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Viral Load after 4 weeks
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Viral Load after 4 weeks

Hi there.  Finally received my results from the viral load testing last week. I am not 100% what "2-log" drops and all the information I have read actually means.  My viral load to start was 2,700,000 and today it is 254,000 what does it all mean :)   Thanks!
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87972_tn?1322664839
The easiest way to calculate a ‘log’ reduction in viral load is to drop the last zeroes off the right of the number. For instance:

2,700,000

270,000 = 1 log drop
27,000 = 2 log drop
2700 = 3 log drop
Etc.

You can also calculate using the ‘LOG’ function on a scientific calculator; just enter the viral load, and press the LOG or logarithm key.

So far, you have received a 1.03 log reduction in viral load; this is respectable but not fantastic for genotype 1 HCV at the 4 week mark. Will you do other viral load tests prior to 12 weeks? You are well on track to get a 2 log reduction by 12 weeks, which is needed to show adequate response.

Best of luck—

Bill
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977806_tn?1249070946
I am not sure about another test before 12 weeks.  On a study but I do think it was mentioned another at 8.  Thanks for your insight.

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717272_tn?1277594380
The studies test more frequently than private doctors.  Clearing by 12 weeks is an important marker.  Looks like you'll make it. Hope so, it's an extra indicator that you are headed to SVR.  
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Avatar_n_tn
'Clearing by 12 weeks is an important marker.  Looks like you'll make it'
On what do you base this opinion?
Viral suppression is not linear.and a 1.03 log drop at four weeks is not necessarily predictive of viral clearance at 12 weeks.
Moreover it is not the main issue.
This person is on a study and order to comment one would need to know.
a) what is study drug?
b) Is it combined with SOC?
c) Is there placebo arm?
d) Is there a lead in arm?
The treatment prognosis could change dramatically in the light of any of these factors.
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977806_tn?1249070946
The study drug is Eltrombopag (I have ITP)
On Pegasys/Ribavirin
Genotype 1
No placebo (if it was my platelets would have gone down and they skyrocketed to 425000 from 21000.  So off Eltrombopag 2 weeks/on 2 weeks seems to work so far.)

Thanks for everyones input and support.  Regards,
C
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87972_tn?1322664839
I didn’t realize you were involved in a study when you initially posted.

If the active interventions in this study are interferon, eltrombopag and ribavirin, then the eltrombopag will not directly affect viral dynamics, to my knowledge. So you are relying on IFN/riba to directly manage the HCV?

This would explain the SOC-like response. Nothing particularly wrong with it, to my knowledge; but more sluggish than one might expect with a protease inhibitor added to the mix.

Stay the course, and I wish you nothing but the best—

Bill
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Avatar_m_tn
HCV, of course one can not compare apples to oranges. But ccurl is on SOC plus the study drug. I believe one could still find soc alone comparison applicable in ccurls case.
"viral suppression is not linear.and a 1.03 log drop at four weeks is not necessarily predictive of viral clearance at 12 weeks."
I suggest you read up on viral kenetics (the first article I pasted is a pretty good one on the predictive value of viral phasic decline

http://www.medigraphic.com/pdfs/hepato/ah-2002/ah022b.pdf
http://jac.oxfordjournals.org/cgi/content/full/53/1/15
http://www3.interscience.wiley.com/journal/118961281/abstract
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Avatar_m_tn
the downside here is, I doubt any SOC dose adjustment would be permitted as it would compromise the collected study data
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Avatar_m_tn
I apologize for the fragmented posts, (still taking pain meds from surgery and my brain is a bit clouded). Since my svr I really haven't stayed current on new hcv studies, etc. (switched to osteoarthritis research(g))
but...wasn't there further research info out on the value of viral kinetics at the last big liverhead hoedown?
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Avatar_n_tn
Thank you for the links.
The material is rather old.
I have perused it and have not found anything at odds with the notion that a 1.03 log drop at four weeks is not necessarily predictive of viral clearance at 12 weeks (EVR).
But perhaps I have missed something.
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Avatar_m_tn
If you dont go UD by week by week 12,you will have to treat 72 weeks of longer.If you were found to be UD by week four on the SOC,your odds od SVR are close to 100%
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