EVR and ODDs

I see that many who started treatment when I did are having good 12 week labs at ND.  What are the odds that they will stay SVR.  In my case I am a 2 genotype and cleared week 5 and 16? What are the odds I will stay clear after I stop the meds.

[Tonyz]

Hi Misty,

You have one of the easiest Geno-types to cure. If you are still clear at week 24, I believe the "odds" of an SVR Or Cure are around 85+%. Other factors to consider, would be the amount of damage that had been done to your liver IE the results of your liver biopsy, also your Viral load before you started TX.


               Hope this helps

                God Bless

                 TonyZ

[mistybean]

Liver is ok.  Alts are normal and viral load was medium range.

[GoofyDad]

What's the likelyhood of a viral breakthough after clearing? Pretty low, I think?

[jmjm530]

Defining viral breakthrough as going from non-detecible to detectible while ON treatment...I think quite low since there's only around a 20% chance for geno 2's not to SVR. Once clear, if the virus is to come back, it would come back within the first 30-days of stopping treatment, if I recall correctly. You don't need to worry so much, you're a Geno 3. :) Or course, I'd be doing the same and in spades. LOL.

-- Jim

[tina-b]

Jim, you stated "Once clear, if the virus is to come back, it would come back within the first 30-days of stopping treatment, if I recall correctly. You don't need to worry so much, you're a Geno 3."

That just isn't true. My man is a 3a and has relasped 2 times. He was 100% compliant on meds both times 24/24 and 48/48 peg and riba. He cleared at 4 weeks and stayed that way through out both times.

First relapse was with in one month....the second time he relapsed was after 7 months of being clear. He tested neg at 4 months post tx and relapsed at 7 month check up with vl of 29,500. His vl 2 weeks ago was 600,000.

There have been many 3's relapsing lately and nobody can explain why. From what I've read, 1's have a hard time getting a response and 3's respond fine but have a higher relapse rate. 2's seem to clear and stay that way most of the time.

[GoofyDad]

I just read comments about if your still clear at week x ..... such as Tony's above, and it makes me wonder. I've felt that once clear I'm pretty much golden until I stop the meds. I mean, I know a breakthough can happen - but I can also get run over by a bus - which come to think of it should pretty much assure a clear PCR at week 12, and beyond :)

So I was curious - are breakthoughs like a 2-3% chance?

[jmjm530]

I don't think I said that but if I did tie me to a tree. :)

What I probably said was that MOST relapses will occur within the first 30-days of stopping treatment. If I remember correctly, the number tossed out by I believe one of the dotors at the HepC/HIV forum was 90%. And in fact, there was a recent study that suggested being clear at 3 months could be considered SVR. That said, the definition of SVR is still being non-detectible 6 months after you start treating. That usually translates to over a 95% certainty. Your husband, relapsing after 7 months, therefore falls outside this norm.

I've also seen it posted before "that many geno 3's are relapsing and no one knows why". But I've never seen the source for this. Is it just speculation based on a few isolated cases or is there something real going on? I really have no idea. There was some interesting data, however, on one of the short-course studies that did suggest that *selected* geno 3's had lower SVR than let's say Geno 2's. Not sure if this had to do with pre-tx viral load, enzyme levels or what. But if I was a geno 3, I'd be checking it out.

-- Jim

[jmjm530]

I still worry every time I take a PCR even though intelectually I know the chance of viral breakthrough while still on medications is very low. I have no idea of the percentage that do break through other than it is small, so the numbers you supply seem as good as any, providing you continue to take full or near-full meds. Maybe 5%? Just a guess. I remember looking for studies on this once but never found one.

-- Jim

[jmjm530]

Regarding the "C4" post above in this thread.

I previously said: "Once clear, if the virus is to come back, it would come back within the first 30-days of stopping treatment, if I recall correctly."

What I meant was that the virus would USUALLY come back within the first 30-days of stopping treatment. I believe the assurity level is around 90% based on what I've read posted by some doctors over at the Hep C/HIV forum.

== Jim

[mistybean]

I just got word that I will only be doing 20 weeks vs 24.  My doctor is pretty confident that with my early SVR, my stats, lack of liver damage,, etc that 20 weeks is enough for a 2 genotype.  That means I only have 3 shots left.  I can do this..cheers

[johnisme]

Glad you got some good news, you have earned it. I know you have had it tough lately.

Best of luck to you...John