how much longer?

I just received a viral quantitative that was "UNDETECTED".  It was the 615 lower limit and I will ask for the more sensitive test when I see my doc.  If all comes out well, how much longer after being undetected is recommended for Peg and riba.  I am most anxious to get off of this poisen but reluctant to do so too soon.  Anyone have experience with this.  Thanks

[dorsey15]

Depends--what's your Genotype?? How long have you been on treatment?? What week was this test done?? Don't understand when you say this test was @615 lower limit?? not sure what test you are talking about?

Please clarify???

[Marcia2202]

615 sensitivity, I suppose.

You need to follow the whole treatment. Even though the virus is undetected in the blood, it is still in all the organs in the body and it takes a minimum of 24 weeks for genotypes 2 and 3 and a minimum of 48 weeks of treatment for genotypes 1 and 4

[Marcia2202]

I just looked at your profile, you are geno 1a and definitely need to do 48 weeks.

Marcia

[Trinity4]

I am not sure sure @615 lower limit means UND.  615 IU/ml is not UND.  What exactly does your PCR say?

[Deb_c430]

>50, > 10.> 5 depending on the lab and sensativity is UND,  I had one that 310 once and it was not und, but i was well on my way

[nygirl7]

615 is really a pretty useless test.  For example my 4 week test had a value 411.  IF I had used the 615 test I would have believed I was truly undetectible (because it would not have shown me that 411 at all because it was under the 615) however i was NOT.  THAT is the most important thing - when you are TRULY UND not when you think you are.

If you are UND at week 4 - 12 for real (using a much more sensitive test) then you would do the whole 48 weeks (if you are a geno1 for example).

If you are NOT UND at week 12 but you are UND at week 24 you need to think about extending to 72 weeks.

The fact that your doctor is using such an old outdated and really irrelevant test says to me that he hasn't read any of the latest studies that have been done and are now being used by the more top, knowledgable docs.  I would be concerned.

It is not only that you find yourself UND meaning you have no more virus. The interferon must have time to TRAIN your immune system to find any virus that is not detected IN YOUR BLOOD STREAM.  Virus' are so so small that they could be present anywhere.....your body needs the extra time AFTER you are UND (say using a test with the highest sensitivity of 50 - but better yet 10 or 5 or even 2) to make sure that your immune system can find them and kill them off.

If I was you I would look around and find a real hep specialist.

I had to extend to week 72 because I was not really UND (to 2) until somewhere between weeks 12 - 24...but I have been cured for almost two years.  It was worth the extra time and I am glad that I learned enough to know about it back then when it was not common.  Now...it is accepted practice by most all of the top docs in the field.

Good luck.

[Deb_c430]

that's an actual test? never heard of it!

[mikesimon]

Hi there. It's nice to see your name.
That is the million dollar question - how long to treat after undetectable. In a naive patient who is undetectable at 12 weeks it would seem that 36 weeks after undetectable is usually the standard duration = 48 weeks total. You situation isn't typical so it's not an easy question to answer. I believe that the longer undetectable the better the odds are of achieving SVR and I doubt I would get much argument on that. The trouble is the side effects/tolerability and the increased chance of long term side effects post treatment. With transplant recipients the fibrosis progression with active HCV is often faster and more aggressive than in non-transplants so I think that must be considered. The odds of SVR aren't good with transplants with standard treatment so I think we have to do a little more to get clear and stay clear. I chose to extend and did so without a lot of support from my transplant team. I felt I had to extend but now, looking back, I wonder if I had to go as long as I did. But, I cleared without any lasting effects aside from a low normal hemoglobin and platelet count and I may have had that anyway. You have to decide what you can tolerate because I don't think anyone knows for sure about duration in the transplant population.
Whatever you decide I certainly wish you the very best.
Mike

[sallyo]

Thanks for the info.  Mike, you are correct in that my situation seems a little different.  I have been on Peg/riba with geno 1a post- transplant since 4-2005.  That is approx week 204 if my math is correct.  Had one break through during that time when I got pneumonia, was off about 2 months and on steroids.  Started right back and just now got the UND with the 615 test.  I suspect this is the test covered my my insurance and that my doc will now order something more sensitive. Thats what I'm hoping.  He is a hepatologist and trained with the transplant team in Miami so I do not question his ability.  I will see him in 3 weeks and in the meantime was told it keep going.  UGG. Good to see your name Mike.  Hope you are also well