Actual Viral load

[Bobby1952]

Here is my Viral load a few months before I started treatment.

Test                                               Result                         Units                    
Hcv Viral Load (Quant)                     6383442                      Copies/m                    
Item Annotations  05/25/2007                                                                
The lower limit of detection is 3,200 copies/mL or 615 IUs/mL            

Methodology: bdna Signal Amplification technology  

My question is....if this is copies/mL then it must be 2,553,000 copies IU/mL .  

If my calculations are correct then I was wondering which one I should go by when calculating whether I have a high Viral load and whether it can lower my chances of SVR. It would seem to me that a 6 million viral load would lower my chances a lot more for SVR than a 2.5 million Viral load.

  I have 5 weeks of TX left and I am starting to think of these things. I am GT 3A but I don't know if I reached RVR because my GI didn't check my Viral load until 10 1/2 weeks which was undetected.

Thanks
Bobby

[Deb_c430]

Thanks again will do

[zazza]

Pro, you seem to be quite a mathematician yourself these days! Nothing to add here, except a link that might be of help:

http://www.hcvadvocate.org/hepatitis/factsheets_pdf/Viralload_%202007.pdf

How are you these days, Pro? It is nice to be doing the final countdown, don't you think?

All, 400'000 IU/ml is more and more stated as the cut-off point for low baseline viral load. And I remember seeing graphs which suggest that the higher viral load you have the less chance of SVR, actually down to 20% for high viral load genotype 1 according to one study.

http://www.natap.org/2006/ICAAC/ICAAC_43.htm
(Look at:
Figure 2: "SVR rate as a function of baseline HCV RNA level (loge scale) for patients infected with HCV genotype 1..."
Table 2: "SVR rates by genotype and by viral load cut-off point of 400'000 IU/ml"
Figure 3: "SVR rate as a function of baseline HCV RNA level (loge scale) for patients infected with HCV genotype 2/3...")

Here is another link with other charts. Read for yourself and compare, it is some while ago since I read them last.

http://www.natap.org/2007/EASL/EASL_41.htm

At a quick glance at the figure 3 mentioned above, it does seem to me that the odds of SVR for geno 2 and 3 does not vary much depending on how much above the cut-off point you are (= how much above 400'000 IU/ml).

[jmjm530]

Do you remember if you had a two-log drop by week 12? If you didn't, then you were a non-responder and your current treatment should have reflected that. All that, and given the fact that your week 4 test shows no viral response -- I would make an appointment with a hepatologist ASAP. If the hepatologists office tells you that there's a long wait, ask to speak to the office manager, nurse or doctor -- and explain that you're mid-treatment -- you're not responding -- and that you really can't wait that long. Very often, a specialist will see you with minimum wait in such a situation. Try and bring as many records -- blood test, biopsy and ultrasound reports, etc -- as possible with you -- but don't let it delay getting an appointment.

-- Jim

[Deb_c430]

No I was on peg and ribovarin and I did drop,  I think if i dig out my labs from that time, I did start slow, BUT it went down. 12 weeks I dropped. by the end of 48 weeks I was UND , stayed that way  at month 6 after tc PCR.
Nines months it was back, I think I told you during the begining of this time I was also on steroids, and some where in my head I have this idea that there is somethin gin that.

No, I am not seeing a hepatologist,  that is probably good advice, I need to look into that.
  Deb

[jmjm530]

Other than you're a relapser, don't know much about your prior tx history. Were you a non-responder (less than two-log drop at week 12) or did you respond and then relapse?

In any event, your week 4 test at best shows no viral response so fat. Hopefully, you're seeing a hepatologist (liver specialist) and they have made whatever adjustments in your treatment they feel necessary. If you're not seeing a hepatologist, now would be the time to have a consultation.

-- Jim

[Deb_c430]

here is mine,  I know it went up at 4 weeks, instead of down.  Sighs I almost
gave up. Next week another one, which hoping goes down after increasing infergen to daily shots.
thanks Deb




Starting baseline
11/02/07

Hep C Virus RNA QU
HCV RNA Quant PCR  
Abnormality Level   H                    203000                                   <5       IU/ml


HCV RNA PCR copi                  
Abnormality Level   H                    406000                                    <10   copies /m



12/13/07

Protien total serum  2.5
Albumin  Serum     3.9
Globum                  2.5
A/G Ratio               1.6
Bilirubin                   0.8
Alkaline Phosphatease, S      69
AST                                      27
Alt                                        23
HCV Quantasure Plus non graph       610,840   IU/ml
HCV  Log 10                                        5.786  Log 10 IU/ml

[jmjm530]

To put things in perspective, most people have more than a 600,000 IU/ml starting viral load, at least from what I read here. FWIW, my pre-tx viral load was 1.5 million IU/ml, and I'm now SVR.


-- Jim

[Bobby1952]

Ok....then I am twice that. Not too bad !!

[goldenrule]

600,000 iu/ML

[goldenrule]

the cut off point for low viral load is 600 IU/ml

[Bobby1952]

Jim

"Isn't your result given in IU/ml? "

No. My health center lab still uses copies/mL for viral load tests.



Test                                               Result                         Units                    
Hcv Viral Load (Quant)                     6383442                      Copies/m                    
Item Annotations  05/25/2007                                                                
The lower limit of detection is 3,200 copies/mL or 615 IUs/mL            

Methodology: bdna Signal Amplification technology  

[jmjm530]

As mentioned in your post to me yesterday -- and as stated by Proacive -- the conversion from Copies to IU/ml vaires depending on factors such as the type of test used. For that reason, the international standard (IU/ml) should be used. Isn't your result given in IU/ml?

Anyway, the TMA test you noted yesterday seemed to use a conversion of "2.7" while the Bdna test you now note appears to use a conversion factor of "5.2". I'm extrapolating this from the way the lower detection limit is expressed -- "3,200 copies/mL or 615 IUs/mL "

So if you divide 6,383,442 by 5.2 you end up with 1,227,585 IU/ml. not the 2.55 million IU/ml you seem to note above. (Please see Janis site referenced by "Proactive" to check all this as I'm much more familiar only working in IU/ml)

That said, it really doesn't matter which viral load you pre-treatment in terms of prediciting SVR. I say this because a study suggests the same chance of SVR regardless how high your viral load is unless it's low viral load which I think was defined as around 600,000 IU/ml but not sure. In other words same chance of SVR if your pre-tx viral load was 2 million or 20 million.

[Proactive]

Setting up a simple formula: given 3200 copies/ml = 615 iu/ml

3200/615=6383442 /X would give

6383442 copies/ml = 1,226,818 iu/ml

but check my math....my mind is pretty crispy these days.
Where's Za? She is our resident mathematician

[Proactive]

here is a site that might help you...You can see there are various conversion methods from copies/ml to iu/ml, depending on your test type..

http://www.janis7hepc.com/Viral_Loads.htm