Timing of Post TX Viral Load Testing

Tomorrow I am 4 weeks post TX and will see my hepatologist.  The study coordinator asked me when I'd like to do my next PCR.  This is what I am asking the members of the forum.  Emotions aside, is there a logical test schedule for documentation if I might need to do TX again.  IOW, is the timing of a relapse important for the doctors to know as we plan future TX.  My next PCR with the study is at 24 weeks post TX.  Should I have a PCR in between EOT and 48 weeks?  If so, how sensitive of a test should be used?

I did 48 weeks SOC with Peg-Intron and Rebetol both weight based.

thank you,
mike

[pigeonca]

If you were UND at week 4 of tx and are still UND 3 months after quitting, and if you do not have cirrhosis, there is 100% correlation between the results at 3 months post and 6 months post.  If you fit those criteria, it would be a great relief to not have to wait an entire 6 months to know you're clear.  If not, I really have no idea whether the timing of a relapse matters that much.

[jmjm530]

It's really up to you, and I guess your insurance coverage although I found my viral loads were always covered as long as I had an RX from my doc.

A post tx week 4 UND correlates around 90% with SVR and a post tx week 12 correlates 100% with SVR if you are not stage 4 -- at least according to a recent study. The correlation btw is pretty good for stage 4's as well, but can't remember the exact figure.

I do suggest, however, that you ask your doc for the most sensitive test you can get. The one I take is Quest Diagnositic's "HCV RNA QUALITATIVE TMA", often written as "HCV RNA QUAL TMA". "Heptimax" (also by Quest) is another good test. Both go down to 5 IU/ml. LabCorp also has some very sensitive tests and one goes as low as 2 IU/ml.

Personally, I tested at weeks 2, 6, 12, 24 and 48 post treatment.

All the best luck with your tests,

-- Jim

[FlGuy]

My doc wanted to have me do a pcr at 3 weeks post.  I didn't really want to because I would not tx again and if a negative (undetectable) it would not give me any real information.  I agreed to do it because he asked and I have a good relationship with him.  I'm of the belief that if someone (not having considerale damage) relapses after tx they should take the time to recover physically, re-assess the position, formulate a plan and then decide what to do.  I would let 6 months to a year lapse if the direction was to re-tx.  And if such a person does not have significant damage and no other compelling reason to tx I just might wait to see what's on the horizon, med-wise, for a while.

[kcmike]

Thank you all for your comments.  I am gt-1b and did not clear until 12 weeks.  I am post TP have no signs of rejection, slight portal inflamation (inflammation) and no fibrosis.  I have a lab request for a Heptimax to draw tomorrow.  My cost $30.  Well worth the information considering the correlation to SVR.  BTW I will not tx again until newer meds are available, unless the TP team can change my mind (listen to me I haven't even relapsed yet).  I only agreed to tx this time as hep doc told me that the less damage the better.  I'm leaning toward a 4 & 12 week PCR on my dime and then let the study pay for the 6 month.  

mike

[FlGuy]

Did not recall the TP aspect which I imagine changes approaches considerably and puts me way over my frame of reference.  I always opt for the positive eventualities until I know otherwise.  Good luck with the results.

[Susie2007]

Over 90% of relapsers will relapse in the first month off of treatment. Good luck for an SVR.

[kcmike]

I'm still have a positive attitude because my tx went very well (not saying I liked it)!  I did 85% of my riba and 100% of my interferon with reductions, but no interruptions.  Just wanted to see if previous relapsers had any suggestions they might have learned that they wish they had done at the end of first TX.  If I recall you just finished your second go around, correct?

mike