Aa
Risky Stopping Treatment?
Hi here are my test results from last week my question is if my viral load was 200,0000 since 2004 and they have changed how much risk am I do develop into something more serious. I am on week 11 of treatment starting this week but I am so sick money is dropping fast because I cant stay at work full time if I stop treatment is this something that would hurt me?
HCV RNA by PCR Detectable for HCV RNA by PCR, less than 43 IU/mL, not quantifiable. IU/mL
Reference Range: Negative for HCV RNA
The Linear Range of this assay is 43 IU/mL to 69,000,000 IU/mL.
WBC 2.91 3.70 - 11.00 k/uL L
RBC 3.26 3.90 - 5.20 m/uL L
Hemoglobin 10.2 11.5 - 15.5 g/dL L
Hematocrit 31.1 36.0 - 46.0 % L
MCV 95.4 80.0 - 100.0 fL
MCH 31.3 26.0 - 34.0 pG
MCHC 32.8 30.5 - 36.0 g/dL
RDW-CV 15.8 11.5 - 15.0 % H
Platelet Count 153 150 - 400 k/uL
MPV 10.9 9.0 - 12.7 fL
Neut% 38.5 39.5 - 74.0 % L
Abs Neut (ANC) 1.12 1.45 - 7.50 k/uL L
Lymph% 48.8 15.9 - 47.3 % H
Abs Lymph 1.42 1.00 - 4.00 k/uL
Mono% 12.4 0.0 - 12.0 % H
Abs Mono 0.36 0.00 - 0.86 k/uL
Eosin% 0.3 0.0 - 6.6 %
Abs Eosin 0.01 0.00 - 0.45 k/uL
Baso% 0.0 0.0 - 1.2 %
Abs Baso 0.00 0.00 - 0.10 k/uL
HCV RNA by PCR Detectable for HCV RNA by PCR, less than 43 IU/mL, not quantifiable. IU/mL
Reference Range: Negative for HCV RNA
The Linear Range of this assay is 43 IU/mL to 69,000,000 IU/mL.
WBC 2.91 3.70 - 11.00 k/uL L
RBC 3.26 3.90 - 5.20 m/uL L
Hemoglobin 10.2 11.5 - 15.5 g/dL L
Hematocrit 31.1 36.0 - 46.0 % L
MCV 95.4 80.0 - 100.0 fL
MCH 31.3 26.0 - 34.0 pG
MCHC 32.8 30.5 - 36.0 g/dL
RDW-CV 15.8 11.5 - 15.0 % H
Platelet Count 153 150 - 400 k/uL
MPV 10.9 9.0 - 12.7 fL
Neut% 38.5 39.5 - 74.0 % L
Abs Neut (ANC) 1.12 1.45 - 7.50 k/uL L
Lymph% 48.8 15.9 - 47.3 % H
Abs Lymph 1.42 1.00 - 4.00 k/uL
Mono% 12.4 0.0 - 12.0 % H
Abs Mono 0.36 0.00 - 0.86 k/uL
Eosin% 0.3 0.0 - 6.6 %
Abs Eosin 0.01 0.00 - 0.45 k/uL
Baso% 0.0 0.0 - 1.2 %
Abs Baso 0.00 0.00 - 0.10 k/uL
Good luck with your test results on Wed mine are tomorrow. This is just no fun is it ha! I just hope going through it for a reason,,,
Shane thank you I didnt know there were two sides of the forum I am having trouble following everyone that has emailed me! I will move myself over to the other side ha! Good luck Wed with your test keep me posted I am doing another test tomorrow and another viral load check.
Stay Strong
Stay Strong
Hi lady
hope you are feeling better. I don't know how the read the tests either (spell check on this site s@cks). good advice given to discuss all options with your doctor. I have not seen mine since before I started tx and only one test at 10 days, my 30 day test is wed. and my doc visit, I am a bit apprehensive. Did you know there is a second side to this forum. This side is the medical side, and there is a social side. under the forums tab go to hepatitis social. This side is for medical advice and the other side is just to discus. I find the other side more emotionally based and not as technical.
hang in there, I have been leaning on you for encouragement.
hope you are feeling better. I don't know how the read the tests either (spell check on this site s@cks). good advice given to discuss all options with your doctor. I have not seen mine since before I started tx and only one test at 10 days, my 30 day test is wed. and my doc visit, I am a bit apprehensive. Did you know there is a second side to this forum. This side is the medical side, and there is a social side. under the forums tab go to hepatitis social. This side is for medical advice and the other side is just to discus. I find the other side more emotionally based and not as technical.
hang in there, I have been leaning on you for encouragement.
Like pooh said -- you are still detectable. Quit now and you go right back to before you started -- or higher.
I think your right my viral load must be lower I am learning how to read all these numbers-I am in stage one and have been since 2004 for some reason its never gone out but I dont drink or do anything I am not supposed to and havent for years. However I appreciate all the feed back I am going to try to do this I guess I need to take one day at a time pay whats necessary and forget the rest. Everyone here is great I really appreciate the support there are amazing people on this site.
Hi there thank you so much for all the information-I think I must of put my viral load on here wrong I am in stage one and have been since 2004 but I think just talking about this has helped me on this forum I did get out a little bit I am not going to quit I will keep pushing maybe its been double hard on me because I am on my 3rd set of anitbotics from a sinus infection. I also think maybe I should force myself to go walk I have a torn labrium in my hip so its hard to walk for any amount of time to far. I spelled that wrong! I dont want this virus getting worse thats for sure. One day at a time I love you guys and dont even know you for the support and information thank you so much for caring about others...
I am sorry you are feeling so sick. It is difficult.
First, your hemoglobin is low and that may be causing a lot of your symptoms. Hopefully you are having it checked weekly so that med adjustments or rescue drugs can be used if necessary.
Secondt, if that viral load is from last week, which would be the end of week 9 or 10, you are still detectable. The viral load is less than 43, but it is there. That means you definitely still have the virus in you. If you stop treatment now, that virus is going to replicate like crazy and your viral load will shoot up again. As long as you have the virus in you, there is good potential for increaseing damage to the liver.
The third thing is, if you stop now, as 1oftheclub noted, you risk developing mutant resistant strains of the virus. If you develop mutant strains that are resistant to the Incivek (or Vic) then you will have to wait for a few years to be able to treat again when new drugs come out.
"Viral resistance with boceprevir and telaprevir occurs because of the selection of preexisting variants during the course of therapy, as a result of failure to eradicate infection on triple combination treatment.[54] In pooled analyses of subjects who had on-treatment failure or relapse during clinical trials with boceprevir or telaprevir, HCV variants emerged, which have been shown to carry several NS3 amino acid substitutions that reduce viral susceptibility to boceprevir and telaprevir (Table 10).[51,53] Extensive cross-resistance exists between the 2 drugs, one of several reasons why they should never be used together. .......... The clinical implications of treatment failure to boceprevir- or telaprevir-based therapy are unknown. In theory, the persistence of resistant variants could lead to patients being ineligible for, or unresponsive to, future regimens that incorporate PIs into novel regimens. Several lines of evidence and reasoning provide reassurance on this issue. First, HCV is not known to be capable of archiving its genome as do HIV or hepatitis B virus. Data suggest that after treatment withdrawal, treatment-emergent substitutions decline in relative abundance over time and that wild-type virus regains its predominance in the majority of cases.[55-57] However, this may take 2-3 years, and subtype 1a tends to return to wild type more slowly. "
http://www.clinicaloptions.com/Hepatitis/Treatment%20Updates/HCV%20New%20Agents/Module/Practical_Guide/Pages/Page%205.aspx
I hope you can hang in there even though it is difficult. But you are the only one who knows all of your circumstances.
First, your hemoglobin is low and that may be causing a lot of your symptoms. Hopefully you are having it checked weekly so that med adjustments or rescue drugs can be used if necessary.
Secondt, if that viral load is from last week, which would be the end of week 9 or 10, you are still detectable. The viral load is less than 43, but it is there. That means you definitely still have the virus in you. If you stop treatment now, that virus is going to replicate like crazy and your viral load will shoot up again. As long as you have the virus in you, there is good potential for increaseing damage to the liver.
The third thing is, if you stop now, as 1oftheclub noted, you risk developing mutant resistant strains of the virus. If you develop mutant strains that are resistant to the Incivek (or Vic) then you will have to wait for a few years to be able to treat again when new drugs come out.
"Viral resistance with boceprevir and telaprevir occurs because of the selection of preexisting variants during the course of therapy, as a result of failure to eradicate infection on triple combination treatment.[54] In pooled analyses of subjects who had on-treatment failure or relapse during clinical trials with boceprevir or telaprevir, HCV variants emerged, which have been shown to carry several NS3 amino acid substitutions that reduce viral susceptibility to boceprevir and telaprevir (Table 10).[51,53] Extensive cross-resistance exists between the 2 drugs, one of several reasons why they should never be used together. .......... The clinical implications of treatment failure to boceprevir- or telaprevir-based therapy are unknown. In theory, the persistence of resistant variants could lead to patients being ineligible for, or unresponsive to, future regimens that incorporate PIs into novel regimens. Several lines of evidence and reasoning provide reassurance on this issue. First, HCV is not known to be capable of archiving its genome as do HIV or hepatitis B virus. Data suggest that after treatment withdrawal, treatment-emergent substitutions decline in relative abundance over time and that wild-type virus regains its predominance in the majority of cases.[55-57] However, this may take 2-3 years, and subtype 1a tends to return to wild type more slowly. "
http://www.clinicaloptions.com/Hepatitis/Treatment%20Updates/HCV%20New%20Agents/Module/Practical_Guide/Pages/Page%205.aspx
I hope you can hang in there even though it is difficult. But you are the only one who knows all of your circumstances.
I know you mentioned your biopsy results in the other thread you had going, but you need to know that no one here is going to be able to guess anything about your risks based on your viral load. The biopsy results are the only thing that matters in determining risk. It makes me want to cry to think of anyone having to quit after having put 10 whole weeks into it already - especially if you are scheduled for 24 weeks rather than the 48 weeks some of us have to do. However, if recent biopsy results show no fibrosis yet, and the current treatment is making you too sick to work and you have no way to manage without that income, then you would probably be okay to stop your treatment. You definitely should discuss it with your hepatologist before making any decision and before stopping any of the meds. You would need to watch the hcv closely, with an ultrasound and blood tests done by your hepatologist every 6 months, and another biopsy in a couple of years, while planning to try treating when the next generation of drugs becomes available in a couple of years. So, was your biopsy recent and did it show no sign of fibrosis? Are you on the 24 week track or the 48 week track? Is there any alternative way you can hold yourself together financially if you can't keep working through the tx? This is a really important decision and needs to be very carefully worked out. Good luck!
what treatment are doing? Are you doing triple with INC? if you stop early, you increase the chance that you will not reach SVR and you may build a resistance to the medications as well.
VL does not tell you how much liver damage there is, there is no correlation, a biopsy or a fibro scan would tell you that. My VL was 2.4 million I only had stage 1 liver damage. someone with a VL 200,000 may be at stage 3 or higher. it would be nice if it correlated, but it doesn't. there isn't a lot about this disease that makes sense.
Treatment may be rough now, but end stage Liver disease is a lot rougher. just take it one day at a time...
VL does not tell you how much liver damage there is, there is no correlation, a biopsy or a fibro scan would tell you that. My VL was 2.4 million I only had stage 1 liver damage. someone with a VL 200,000 may be at stage 3 or higher. it would be nice if it correlated, but it doesn't. there isn't a lot about this disease that makes sense.
Treatment may be rough now, but end stage Liver disease is a lot rougher. just take it one day at a time...
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