What would be the 2 log drop?

About 7 months ago my husband Greg's VL was 248,000.
His last blood draw a week ago to determine his pretreatment VL was 189,168
I hear it's not uncommon for the VL to vary but I was still happy to see it was a little less.

Hearing that he should have a 2 log drop for 4 week blood draw what number would that be?
I hear things like drop two zeros at the end, etc but I'm lost?
Hes 189,168 now so what should he be below in 4 weeks... can someone do the math for me? LOL
Thanks, Janet   :)

[jmjm530]

You simply move the decimal point to the left for each log. So, if you start with a pre-treatment VL of 189,168, then a two log drop would be 1,891 IU/ml.

BTW there is no clinical difference between 248,000 IU/ml and 189,168 IU/ml. The difference fall well within the test variance. Also, while a two-log drop by week 4 shows viral response, it's always better to be UND by week 4 via a sensitive VL test that goes down to at least 10 IU/ml.

-- Jim

[burned74]

a two log drop would be to 1,891

a one log drop would be to 18,916

[Pinksmything]

So if he only has a 1 log drop at 4 weeks is it all a no go?  or what happens after that?

[jmjm530]

It sort of gets a little complicated, but in a nutshell, and a very general nutshell at
that --

A one-log drop would be the minimum response they tend to  look for at week 4. If he gets the one-log drop that means he's responding. If he gets less than one-log drop that means he's not responding and a savy doctor might adjust his medications. Of course, the best scenario is that he is UND at week 4. A two-log drop by week 4 is also very good.

If your husband doesn't get a two-log drop by week 12, then some doctors will recommend stopping treatment.

If he gets a two-log drop by week 12, but is still detectible, then some studies suggest extending treatment to 72 weeks for a significantly better chance of SVR.


-- Jim

[Pinksmything]

Thanks so much!  Clears things up!   Janet

[jmjm530]

Takes a while for all the different factors to sink in, at least it did for me.

The important thing in the beginning is to make sure he doesn't skip any medications and has CBCs (blood counts) every week or two, to make sure he isn't getting too anemic, among other things.

If he starts getting overly fatigued -- troubling walking up stairs, out of breath, etc -- then don't be hesitant to call his medical team at any time and request a CBC to check for hemoglobin, etc. Some of us, especially men, don't function very well when the hemoglobin drops even a few points over a short period of time -- regardless of the number. In these cases, doctors often prescribe the helper drug, Procrit (epo).

Then comes the week 4 test, unless your doctor chooses to test earlier, and by all means try and get a week two test if possible, although be prepared for your doctor saying "no".

But by week 4 you should have a good initial indication of how the virus is responding. So you sort of take it one step at a time, but always keep thinking ahead  if that makes any sense.

-- Jim