viral load after four weeks before victrelis

[zerohedge]

My baseline viral load before starting triple therapy (victrelis) was 978,000

My results after the first 4 weeks with ribvirin and Peg interferon are below

Hepatitis C Vriral, RNA
Quantitative PCR
HCV RNA, PCR, Quant HI 4370 (Reference range: <43 Unit: IU/mL)

So does the result show my viral load was reduced?

Another result on my lab result is below.

HCV RNA, Quantitative HI 3.64
Real Time PCR (Reference range: <1.63 Unit: LogIU/mL)

Anyhow all other liver tests were within normal range.

[zerohedge]

Thanks, You've been following since the beginning. Ya I'm looking forward to getting the next 77 days over with and onto the other side. I'm back in college with 10 units and it is speeding things up a bit.

[can-do-man]

"Now my question is: What percentage of first time treatment people, non-cirrhosis, with triple therapy (victrelis) genotype 1B that are HCV RNA not-detected at week 8 and week 12 become HCV detectable at Week 24?

In other words how often percentage wise does the 1B virus come back in a mutated form by week 24? "
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While anything can happen the odds are very slim that it will, as a matter of fact being you were a eRVR, geno 1b, the odds are very much on your side it will never come back...... BTW, great labs. Wishing you the best.

[zerohedge]

Looks like my 16th week blood levels stabilized for the first time from going down. I have 11 more shots to go (if I go till 28 weeks).
WBC: 2.2
RBC:3.55
HGB: 11.4
HCT: 33.8
RDW: 17.9
MONOS: 15
SEGS ABS: 1.0
Those were the only out of range lab results.

Now my question is: What percentage of first time treatment people, non-cirrhosis, with triple therapy (victrelis) genotype 1B that are HCV RNA not-detected at week 8 and week 12 become HCV detectable at Week 24?

In other words how often percentage wise does the 1B virus come back in a mutated form by week 24?

[Idyllic]

I followed this thread since your post and I just want to comment how well things seem to be going. By "well" I only mean your numbers look good especially your Hgb. It can really be a drain when it starts to drop to those levels but generally our bodies adjust somewhat. Like Will said some kind of intervention (Riba dose reduction or Procrit) is often considered when Hgb drops below 10 but lots of people managed without either.

Continue jogging or some type of physical activity for as long as you can. If you can't run then walk. I just want to second what Bo said in that it is not the exercise but a side effect of the drugs (Riba & the Vic) that can cause your Hgb to drop.  I really believes at least some type of physical activity helps with the emotional aspect of all this plus like Frijole said about muscle .. well I lost a lot of it as well and getting it back is way harder than I thought it would be.

I hope you continue to post your progress as well as anything else that is going on. Treatment can be a little isolating given how intense the drugs are and the people around us do not really quite understand.
♫

[BoceprevirGal]

   You have many things in your favor, such as, you responded to the Interferon rapidly, and that is also a good predictor. You are also young, and also active.
   But...the longer we Treat, especially us Victrelis people, the lower the HGB does tend to go(Inciveks get to stop the third med at 12 weeks, remember). Yours looks like it is holding up so nicely, that you wont even need any Ribavirin reduction (another plus, a good predictor of cure, taking that full dose) but if you start to feel more pooped out, make your exercise more mild, and dont forget to pamper yourself~
   Oh, I wanted to add: there is beauty in you going Und early enough to only have to treat for 28 weeks, because having to take Victrelis for 48 weeks is super tough...congrats!

[zerohedge]

Ok then I'll plan to be cured. I was planning on awaiting the toss of a coin before your comment.

I've always taken my full meds and on time. I'm at 93 days to go before end of week 28 and I"m still taking 180 P-Interferon, 1200 Rivavirin and 2,400 Victrelis daily.

And even though it is hot out right now. I"m going walking.

I'll post my next labs at the end of this month.

[Dee1956]

Congratulations!  You are doing very well.  As Frijole said, you are my hero for continuing to exercise.
I think that is great!  I wish I had listened to others and continued to at least walk.

My best to you
D

[BoceprevirGal]

  It's not the jogging that is lowering your HGB, it is the Triple combo of meds, that does it.  My HGB was down to 9.4 by my 9th week, and less then 10, caused by the meds, is termed "hemolytic anemia".  No amount of iron pills(not recommended to take during Treatment) or foods high in iron, will correct the problem. It just goes away when you discontinue the meds~
   I also did the 28 week Tx with Victrelis.  That is great that your HGB is still that high :)  
   About those stats listed above, the 71% for geno 1b, etc:  when they conduct those "cure rate" studies, they use a method called "intent to treat". meaning they count everybody in that study, who took even one dose (but then dropped out) because the person had intent to treat. So this throws the #'s off (making them lower).
   If you are a person that is taking 100% of your meds, and your Victrelis is being taken exactly every 8 hrs, then I think you have an excellent chance at SVRing, which is what I also achieved.
   I go to a support-group for Hep C, and all of us Treating did achieve SVR. There were 3 older ladies who were prior relapsers, and had to do 48 wks, with the Incivek,and achieved SVR, and me and another middle-aged person, a guy, who both did 28 wks with Victrelis, and we both cured.
    I kept up on my walking also: at least two 20 minute walks, twice a day.
    
  

[zerohedge]

Ok I found this at this link

IAS 2011: Boceprevir Response and Resistance Differs According to HCV Genotype 1 Subtype

http://www.hivandhepatitis.com/hepatitis-c/hepatitis-c-topics/hcv-treatment/436,197,546-hcv-drug-resistance-hcv-drug-resistance/3104-ias-2011-boceprevir-response-and-resistance-differs-according-to-hcv-genotype-1-subtype

"A similar pattern was observed in RESPOND-2, with SVR rates of 71% for genotype 1b and 64% for 1a with triple therapy, compared to 18% and 24%, respectively, with pegylated interferon/ribavirin alone."

This was after 48 weeks and not 28 weeks.

So maybe a little less than 3 out of 4 chance of getting to SVR

[zerohedge]

I found this from 2012 but I think it is wrong.

Dual antiviral therapy is more effective against HCV subtype 1a than against subtype 1b and this difference is independent of other factors that may favour viral clearance.
TRIAL REGISTRATION:
ClinicalTrials.gov Identifier: NCT01342003.

[zerohedge]

Yes it could be that a lot of exercise reduces the hemoglobin level. I think I jogged at the Santa Monica College track that morning of the test.

Question:
I'm wondering if anyone knows of the success rate for naive, non-cirrhotic triple therapy using victrelis and having genotype 1b?

I looked on the web and found the new treatments are about 97% success after 12 weeks but could find nothing for current treatments..

[frijole]

Keep up the walking/jogging as long as possible.   I amazed at the loss of muscle mass I had over the 48 weeks.  Even though I completed treatment last August, I do not excercise as well or effectively as I did pre treatment.  Two miles a day plus walking is extemely good.  Just watch it.  You may need to conserve energy as you continue treating. I worked full time (desk job) and needed all my strengh just to sit at a desk!  
frjiole (bean)

[zerohedge]

Also, I wish to thank everyone for their replies. Very helpful. Now out for my morning walk/jog

[zerohedge]

I jog 2 miles without stopping. Walk 3 to 4 additional per day. Some days feel too weak to jog but always walk.

[frijole]

Your numbers are amazing.  Are you still jogging those 5-8 mi per day????  IF so, you are my hero.  By that time I was letting excercise go.  As Will stated, the only number that is getting low is the ANC and you are probably fine unless it gets down to .4.  At that point the doctors may recommend Neupogen to boost the white blood cells.

I did Victrelis and my VL was about 2600 at the 4-week PCR and UND after that.  Due to cirrhosis, I had to treat a total of 48 weeks but am glad to say I did reach SVR.

You are doing great.
frijole

[Reidmusic]

Your labs look pretty good to me. I didn't see your platelets listed but low Hgb. and low platelets were my main problems. I could function with an Hgb. of 11 but when it got in the 9's it became difficult. You've got a cushion of a couple points that hopefully will see you through to the end of treatment. Good news that you're still Und. Since I treated at the same place as you, I can tell you that the Dr. and NP didn't reduce my ribavirin until my Hgb. dropped to the low 9's.

[willbb]

if HGB. falls <10  the treating physician may elect to start the growth factor  'procrit" or because you are already UND. to reduce Riba.

Anc  of .8 is a tad low however still room to drop further .
many knowleagble physicians do not get overy concerned with this level getting quite low  (even down to .3 or so) hower some will start  "neupogen" the WBC growth factor drug

best...
Will

[willbb]

So everytime I get tested I get a little worse. I figure by the time my treatment is over in 97 days I'll be dead.
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Oh I don't know :) . Those numbers look great for someone with  just 13 weeks to go. Keep up the good work.

Will

[zerohedge]

Ya so here is my 12 week out of range results due to treatment.

but WBC 2.4
RBC 3.63
Hemoglobin 11.1
Hematocrit 33.6
MCHC 33.1
RDW 17.6
Lymphocyte 48.1
Monocyte 14.8
Absolute Neutrophil 0.8

Good news was HCV RNA not Detected.

So everytime I get tested I get a little worse. I figure by the time my treatment is over in 97 days I'll be dead.

[zerohedge]

Update at beginning of 15th week on P-Interferon, Ribavirin and Victrelis.

I'm still HVC not detected and now on the 28 week program track. I'm exactly halfway through. All good so far. Did a 6 week summer school college class with an "A" and will be starting 3 classes on August 26th.

Hemoglobin now down to 11.1 Today

I felt great all day despite the low result which was actually from a month ago.

[Dee1956]

I have diabetes, for some reason during tx, my sugar was normal, odd

[zerohedge]

Maybe I can some information of insulin dependent diabetics and triple therapy (victrelis). I've been an insulin dependent diabetic for 28 years. What I've noticed so far (week 7) is that I have to test my BG more frequently and that the symptoms of low blood sugar are slightly different than before starting treatment. During my walks or whenever my glucose goes low (below 100) I start to see things really bright in SoCal. I get a bit more light headed than before and I use less Humolog or Novalog than before starting treatment. That's about it.

[zerohedge]

Hope the best. Will keep posting as updates come in.

[Carlhcv]

Please keep us updated. I was at "9" on week 8. Detectable, but barely. I am 1a. Same drugs and on week 19. Critical 24 week test coming up for me. I started with 4,000,000 VL.