HBG, RIba, and success of SVR- help

Hey all. I need some help in regards to lab questions and success of SVR.

First off- I am Gt1a , 40 weeks into treatment (just RIBA and inf). Original VL was 325k, 280 at week 4 and UND at week 12. I am on 1200 RIBA daily.

Here's my question- I heard recently heard that there is a direct correlation between RIBA absoption and HGB level drop and SVR.  I'd like to know if my HGB has dropped well enough (I know sounds weird) for high success of SvR. Here are my stats:

Original HGB- 15
December - 11.7
Jan - 11.2
March - 12
May - 11.5
June on is around 11.2

Any thoughts?  I could really use advice. Also, I've been on neupogen since week 12-" due to low WBC.

Thanks in advance!

[nygirl7]

I dont think anyone really knows - I think clearing at week 12 gives you the same 45% chance as every geno1 - but considering you were not tested between weeks 4 - 12 you could have been clear like at week 5 or 6 maybe and then that would act in your favor for sure.

[Bali05]

There is a study  that showed that >3g drop by wk8 (the latest) received higher SVR rates.
However this is not a standard. What counts is serum concentration and we do not
have a test for that commercially available. We indivdually can react very differently to
Riba .I know someone in Sweden that treated and had the serum test available.
It showed that despite no major HgB drop her Riba concentration was adequate.
When I started I  wanted that >3g drop and needed to dose up to 2400mg to get
there.

b

[Aaron57]

Did you start Tx in late Oct. or early Nov. 10' ? We are about the same stage of P/R Tx (Wk.38 for me) with the same Wk. 12 results .. Und : ) ! cEVR ..

There are  several reports since 2009 that put the odds at 60%+ for Wk. 12 Und ..
cEVR Complete Early Response ...

Our situation should not be lumped together with EVR >2 log drop at Wk. 12 but still detected .. when calculating odds of success ...
Achieving a cEVR puts the patient above the overall average of 40% for G1a : )

Unfortunately for us .. most P/R research was switched to the PI's and P/R Tx studies kind of got shelved ... Just about the time the scientists and doctors were starting to understand P/R Tx : (  

Bali is correct that we all have different Riba serum concentration rates & there is no established equation for us to go from ... however,
You having a greater than 3g drop within 2 months if you started Tx in Nov ... it fits the so called profile of response ... and since you got a cEVR .. only a guess but it seems the meds are working for you ... me too : )

I hope your last 2 months goes well & you have success !

[Believer7777]

Aaron, thanks for the encouragement. Yes, we are on the exact same path- I started treatment in nov '10.  I see you referencing cEVR?  What is the distinction between that and RvR?  That we weren't UND at week 4?  You're insight is great- thanks for sharing.

[Aaron57]

Hi B, .. you are responding well to the meds .. many folks don't even get this far We are all in this together n a way .. happy to share :) ... I started Nov. 24 , 2010 .. time is flying by .. Sx are tolerable .. How about yours ?

cEVR - Complete Early Viral Response = Virus Und @ Wk. 12  - nowadays using PCR test with <15IU/ml or more sensitivity rating

EVR - Early Viral Response = more than a 2 log VL drop from baseline at week 12 , but Virus still Detected

RVR - Rapid Viral Response = Virus Und @ Wk. 4 - only apx. 15% G1's get this lucky ..

As you probably know .. these references are about Tx responses, our decisions made from the responses .. and what keeps me going ... the possibility of successful Tx .. if not ..... taking a load off my liver for a while ... borderline F2-3 .. that's why I got motivated to undergo Tx ...

Cheers !

[Believer7777]

Aaron, awesome info !  I started November 12th- 2 weeks before you. So excited to be done with treatment and pray I SVR. I have a family to start (I'm 29) and I can't wait.

It sounds like I did cEVR, however the PCR my doc uses is <43iu/ml. Hopefully it was and still is gone and not hovering at 30!  

Sx have been tough but manageable too. Exhaustion and lack of sleep have been hardest. Itching was really bad early on, but that is gone now.