Viral Load

[hoocbud2]

Called nurse to see if Viral Load had came in.  She said I started at 109931, as of Sept 1 I'm at 9110 but she does not know if that is good or not.  Can someone clarify for me that I am responding to the meds.

Thanks
Debi
  

[snadge]

ALINIA is a drug administered for Diarhorea
http://www.romark.com/products/alinia.aspx

but it supposed to be effective against Hep-C in low viral loads only (under 400,000 iu/ml)

[hoocbud2]

What is Aliana?

[copyman]

tell the nurse to contact the doctor and tell him you want to talk to him about tweeking your treatment so you have the best chance of clearing by 12 weeks or sooner. It can not wait 3 weeks until next appointment, Tell the nurse you need five mins of his time, even if it is over the phone, Write down the questions you want to ask him and have some study data  to quote him to back up you increasing Meds for a few weeks or adding Aliana. Ask him to check out treatment options from his peers at the site for doctors:

clinicaloptions.com

[hoocbud2]

wait for my appointment (is what I meant to say) my next appointment is 3 weeks from now.  But I do blood work every week.  

[hoocbud2]

I only get to see the doctor every month.  Have to go thru nurse.  She always says what for my appointment with doctor

[copyman]

Interesting point but I have to disagree somewhat. Since it is still early I think increasing the Riba "may" help.  She could also ask her doctor about doing the interferon shots every five days instead of seven. Or even adding Aliana to the SOC drugs. My point is whatever it takes to knock this virus down quickly!  Hopefully 12 weeks or sooner.

I do see where she mentions her bloodwork is dropping which is a sign that she is perhaps getting enough Riba already so maybe a different plan needs to be pursued.

Of course this is something she should discuss with her doctor ASAP.

[HCA]

Sorry,but the ribavirin dose is not relevant to the degree of viral suppression achieved at four or twelve weeks-that is entirely an interferon function.
Ribavirin prevents relapse by causing fatal mutation error but it's impact is not measured in the treatment PCR tests.
The efficacy of ribavirin is reflected in relapse rates whereby underdosing will increase risk of relapse.
I continually see people who are not responding as well as hoped being to take more ribavirin.
Although this may not be a  bad thing it will have zilch effect on knocking out the wild type (unmutated) virus and is therefore not relevant.
You will all surely know that SVR can be predicted from the response to the first dose of peg,long before viable ribavirin levels have been achieved.

[justme53]

How have your other labs been running, specifically your hemoglobin ? I agree that it would be wise to discuss perhaps upping your Riba until your 12 week PCR with your Dr. It will take close monitoring during those weeks, but may increase your odds of being undetecable at 12. That cEVR is SO important to those of us that didn't hit it at 4 weeks. Keep us posted on what you  and your Dr.decide.......Pam

[hoocbud2]

I don't know if the doctor will up my dose or not.  My blood levels are low and drop slightly each week.  Maybe I can get him to give me procict (however you spell it) get my blood levels up a little and then try for a increase.

I weight 110 and take 800 mg of riba and 50mg of Promacta to try and keep my platelets in the 50's or 60's range.  I have already been stopped once do to the platelet problems.

Hoping for the best.  

[nygirl7]

Deb

Some of us are slow pokes when it comes to totally clearing the virus.  Doesn't make our SVRS  any less exciting though.  :)

Hang in there.  The 12 week is the really important one.  You NEED a 2 log drop by then but really WANT to be UND.  If you are not UND at 12 but you ARE by week 24 you can try extending like I didd.

Any chance you can get the doc to give you maybe an extra riba every day or something to try and goose it up a bit?  How much are you taking compared to your weight is it enough? (My problem was different I went to 400 at week 4 but then stayed there....and stayed there..........and stayed there until somewhere before 24).

Are you making sure you are taking it with fatty stuff (I know some don't totally believe in the binding theory stuff but I do cause it seemed logical).

Have you spoken to the doc yet because while your results aren't the end of the world they are just not all that exciting...you sstill have 8 weeks to get rid of them but you want to make sure you do that so you don't have to extend or anything.

Deb

[copyman]

I would ask the doc to increase your Riba until 12 weeks. Forget about the "old" protocol of "2 log drop" by 12 weeks. To have a decent chance at SVR is to be "undetectable" by 12 weeks. Do whatever it takes to acheive 12 week unde. Good luck

[snadge]

4 weeks she said - so she should be ok for 2 LOG by week 12 hence stay on treatment

another way to work it out is take zeros off the end for each log drop...

hence:

start viral load: 109931
1 log drop: 10,993
2 log drop: 1,099
3 log drop: 109

so you need to get to 1099 or lower by week 12 to be allowed to continue treatment - also those not clear by week 24 may also be stopped

i'd say your chances are good, just keep up the battle, I made a 2-log drop by week 4 and was still positive at week12 but now im clear (week 16 + 24) im now at week 38

[HCA]

Sorry-you do say it's four weeks.
It's a rather unexciting result-you are responding but not particularly rapidly.
I would guess that you would make 2 log but not necessarily clear at twelve weeks in which case you would need to extend.
I am only guessing,but you asked for opinions.

[jdwithhcv]

My doctor wanted to see at least a 2 log drop by week 4, and definately by week 12.  Its impossible to predict if you will get a 2 log drop by week 12, because this is a non-linear type of thing.  I did not ever discuss it in depth with her because I was UND by week 4 so there was no need to have the conversation.

At least you are showing some response to the meds.  Ask your doctor about what he/she will do in the event you do not get a 2 log drop by week 12.  Depending on the condition of your liver you may be able to extend tx, or possibly you may be in a position to wait for Telaprevir.  

For now, try not to worry too much.  You are not a rapid responder but that does not mean you won't get 2 logs by week 12.  Just make sure your doc has a plan if you don't.

Good luck.

jd

[HCA]

It's a 1.08 log drop-after how many weeks treatment was the blood taken?

[jdwithhcv]

I thought there was a way to get that one to do scientific functions, but I could not figure out how.  Thanks for the help.

jd

[hoocbud2]

This is week 4 viral load.  Are my odds any good to reach the 2 log drop?

[chuckles333]

Start>Programs>Accessories>Calculator
Change View to Scientific and use the log function there.

[jdwithhcv]

109931 is log 5.04.  9110 is log 3.95.  This is just over a 1 log drop.  What week of tx was your PCR?

BTW, I use an online scientific calculator to convert the viral load into its log value.  Just type in the viral load and hit "log" and it will give you the value.  Here's the link to the calculator I use:

http://www.calculator.com/calcs/calc_sci.html

jd