Post TX PCR's

I will have the possibility to get two post tx PCR's.

At my hospital they usually do 12 and 24 weeks, but I'd prefer to request 4 weeks and 24 weeks. I'd prefer to know, if I relapsed at 4 weeks, than sweating it until 12 weeks.

What do you think?

[zazza]

I also only got two post tx PCRs. I wanted a 3 month post, since it is nearly 100% conclusive. So I looked at my liver enzyme tests at 6 weeks post, which gave me an indication of where it was heading, and then I waited until 3 months post.

ALT often sky rockets post tx if one has relapsed. My post tx ALT was better than ever since I got hep C. If you are a woman and have a BMI of less than 25 and your post tx ALT is 19 or below, that is a good indication of SVR. However I know HepCC here on the forum had an ALT around 40 post tx and still was UND. So don't give up if your ALT does not look good enough to you.

[epiphiny]

Great question and one that I ave been pondering as well.  I was thinking of getting a 4 week (and then go on holiday immediately) then an 8 and then a 24.  I have no idea if that is possible but am going to discuss it with my nurse next week...

[FlGuy]

If I had two to spend I would have one at four weeks, one at twelve weeks and one at 24 weeks.

[zazza]

Remember we had that discussion about how to convert liver enzyme results from the US (IU/L, international units per liter) to Scandinavian units (microkat per liter). It is about time, thus divide (or multiply) with 60.

0.32 microkat/L = 19.2 IU/L (0.32x60 = 19.2)
19.2 IU/L = 0.32 microkat/L (19.2/60 = 0.32)

[zazza]

Isn't that 3?

[Kristina538]

If I had a choice of 2 I would probably go with the 4 week and 24 week,  although you may be 'kicking yourself' around the 12 week mark lol!!!

I'm only able to get EOT and 24 week post PCR's.   When I relapsed last time, my ALT went from 13 to 140 at 12 weeks post tx, because the virus was 're-establishing' itself in my liver.  By the 24 weeks post the ALT was down to upper limits of normal (45).

So I will very much be watching my ALT's.  Because they've been a little above normal during this tx, I would expect them to go down initially, and, all going well, stay that way.  If not, I feel confident in 'knowing' whether I've relapsed if there is any repeat performance with my blood tests showing a sudden climb to very high levels compared with baseline pre-tx.

Good luck with your decision!!

[sunshine585]

I agree with you, I would not be able to wait until 12 weeks. I've read many times if you're going to relapse it usually is in the first couple of months.

[jmjm530]

If I had to balance "want to know" and economics, I'd test at week six and week 12. No study data on week 6, just a more conservative version of week 4. Also, I'd start counting my weeks after the last riba pill, assuming you stop the riba one week after your last Peg injection. The 12 week correlates close to 100% with the six month. But if you wanted more assurance, or something went awry like a spike in enzymes, you could always test at six months and pay out of pocket. On the other hand, you could wait and test at one year for your third test. Most here in the U.S. will do a one year post treatment test just to be extra, extra sure.

-- Jim

[FlGuy]

It was a test for brain fog.  You pass.  Congratulations, you must be feeling better.

[comeagain]

I will only get a pcr at 24 weeks but blood will be drawn for alt and ast week 4 and 12.
And if my alt gets above my ast which is an indication of inflamation (inflammation) of some kind going on in the liver they will immediately give me a pcr.
This  if alt is bigger then ast is only if values is out of range.

The use to do 12 weeks pcr but has stopped that because as he told me they have had some that wasn´t cirrhotic that has shown UND at 12 weeks but not on 24.

When i tryed to question him about that he was very vage and said they have had a
result that said detected but neither plus or -

The test used is taqman<15iuml and if UND it says -<1.18 which is in log its the same as -<15iuml and if you have a borderline result as I had the test would say+<1.18

This people noncirrhotic that has showed detected at week 24 their tests came back <1.18 but neither with a + or - I would call that borderline borderline then I said but surely the virons cant come back after six months and stay that low I asked what about them know are they still that low or has the virus came back big time I only got a cryptic answer to that he said we are not consider them SVR.
Sometimes I wonder if not giving strait answers but answer in this cryptical way is something they teach at medschool since its all to common.

ca

PS The idealistic ratio between alt and ast should be half time bigger ast then alt if alt 20 ast should be 30

[apache1]

Ya with 6 shots to go,  I been thinking about that too Marcia.

My Dr also does eot, 12 and 24....but my Drs are very flexible and the ins does whatever they want. Might have to ask for a 4 wk also and hope they go for it.

Not sure what is worse...waiting for RVR, UND or SVR. Somehow SVR seems like the biggie. at least we wont be on TX for the SVR wait.

apache

[Rockerforlife]

you will want the 12 wk...trust me...id save your cash and go with the LFT at  wk 4...if they spike...the cat came back

[apache1]

quote by comeagain,
Sometimes I wonder if not giving strait answers but answer in this cryptical way is something they teach at medschool since its all to common.
==================================================================

LMAO....true

Hey comeagain,  alt 23 and ast is 24...are they backward ?

apache

[epiphiny]

"The idealistic ratio between alt and ast should be half time bigger ast then alt if alt 20 ast should be 30"

I'm a bit confused by that, could you explain further?  Does that therefore follow that if alt is 10 then ast should be 15?  

And are we talking about 'normal' results post tx or during tx?

[comeagain]

Its good but the alt ast during tx says nothing for sure, better they low than high though
and your ast is higher thats good .

But as said before alt ast can vary and only be an indication to be sure you need a pcr.

[comeagain]

Thats correct why I dare to say this is I asked my doc if this ratio is correct and he confirmed that, but this is the ideal ratio for a liver that feels good.
As long as théy both within normal range it doesn´t matter much if alt is bigger than ast , or if ast is double alt.

But if ast is more than double alt it could be a reason for consern.

[epiphiny]

Roger that!  Thanks for the clarification and new piece of info!  Love new info!!

[Marcia2202]

Thanks for the equation.

[Marcia2202]

Thank you everyone for your input!!!

Ideally I would take Fly Guy's advice.... 3 in 2 sounds good! ;-)

It is difficult to get an out of your own pocket PCR here in Denmark. If I was to have it done privately, it would cost me USD 800. I don't want to spend that much, just to satisfy my curiosity.

I have just looked at my calendar and I will have a problem with the 4 week PCR, as hubby and I will be in Hungary having our teeth done. I will have to do it at 5 weeks.

At 6 weeks and 12 weeks, we will not be in Denmark either, we'll be in Indo finally enjoying our well earned freedom from tx.

So I guess I will have to do my own modified way and go for 5 weeks and 24 weeks.

[jmjm530]

Sounds like a reasonable choice, five and 24 weeks. If you're not impatient, wait another seven and make the more classical 12 and 24.and you can be pretty positive by the first test.

Not sure what "having your teeth done" means, but I was advised not to have major dental work (especially involving bones such as with a tooth implant) on treatment. The same should apply four weeks post. Reason being that interferon can temporarily weaken the bones in your jaw, not to mention the fact that your immune system will still be in recovery at week 4. So, if it's anything more than having some cavities filled, or maybe a crown or something cosmetic, I'd put it elective work for at least six months post tx.

-- Jim

[Marcia2202]

Thanks for advising me on the dental work. I wasn't aware of all that.

I'm only having a post tx check up and having them cleaned. I had all necessary work done just before starting tx. It's my hubby who is having major work done. I will be making sure that he will get some nutritious vegetarian food while we're there. We are renting an apartment for the time there, so we can do our own cooking... :-)

[comeagain]

Such test cost here in sweden 200$ I saw in yor mothers biografhy she originally comes from Småland and then I understand you have it in your genes LOL.

Long time ago I vas selling knifes and  pair of scissors at market places and we use to clip a one cent coin in two to show what  a marvelous  pair of scissors we  were selling and we always said before clipping the coin if there is anyone from Småland he she has to close their eyes know.( we coulden´t say that in Småland though)

Once you clipped a coin with them scissors  they were totaly useless and of course everyone who bought one had to  clip a coin when coming home LOL

Most people who imigrated to the states came from Småland it was a poor part of Sweden only a lot of stones in the soil, hard to get any harvest out of there.

But to tell you the truth people in Bohuslän not far from where I live are even greedier 100 years maybe even 50 years ago they coulden´t afford to eat the fish they were catching but nowadays many of them are millionaires but pretend they still poor as hell .

ca

[Marcia2202]

LOL.... Never heard that one.

Actually one of my mom's grandfathers went to the US during the silver rush and after a few years all of a sudden his letters stopped coming. He died before he was able to bring his wife and two children over. His wife was a Danish priest's daughter.

The other one was painter Knut Ekwall and was married to an East Prussian chamber singer. My grandma was born i Småland on the family island of Romanö, Sommen. (near Tranås)

Mom was born in Malmö, of all places... ;-) I was born at Karolinska in Solna.

[comeagain]

See Knut Ekwall very famous and your mom too you just got to be loaded !!!!!

[Marcia2202]

Fame doesn't necessarily make people loaded and it's not like they were some kind of hip hop stars or royalty, where money stays in the family for generations. :-)  Artists are a whole different ball game, my friend.