Prove 3 week 32

[Andiamo1]

I am still undetectable, but my GGT was elevated: 130.  everything else was normal.

I suppose that is due to too many NSAIDS.  Anyone have any thoughts on this?

I will go off the NSAIDS and re-test.  I was taking Alieve 4 days a week.

[mremeet]

Not much to contribute other than GGT can be elevated by certain meds (possibly including the aleve as you obviously already suspect). And I certainly wouldn't interpret an elevated GGT at this point in time as an omen of relapse considering how well you've been doing and how long you've been UND.

[Andiamo1]

Thanks.  How are you feeling these days?

[dmhrdh]

Congratulations!!!!!!!

[mikesimon]

I agree that it isn't anything I would worry much about. I don't know the reference range on your labs but mine show a high normal of 85 so, if that is close to your lab range, 130 isn't really that far out of range. Have your GGT numbers been significantly lower on previous labs? I ask because my GGT is usually between 11 and 14. I sometimes pay more attention to significant disparities or sudden changes in trends than I do to absolute numbers.
Good luck, Mike

[jmjm530]

GGT is so liver non-specific, that it's rapidly disappearing from many liver enzyme panels. That said, my NP suggested (when my elevated) that it may have been caused by fatty liver, and it therefore probably will stay elevated.  My doc frowned when I told him. Doc was right, GGT returned to normal shortly. Just noticed that this year they don't even test for GGT.

-- Jim

[jmjm530]

"...GGT HAS LITTLE UTILITY

The combination of high sensitivity and very low specificity seriously hampers the utility of GGT. Clinically, the value of the GGT is marginal. If other hepatic enzymes are elevated, the GGT level provides no incremental information.

GGT measurement is often used to determine if elevations in other enzymes (especially alkaline phosphatase) come from the liver or a nonhepatic source such as the bones or placenta (4). Only if alkaline phosphatase and GGT are both elevated�but the other liver enzymes are not�does the GGT provide important utility (5). If both alkaline phosphatase and GGT are elevated, at least a portion of the alkaline phosphatase is of hepatobiliary origin. Conversely, if the GGT level is normal, the alkaline phosphatase elevation derives from nonhepatic disease (eg, bone disease). Even in this situation, however, comparable information can be obtained by measuring alkaline phosphatase isoenzymes.

Although GGT has been shown to rise with alcohol consumption and has been used as an indirect measure of compliance with alcohol abstinence, some experts doubt this correlation is sufficiently constant to permit GGT levels to serve as a surrogate marker for alcohol consumption (6).

Most often, GGT measurement is included as part of a bundled panel of tests. Owing to the limitations of GGT as a test, the Cleveland Clinic has removed it from its "liver panel," as have many other major medical centers. Yet the test persists, and many clinicians receive GGT results whether they request them or not."

http://tinyurl.com/2uw957

[mremeet]

I'm feeling great thanks for asking. Just got my 24 week post tx UND results the day before T-giving, so my official schmichial SVR is in the bag. Currently trying to get back in shape by mountainbiking in the snow and trying to force myself into a weight training program. Not easy, but I'll git 'r dun. Also enjoying food and beer, maybe too much sometimes (got a nice porter to try tonight). The biking keeps the weight off though, pants are loosening up and I think I've dropped into the 190-ish zone (was up to 205lbs, started treatment at 180lbs). I'm 6'2" by the way.

Anyway, sounds like your SVR's in the bag, keep at it and here's to your final victory!

[Andiamo1]

Thanks all.  My baseline GGT has been 85 since I started treatment; it was in the normal range before treatment.  So this test showed a jump to 130.  

My Doc thinks it is nothing to worry about, so I will just spend a week without taking anything and re-test just to make sure.

Thanks again.
Eric

[FullOfHope77]

I don't even know what GGT is or measures? Please share if you do... if I didn't allow myself to take an opioid to get through tx I don't think I could make it. Alieve seems a very small issue to be concerned with but some may know better. it's hard to believe that you're only 15 weeks away from the finish line and you've done it like a champ! Good luck and know you're on your way to SVR!

[miked]

Hey guys, way to go Prove 3 brothers!  I'M SO HAPPY FOR BOTH OF YOU.

January 3rd I'll have a PCR for 8 weeks post tx.  I'm praying for your results.

Congrats!

miked

[abby105]

Your SVR is not counted in Vertex Prove 1 official result, right?

[Forseegood]

ride em cowboy! bodes well I think!!!!

[mremeet]

miked - thanks for the kind words of congrats I really appreciate it. However I'm not in the prove 3 group with andiamo, I was in prove 1. I was in the 48 week group and made it to 41 weeks before stopping (although re-reading some of the above I can easily see why anyone would think we're in the same prove group). And yes it feels good to be 24+ weeks post tx UND! If you're coming up on week 8 post tx PCR, then you certainly know that "building" feeling. I'm sure you're worried, at least a little bit - I know I was. But if you've already made it 4 weeks post tx and maintained UND, you're in all likelihood 90%-plusville of getting your SVR at this point. You'll very probably be UND this time around and thereafter *ad infinitum*. Good luck!

abby - My SVR will be counted and included amongst the 'prove 1' 48 week group that received 12 weeks of VX950+SOC + 36 weeks of SOC. Even though I only really received about 8 weeks of VX950, experienced significant/sustained ribavirin dose reductions, took extensive courses of immunosuppressives and only really completed 41 weeks of total treatment.

[Andiamo1]

4c Thanks.

FullOfHope77:  It is an enzyme contained in the liver and can be a marker for alcoholism and other problems like fatty liver.  As many others have said, it is not very useful by itself.

[orleans]

Hey, Refresh our memories about the immunosuppressives. Your post is strangely encourgaing to someone considering doing the vx thing. jm

[miked]

Oops, sorry but I forgot.

I'm grateful that you Prove 1 & 2 guys paved the way for us.  

The 90% figure is out there for me but so is the remaining 10% that keeps me awake....I know that you know what I mean.

miked

[mremeet]

Well in a nutshell what happened was just as I described above. I started treatment with VX+SOC, then I got a bad rash. The rash was being caused by an allergic reaction to VX950, exacerbated by the *immunostimulative* effects of the SOC drugs. So long story short is that I had to stop taking the allergen (VX950) and also start taking an immunosuppressant to get things calmed down (the ramped up immune system makes allergies worse than they normally would be, which made this rash out of control). So I stopped the VX at week 8 as opposed to week 12 as originally planned. And I had to take prednisone (the immunosuppressant mentioned above) by the handful, I took quite large doses of it and took it for well over a month right smack in the middle of treatment - and early in treatment too. And then to cap it all off I had to get a shot of this very powerful immunosuppressant called solumedrol (on top of the prednisone). Solumedrol is adminstered through an IV, so you're really getting a jolt of the immunosuppressive juice. And all this is going on without taking the VX950 anymore, plus my riba had been discontinued for several days, and when it was restarted it was at a lowered dose in order to help get the rash under control.

Eventually the rash settled down, at least to the point where I could continue (without the VX of course). But I still couldn't tolerate full riba, so I was on 800mg (as opposed to 1200) pretty much throughout the remaining 30 weeks or so. All in all my treatment was all beat out of shape by the time I reached week 12. I feared the whole situation was for nought, and all that prednisone and solumedrol and early discontinuation of the VX and the lowered riba dosage...and all this happened early in the game, so I thought my odds were poor for SVR-ing (especially being blinded and not knowing if VX950 was really working anyway).

But that was not to be. Apparently the VX950 and the SOC drugs together so ferociously, and so successfully kicked the virus' a$$ during that first 7-8 weeks, the immunological debacle that ensued afterwards wasn't even enough to bring the virus back. I also happen to think that I probably could have discontinued all drugs after week 7 or 8 and come out SVR in the end. I think my SVR was established within the first 4-8 weeks. Can't prove it, but when you consider my particular situation, it seems hard to imagine I wasn't cured by the time I went on prednisone. Also, anecdotally I've heard stories of other people who dropped out very early due to rash etc (some dropping out by week 4) and yet STILL managing to get their SVR's. I recall dointime and happyhungry (prove 2 UK participants) described a young woman in their group that got the gnarly rash and dropped out, and yet she was still cured afterwards.

Anyway, that's my story. And also I only did 41 weeks too (instead of the planned 48). So as you can see, VX950 really does add a new dimension in helping to cure geno 1's. It's not perfect, but even in a trainwreck tx like mine, IT WORKED!

[APKhaos]

I'm another Prove 1 lab rat, and was in the 12 week VX+SOC followed by 12 week SOC arm. Aside from a minor rash that was cleared quickly by Lidex cream, and HGB numbers that bounced along the bottom either side of 10.0 for 24 weeks, my tx was fairly smooth sailing. That said, I've since heard from friends a colleagues who tell me I looked terminally ill towards the end of tx.

Initial conditions were Geno 1B, VL 24,000,000+, Stage 3. UND since around day 15. SVR since 12 weeks post-tx, and tomorrow is my FINAL 48 weeks post-tx clinic followup visit.

Andiamo:
Sounds like you are heading into a fine day with a following wind, my friend! Congratulations and welcome to the VX SVR club!

[glucklich]

Stay with it eric.

I had ggt of 900. No booze or fatty liver. Just high GGT. When my vL started its dance about 9 and  29 my ggt began to rise form 30 to 250.

Maybe you have been dreaming of the old days out on the town??


Keep on the program.