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427265 tn?1444080036

4 week PCR results

Well…I got my 4 week PCR results back today and I only got a one log drop from 848,000 to 38,600. To be honest, I thought RVR was a long shot considering my stats going in, but with the amped up doses, I really thought I’d see more of a drop. So now instead of decreasing the Pegasys down to 1 ½ doses a week, I am to stay at the full 360 mcg a week and stay at 1400 Riba until the 12 week mark and then extend SOC to 72 weeks. I’m almost too disheartened to cry right now, but I’m sure the tears will come at some point. I still wonder if I am getting enough…what do you call it? Saturation?  with the Riba even at 1400 mg since my hgb is hard pressed to budge downward.  But the thought of upping it to 1600 makes me almost physically ill, not that it’s been recommended.

So what do you do? Cuss and cry it out for a day then start putting one foot in front of the other again. I mean, what else can you do?  I want to clear, but I don’t want to nuke myself in the doing…… So I’ll give myself another jab tonite and hopefully kill off a few more of those buggers, Any suggestions of anything more I could try, even if it's outside the norm?

Pam
69 Responses
Avatar universal
It is a 1.34 log drop, which is good enough for a geno 1 at week 4. Sure enough, you might be heading for 72 weeks, but at least you are responding. A lot of geno 1s do not respond.´I see you are on a tough regime. Wishing you well, Za
577132 tn?1314270126
You could try increasing the amount of fat you are taking with your riba meal to try and increase your riba absorption, rather than taking more riba.  And make sure you are not taking your riba with fibre or antacids - riba binds to the fibre and moves through too quickly to absorb well, antacids block the absorption.  

Riba likes to bind to fat.  I have really noticed a difference in the sx when I take my riba with more fat...
427265 tn?1444080036
Thanks for the encouraging words...

Zazza....a 1.34 log drop sounds loads better than a measly 1 log...and it is going down. And an evr at 12 weeks is my new goal!

Epi - I've been taking my Riba with a meal at 8 am and 6 pm and then with a spoonful of VCO..yet my hgb just began a slow decline the past week (4)You said you noticed a difference in sx since you started taking Riba with fat....I'm assuming you mean less of them?

Now if I can get my WBC's and platelets to stabilize.......
446474 tn?1446351282
Pam,

I don’t know your medical history details (liver condition, treated before etc.) but you seem to be on track generally.

RVR (Rapid virologic response) occurs in approximately 15% of patients (SRV rate 90 %) with HCV genotype 1.
Most genotype 1 patients, 35 %, achieve undetectable HCV RNA before week 12. And 66 % of these patients achieve SVR.
15 % achieve undetectable HCV RNA between weeks 12 – 24. SVR rate 35 %.

All is not lost by any means. As long as your viral load becomes undetectable before week 12 you still of a greater than 50 % chance of achieving SVR.

By the way your platelet count is at 95,000 I believe. Which is plenty of platelets. You have a long way to drop to even get close to danger there. (20,000).

Hopefully your next HCV RNA test will be UND or close to it.

Best of luck.
HectorSF


All is not lost by any means. As long as your viral load becomes undetectable before week 12 you still of a greater than 50 % chance of achieving SVR.

By the way your platelets are at 95,000 which is plenty. You have a long way to drop to even get close to danger there. (20,000).

Hopefully your next HCV RNA test will be (848,000 to 38,600) UND or close to it.

Best of luck.
HectorSF
Avatar universal
To be honest, I thought RVR was a long shot considering my stats going in,
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Sir if I missed it or forgot, what exactly are your stats and any prior treatment history if any --, and why is it that you already committed to 72 weeks when you still have a chance to be undetectable by week 12? that's a fairly aggressive approach, but again, not sure what your stats are, possibly your stage four?

As to the hemoglobin, you mentioned hasn't budged much. What was your pre-treatment hemoglobin and what is it now? how much do you weigh?
Avatar universal
if possible i would do pcr's weekly or at least week 8 (draw blood day of 9th shot but before shot) to see exactly when I became UNDE. If early enough and also unde at 12 & 24 weeks I would only do 48 weeks of tx.  with new drugs in the pipe line no way would I subject my body to 72 weeks of these drugs. Best of luck
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