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Undetected at 12 wk EOT!

I had my bloods drawn yesterday for my 12 week EOT test after sofosbuvir/simeprevir/ribavirin. I am lucky to continue to be undetected!!  Of course I'm very pleased with these results, and will next follow up with the test in another 12 weeks to make it official at 24.  I hope many more here have good test results, too!!
Mark
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Avatar universal
Welcome to the forum, Dbzc2.  If I had not found this forum 3 years ago, I don't know how I would have survived without having a nervous breakdown.
I'm not being dramatic - its a fact. My husband has been through so much and I have been doing my best to support him. This site with all the wonderful caring members have been MY support.

SVR12 (or UND 12 weeks after EOT) is when the experts say you have  been cured of the Hep C virus.

I wish you the very best in reaching SVR 12!  Keep us posted.  Every successful outcome is a win for us all!

Nan
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9662954 tn?1405606159
Mark, all:   From what I understand, being undetectable for a solid three months is what the pharmaceutical and COSMOS study count as a success.  Beyond that has not been discussed much...although I have to read the links and studies sent to me within the past 24-48 hours--I forget!

I found out if you are undetectable for more than two weeks after the treatment I was on (S&O only for 12 weeks), then that is a good sign for the future...so congrats Mark on your 12 weeks post treatment undetectable!

To be honest, this is where I have been a total spaz!  I am doing everything I can personally so that these drugs will not let me down.  I had my blood work done 10 days post treatment (July 9th).  I am on a razor's edge and completely groundless! I'd be lying if I did not admit my stomach drops with each result reported. It is stressful and hopeful at the same time.

I am so glad I am finally  in a community that is on the same page as me! This is really helping me to find my grounding. (Soon I will be more brief too! The rambling came on when the disease amped up?)

Best wishes, dbz

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Avatar universal
Good point, Nan.  It's all so stressful.
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6708370 tn?1471490210
Yay!!
That is such wonderful news, Mark!
Congrats!
~Linda
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Avatar universal
Congrats Mark and wishing you SVR!

Jules
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Avatar universal
congrats to you!
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Avatar universal
I hope for the best test results for all of us.
The disease is rough; treatment has gotten easier but is still a challenge to get through, and is expensive. We all deserve some good news!
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Avatar universal
Great news , congratulations Mark!
I will be doing my 12 week post treatment test in about 3 weeks.
Your news is encouraging.
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276146 tn?1453921024
Congrats Mark!  Gives the rest of us hope!
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Avatar universal
I totally agree with you as we are now seeing the virus becoming detectable for some, and its emotionally devastating for them.  It's heartbreaking to see.
As you mentioned, it's setting everyone up to feel as tho they have failed themselves and others.
Perhaps when advice is asked, it may be a good idea to include that the new meds are not a sure thing, and UND simply means a reduced or lower viral load.
Take care.  ...Kim..
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Avatar universal
Kim,

See that's my problem - the fact that they know that there are likely trace amounts of the virus in the blood at Week 4, 8 and 12, etc. tests, that can cause a resurgence of the virus at EOT and yet still call it "undetectable".
Hearing you are undetectable at each of these weeks only makes it harder on the patient should they relapse. If they just stated LLOQ (lower level of quantification), I think the patient would be better mentally prepared for the possibility of relapse. Not everyone is as well educated about this as most on this site. It just seems to me that they should be more careful about getting
the patient's hopes up for SVR from practically the beginning of treatment.

Nan
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Avatar universal
I had the same question regarding UND prior to treatment and this is the answer I came up with.  When you become UND, there are still trace amounts of the virus still present in the blood.  If in fact you remain UND for
6 months, you are then considered cleared or cured.  With the new treatment that we are on, they say if your are UND for a period of 3 months, then you are SVR12, or cured.  Lets hope that's true!
Happy to hear that your husband is doing well with HE, and only has a few more weeks to go.  You are so right that either if he clears or not, his liver has had at least a chance to regroup and heal, until newer meds are available.
Be well and hope for continued wellness
...Kim..
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Avatar universal
Great news, Mark.  Kind of ironic that you get this news just as another poster learns he has relapsed.  Goes to show you how each patient is unique with their own particular medical issues and circumstances all of which can impact on their ability to reach SVR.

My husband has three weeks left of 24 weeks total on treatment. He has had to keep his dose of ribavirin at the minimum dosage due to post transplant anemia. Yet his platelets have always remained in the lower normal range since transplant. Though we remain hopeful, because of the low ribavirin dosage, we know that reaching SVR12 is probably unlikely.Nevertheless, as difficult as this treatment has been for him, we believe that the treatment has helped to prevent him from decompensating further.  (He has portal hypertension and bouts of hepatic encephalopathy). The HE has recently  improved a great deal.

There is something I just can't wrap my head around. Maybe someone can explain it to me. How can a virus that is "undetectable" for 24 weeks return?
So is it that the term "undetectable" actually means ""below the level of quanitification"? Shouldn't they just say that in the results instead of using a term that is misleading test after test?

Personally,  I think something that is "undetectable" should be reserved for something that is gone for good, not a virus that can return as soon as you stop the treatment.

Nan





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215858 tn?1420171556
Congrats on your EOT-UND12!  I'm superstitious and won't be celebrating myself unless its SVR24.   Until then, take stock, you're on your way.
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Avatar universal
Wonderful!  Happy to hear this wonderful result!  We all share this journey- the good, the bad and the yet to come!  Enjoy your report!  :)
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446474 tn?1446347682
One the the reasons I brought up the issue of being "undetectable" is that here in San Francisco at the UCSF hepatitis clinic which is treating scores of people with the new oral treatment we have seen some lab results showing "detectable but unquantifiable" with patients during treatment. Since it is known from trial data that once a patient becomes undetectable they stay undetectable as long as they are treating (this is assuming the patient is taking their meds properly) these labs result are an error of the test. In fact we has seen one lab the result as "undetectable" while at another lab the result can be "detectable but unquantifiable" (<15 IU/ml) HCV. Note we haven't seen actual viral load numbers only results that are below the level of quantification.

By understanding how these new treatments work, which is very different than past peg-interferon treatments we realize there is little purpose in performing viral load testing during treatment once a patient is undetectable and I would imagine soon many of these test will be eliminated as part of treatment protocol because they serve no useful purpose related to the treatment. But for now we can be sure that any lab test indicating a detectable viral load during treatment (after becoming undetectable) is only a lab error and that a repeat of the viral load test perhaps at another lab would indicate the proper "undetectable" result. One less thing to have to worry about during treatment.

My main point was the outcome of treatment is dependent not on what happens during treatment but what host factors (genotype, subtype, cirrhosis,etc.) exist prior to treatment and what treatment best addresses these factors which will result in the best outcome. This is why in the future we will see treatments the are for special populations of those infected with HCV. The treatments will be based on these host factors. We are already starting to see some of these early approaches. In the genotype 1, treatment naive people who have a 93% SVR rate with only need 8 weeks of Sovaldi/Ledipasvir. In the simple case of cirrhotics we know that interferon based treatments can be detrimental to the person's liver disease and can cause decompensation or liver failure in some patients. In post transplant patients there are the drug-to-drug issues of the past which are not an issue with the new Sovaldi based treatments. We now are beginning to see which treatments in trials are most effective in co-infected people, in people with genotype 3 and genotype 1b vs 1a.

Cheers!
Hector
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Avatar universal
It came back the next day. I was very surprised (although usually it comes back within two days: this is a major medical center in NYC, and they do their own testing). Not complaining!
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Avatar universal
FANTASTIC news Mark!!!  Yeah!  Congratulations to a life Hep C free.

How did you find out the results so quickly?  I thought it takes a week for results to come back for viral load.
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1815939 tn?1377991799
Wonderful news! Congratulations!
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Avatar universal
Awesome news. Congratulations! Jo
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Avatar universal
Gotcha ....Thanks guys for clearing that up!
..Kim
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Avatar universal
Can-do-man, you are correct.  My post was meant to reflect the fact that now, 12 weeks AFTER the completion of treatment (EOT, completion of therapy), my HCV RNA remains "not detected".  This follows being <15 at two weeks during treatment, and not detected at 4 weeks and 12 weeks during treatment.  My 4 weeks post EOT was not detected, and now the 12 weeks post EOT is the same.  Looking good, but I will believe I am "cured" when I do the 24 week post EOT HCV DNA quantitative test.  After all, I remember relapsing at some point weeks or months after completing my multiple various older treatment attempts in past years.  So thanks again Livelife777 and can-do-man: Undetected at 12 wks post EOT!  Will post again at 24.  Hoping that all those who finished more or less at the same I did will also be undetected on THEIR 12-week post EOT.
MARK
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Avatar universal
Just want to add it would make it clear if the title of the thread read.

Undetected at 12 wk post EOT!
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Avatar universal
Not Hector but to clear up any confusion which there seems to be. If one is UND after doing 12 weeks of treatment and THAT PCR says your UND at the EOT then yes it is possible you might relapse. Now if one is post 12 weeks EOT and their PCR shows they are still UND 12 weeks after ending treatment then yes they are considered cured with these new meds.

Hope this helps
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