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do you think this is a relapse
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do you think this is a relapse

im new to this, so here goes- told i have hep c nov 09,  geno 2 b, started tx april 2010 but only lasted 16 weeks {instead of 24]due to low platlets, low white and low red count, ended up in hospital for 4 days, tested neg at 4, 12 and 16 weeks on tx,  then tested neg at 12 week post tx. just after that had case of flu with slight fever, headache  for 2 days, muscle aches, pain in elbow joints and sleeping in daytime etc...not been called up for my 24 post tx pcr yet even tho its been 30 weeks post tx, any replys will be very welcome as i'm very worried  thanks
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Avatar_m_tn

Ditto to what James10500 said, but the following study may be somewhat reassuring for now.


Sustained virological response (SVR) to hepatitis C treatment is usually defined as continued undetectable HCV viral load 24 weeks after completion of therapy. Michelle Martinot-Peignoux and colleagues from France evaluated whether assessment of serum HCV RNA 12 weeks after the end of treatment was as relevant as 24 weeks for determining SVR.

The investigators analyzed sustained treatment outcomes among 573 chronic hepatitis C patients who received pegylated interferon (Pegasys or PegIntron) plus ribavirin and had an end-of-treatment virological response. Viral load was measured using a sensitive TMA assay with a lower limit of 5-10 IU/mL. Viral relapse was defined as reappearance of detectable HCV-RNA between the end of treatment and post-treatment week 24.

Results

All 573 participants had undetectable HCV RNA at the end of treatment.
At 12 weeks post-treatment, 409 participants still had undetectable viral load.  
At 24 weeks post-treatment, 408 participants (71%) achieved SVR.  
Looking back at week 12 results, all but 1 of the patients who were undetectable at week 12 remained so at week 24.
Week 12 response had a positive predictive value of 99.7% for predicting Week 24 SVR.  

The researchers concluded that assessment of serum HCV RNA 12 weeks after the end of treatment using a highly sensitive TMA assay "is as relevant as after 24 weeks to predict SVR and make decisions on the management of treated patients, suggesting a new definition for SVR."

Institut National de la Santé et de la Recherche Médicale, Centre de Recherche Biomédicale Bichat-Beaujon CRB3, Université Paris VII, Paris, France; Service d'Hépatologie, Hopital Beaujon, Clichy, France.

6/11/10

Reference
M Martinot-Peignoux, C Stern, S Maylin, and others. Twelve weeks posttreatment follow-up is as relevant as 24 weeks to determine the sustained virologic response in patients with hepatitis C virus receiving pegylated interferon and ribavirin. Hepatology 51(4):1122-1126 (Abstract). April 2010.

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14 Comments Post a Comment
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Avatar_f_tn
I doubt very much that it is a relapse. First of all you are a 2b, which is the easiest to treat successfully. Secondly, the vast majority of relapses take place in the first 30 days off treatment. I don't think you have anything to worry about.
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Avatar_f_tn
thanks susie, always worries me because i only done the 16 weeks
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Avatar_f_tn
also i could'nt eat any food for days and lost a lot of weight
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Avatar_m_tn

You would think that you have not relapsed,seeing as you were UND at wk.4 and 12 of tx. Also being UND at wk. 12 post treatment is a good sign. However just to be sure you should consider doing your 6 mo. post test to expel any fears you still have.

Hope that helps some


WILL
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Avatar_f_tn
forgot to add that i had night sweats.   as you all can see i still suffer with brain fog,ha
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1491755_tn?1333204962
Why not call the Doc and set up your test ?  There is no Internet diagnosis, and as you know there is only one way to tell if you have a VL.

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Avatar_m_tn

Ditto to what James10500 said, but the following study may be somewhat reassuring for now.


Sustained virological response (SVR) to hepatitis C treatment is usually defined as continued undetectable HCV viral load 24 weeks after completion of therapy. Michelle Martinot-Peignoux and colleagues from France evaluated whether assessment of serum HCV RNA 12 weeks after the end of treatment was as relevant as 24 weeks for determining SVR.

The investigators analyzed sustained treatment outcomes among 573 chronic hepatitis C patients who received pegylated interferon (Pegasys or PegIntron) plus ribavirin and had an end-of-treatment virological response. Viral load was measured using a sensitive TMA assay with a lower limit of 5-10 IU/mL. Viral relapse was defined as reappearance of detectable HCV-RNA between the end of treatment and post-treatment week 24.

Results

All 573 participants had undetectable HCV RNA at the end of treatment.
At 12 weeks post-treatment, 409 participants still had undetectable viral load.  
At 24 weeks post-treatment, 408 participants (71%) achieved SVR.  
Looking back at week 12 results, all but 1 of the patients who were undetectable at week 12 remained so at week 24.
Week 12 response had a positive predictive value of 99.7% for predicting Week 24 SVR.  

The researchers concluded that assessment of serum HCV RNA 12 weeks after the end of treatment using a highly sensitive TMA assay "is as relevant as after 24 weeks to predict SVR and make decisions on the management of treated patients, suggesting a new definition for SVR."

Institut National de la Santé et de la Recherche Médicale, Centre de Recherche Biomédicale Bichat-Beaujon CRB3, Université Paris VII, Paris, France; Service d'Hépatologie, Hopital Beaujon, Clichy, France.

6/11/10

Reference
M Martinot-Peignoux, C Stern, S Maylin, and others. Twelve weeks posttreatment follow-up is as relevant as 24 weeks to determine the sustained virologic response in patients with hepatitis C virus receiving pegylated interferon and ribavirin. Hepatology 51(4):1122-1126 (Abstract). April 2010.

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Avatar_f_tn
I don't think anyone is trying to diagnose deb....just trying to give her the facts so she doesn't feel that stressed out. Of course nothing is 100% but her chances are excellent that she just had another infection.
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1491755_tn?1333204962
lol.....Susie you just diagnosed her.

Not sure if you've ever treated or not.  But to be considered SVR you have to be UND at six months.  If the question is " am I SVR" get tested.

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475300_tn?1312426726
Hi, Even a year, 2 years now 3 years thing go on with the body that gives me this niggling feeling "Oh please don't be back!"  As far as the night sweats go, I had them at 20 had them at 40 and sitll do at soon to be 50 so they are not all that reliable.

I would def get that PCR to put your mind at rest

Good Luck
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Avatar_f_tn
thanks everyone, i'm going to my gp''s next week so will ask her to hurry the consultant up.i will try and relax till then, i was treated with 180 pegasy and 800 riba, i think thats the reason i ended up in hospital because i only weigh 6.5 stone but getting there now, thanks again and i'll get that test
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1491755_tn?1333204962
Deb, good luck with your test.  I am only 3 weeks off meds, but if I had a dollar for every time a bone cracked I'd retire.  Some days my body feels like I'm still on the juice, some days I feel good.  I suppose it will just take some time.  My mental state is much improved though.  Good luck with your recovery and SVR !!
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Avatar_f_tn
thanks james will keep you posted, good luck with your 12 week pcr, i felt the same after tx but it improves montth to month, i'm 7 months off the meds now and still having some bad days - no energy etc..but it is improving, so keep your chin up and still rest james or you will find yourself getting tired ,
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Avatar_n_tn
just after that had case of flu with slight fever, headache  for 2 days, muscle aches, pain in elbow joints and sleeping in daytime etc
____________________________

You diagnosed yourself.  You're in the UK.  It's influenza season.  

Chill.  You're fine.
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