can get an additional PCR between week 4 and week 12 to give you a clearer picture of when you reach UND.  That's just me tho...I go kinda crazy with the PCRs.

Either way, baby.....I say KEEP KICKING IT!!!!!

[zazza]

"The studies I have read indicate that if not a 1 log drop by week 4, one should discontinue treatment."

I used to think this also, but I have seen a couple of examples of people without a 1 log drop at week 4, still become UND by week 24. So if you are prepared to extend to 72 weeks if you are not UND by week 12, I would say go for it.

There is always the option of waiting for the new drugs as well. Hopefully they will be approved in 2011 or thereabouts. Only you can decide how motivated you are to treat now versus to wait.

[AnotherJourney]

At first I was real excited when the family doc called. Then when I did the calculation, I bummed out bad. Hence my post....  knew I could find the strength I need to keep going from folks here. So I am thinking I might as well keep pushing to week 12 and see what happens. Like Lisa says, make a decision then. Also when I see hep on 25th gonna show her the results and ask her to up my riba another 200mg. That would be more in line with the weight based dosing calc Za did for me. So at least I have another plan for a bit ... just keep being diligent about my treatment and making sure I stick to my regimen and a prayer now and then.

[Tippyclubb]

I feel so bad you didn't get the news you wanted but keep going and recheck at week 12.  Hopefully, you will be UND then.  That's all you really can do now.  I will be praying for you !

[Isobella]

Count me in for that too.....new we wait for  week 12 and the good news...UND.

Hang in there =)

[Marc1955]

I'm not sure what studies you are citing regarding a 1 log drop at week four. I thought the standard protocol looked for a two log drop by week 12.

When we start this treatment, we all think we're going to be in the lucky half. We have a positive state of mind and we stick rigorously to the treatment. The truth is that positive state of mind doesn't make a difference to success of the treatment (although it helps in other ways). We're not all lucky. Some of us try our hardest and still don't get a SVR. It's the way of the treatment.

You're doing fine. There's no reason for you to stop treatment. Yeah, you're not in the lucky group that get an early response but you still have a perfectly reasonable chance of success as Isobella so clearly laid out.

So you're not lucky. Life is complicated. Stick with it. Don't give up.

[justme53]

I was a bit diappointed in my 4 week PCR too...just over a 1 log drop but I was holding out with high hopes for UND :-) So I'm hanging in there for the 12 week one. I'm on the same dosage of Riba (1400 mg/day) but my hemoglobin didn't start dropping until about week 4. How're your CBC's holding up?

Here's hoping 12 is the lucky number for us!

[zazza]

"When we start this treatment, we all think we're going to be in the lucky half. ...We're not all lucky."

This is true, but d@mn if we are going to give up because of that. With persistance and endurance we can beat this virus still.

Za,
72-weeker and SVR

[jmjm530]

How much liver damage do you have? If you're stage 2 or below, stopping treatment is a very reasonable decision after you weigh the risks of the treatment drugs with what probably will be an extended treatment period (72 weeks) and uncertain odds of SVR. If you do decide to continue, you really should speak to your doc to change something in your tx. I'd also consult with a liver specialist (hepatologist) moving forward if you already aren't