Damn! Still Detectable @ 16 weeks!

I thought for sure I'd be UND by now.  16 week labs show a VL of 20,000.  My chances of SVR seem to be getting slimmer and slimmer.  

My progress:

baseline:  2,910,000
week 4: 261,000
week 8: 58,000
week 12: 40,000
week 16: 20,000

For now, I'm continuing tx.  Any slow responders on this board that have achieved SVR?

Tim

[miked]

My first treatment was three years ago using Peg-Intron with 1200mg of Ribavirin daily.

My numbers were very similar to yours posted above.  At Week 32 my VL was 9,600 and then rose due to a viral breakthrough.  I'm being honest and direct with you.  Everyone with HCV responds differently though.

Before my Week 32 breakthrough, I was urging my local-yocal doc to either UP the Peg-Intron or change me to 180 mg of Pegasys.  The stats for slow responders aren't great as tx time moves on, although some do clear.

Would your doctor consider changing interferons or going off-label and increasing your present INF?  Double Dose is  a guy on this forum who treated with 2x the amount of INF....cleared and stayed UND.  Maybe DD will comment.

I'd hang in there for another 4-6 weeks,  If still not UND you should study your options.

For me there may be a happy ending.  Four weeks ago I completed 24 weeks on Vertex' Prove 3 trial for VX-950.  I've been UND since Week 2 and still UND 3 weeks post tx.  When I get to 12 weeks post-tx UND is celebration time.

Sorry not to sugar-coat this but nobody here would be direct with me when I had the viral breakthrough.  I wanted direct information too.

Mike

[GrandmaA]

I'm sorry to hear about your breakthrough, etc. It's a terrible disappointment. Do you have a hepatologist instead of a GI? Good luck to you. God bless.

[motheroffour]

My H was a slow responder although his viral loads were under 100 but he started with a very low viral load, he never spiked just a slow very steady decline each week until undetectable.  He chose not to go the 72 and relapsed two weeks after finishing the 48.  If you choose to continue for the health of your liver and with the remotest hope of clearing I would not stop at 48.  I wish every single day that I had begged my H into continuing on to the 72.  Now we're in a medical no man's land with him retreating after a brief 3 week break in treatment because his doc freaked that he relapsed (dumb) and insisted he start again immediately, which my ever so compliant husband did.

[motheroffour]

Sorry, his viral loads were well under 100 at 16 weeks.

[Forseegood]

just want to say that I hope you have helped yourself with your treatment in any case, and that you have better luck with your next endeavor in this area...be well....

[Proactive]

sorry to hear about your late responder status (without a 2 log drop by 12 weeks), seems you plateaued around 8 weeks. Have you discussed increasing meds with you doc?
For what it's worth (maybe nothing) you can check out my stats on my profile, my riba was increased @ week 8 and again at week 12...My anxiety has always fallen on whether there would have been benefits to increasing the peg also, although I haven't read much about peg dosage increase('cept for charm?) with slow responders and only a few such as myself who had riba increases as a response to slow respondance.
Past time to kick some *** and become super proactive to you situation..second opinion maybe?

[miked]

You may want to call a doc in Lousville, KY who has treated many hard to tx with INF + Ribivirin, only at off label dosages.

http://www.hepatitisdoctor.com/

[nygirl7]

I dropped from 568,000 to 411 at week 4 but then stayed in the 400s until my test at week 24.  I treated for 72 weeks and am SVR.

But I had a 2 log drop by week 4 even though I hit the dread plateau so it's not really the same case.

Still I was taking extra riba the whole time and I had a lower v/l than you  with a two log drop but...I wouldn't stop until week 24.

Going to 72 at that time was relatively unheard of and I had to jump threw hoops to get it but I am glad I did because I completely and totally believe that was ALL of the difference in the world.

I wish you all the good turns of luck that are possible on this hep road.  I'd ask my doc to up everything for the last few weeks to get you to UND by 24 and then see what happens.

[wyntre9]

Well, you were very close to a 2 log drop at week 12;  29,100 isn't that far off from 40,000.

I am a slow responder, too.  I didn't reach UND until between weeks 16-18 but I've remained UND ever since and I'm now on week 48 going for 72.

I agree you may want to consult further with your Dr. about tinkering with your meds to give you the best shot at UND by week 24.  And if you do get UND, you may want to extend to 72 weeks.

All the best,

wyntre

[frijole]

It really seems that you need to change stragegies at this point.  I like what Proactive did - increasing the riba substantially.  What has your hemoglobin been doing?  If you have not had a substantial decrease in hemoblobin, you may be way underdosed.  Fishdoc had some pretty significant VL at week 12 and she cleared, upping the riba to maybe 1800@ day and going for 52 weeks.  You do need to take some action, I think.
frijole

[fishdoc]

look in archives under "fishdocs consult"....same situation, started at 2.9 mill, 12 week was at 3,80000, less than 2 log drop- close don't count here, only handgrenades and IEDs.  Consult was the only reason I cleared, I really believe that.  He gave me a 17% chance of clearing give the current tx, (1200 mg riba)...theres an explanaation in the archives...best of luck- its worth the fight..

[Old_Broad]

I went thru 42 wks of peg-intron then went thru 70 wks of Pegasus and Still have hep c. My viral load was very low for a while. Quit Pegasus in Jan   april viral load was 4,  Aug 10   Dec 20 this past July 180 millions. I'm just hanging in there waitin for the best. My doc is one of the heads at Shands in research at in Gainesville Fl. I am hoping for a study with a new med for non responders.  Heard nothing yet but am hoping. The meds did help my liver. It bought me some time. I am thankful for that. Doc said that FDA should have this new stuff approved in the next 3-5 yrs. They are using it on people that have never been treated before & she said they were getting some good results.  So hang in there. There is light at the end of the tunnel. My dr name is Soldevilla-Pico.   She is great. My brother had hep c but died of lymphomia. diag 2 weeks then died. I have the little veins on my throat & chest that like to rupture. whayever they are called. So far no ruptures. My cousins husband went to the hosp yest for high amonia (ammonia) count. He lost it mentally.  We have a lot of unfortunate things to look forward to. My thyroid is screwed up also. The peg-intron did that.
Thanks for lettin me have a say.

[Proactive]

doc, can you provide a link to "fishdocs consult"? I have attempt to search before for this post and am unable to find it through Medhelp's search feature (maybe this is a better place for them to spend their efforts, instead of more worthless fluff upgrades...Thanks :^) pro