5 log drop

[jankar]

Pre -treatment I was log 5.36, after 4 weeks I had more than a 5 log drop making the virus almost undetectable but not quite. What does this mean in terms of my treatment - i.e. the length and success of the treatment.  I am geno 1b, no liver damage, no cirrhosis, not sick, had the virus maybe 20 - 25 years.

[jankar]

I will get my exact results from the nurse, type of test, etc as suggested so i can see what is going on.  I was too busy at work yesterday so will have to wait till Monday to get on to it - will post results as soon as I hear.  Interesting discussion and obviously a text message is not the best way to hear things and then try to interpret.  Nurse is also a little reluctant to give me precise results - attitude is that I probably do not really need to know that.  I need to re-train her I think.  

I am geno 1b.

Thanks so much for the useful and interesting summaries and comments.  I would go 72 if I had to, no worries.  Not going to stop now.

Jankar

[nygirl7]

Can you please post your starting viral load and then what your test result was at, at week 4?

Something is not making any sense at all with these numbers.

Since you are a geno 1 just get used to the idea of doing 48 weeks.  If you are not UND until after week 12 then you would need to seriously consider doing 72. I had a great viral load reduction at week 4 however I hit a plateau and was still at 400 until after week 12 but before week 24 I cleared.  Those are the important milestones in our deciding on our course of treatment.

Nobody really WANTS to go passed week 24 - but you are better off just getting used to it and getting all the chance that you can to succeed so you don't ever need to do treatment again.

[jmjm530]

As CS suggests, something doesn't seem correct. You therefore need to get hold of the actual test results, not a text message summary. Hopefully, it will turn out you are actually undetectible  to the sensitivity of the test as opposed to what you term "almost undetectible. BTW what is your genotype?

----------------
Epi,

Not sure if I'm reading you correctly, but if you are UND to the limit of your test (15 IU/ml) then you are UND via a very sensitive test with limits very similar to those used in major trials. I wouldn't worry about getting tested with something more sensitive unless readily available. Main thing is to get your own hard copy of the test results and make sure you know what the exact story is. Unfortunatly, we've seen numerous cases here where scores were not interpreted correctly by either NPs or doctors who should know better.

[CockSparrow]

Sounds like NZ is using Roches Taqman test.
You might be able find some place that uses the Abbott Test which goes down to 10IU
But 10 15 whats the difference.
Zazza got detected but not quantifiable, using the Taqman test. So you could assume that was less than 15.

There is nothing stopping you from sending your blood to the US if you wanted to get the 2 or 5IU test done. Cost you a bit though.

CS

[epiphiny]

That's why I was asking about the sensitivity of the test; in NZ I thought we only went down to a sensitivity <15IU.

My pre tx VL was 6.24 logs and at week 4 it was <1.18 which was a log drop of 5.06. That meant I was UND <15IU.  If there is a more sensitive test here in NZ I really need to know!!

You could give your nurse a call, jankar, and put us all out of our misery!

Epi

[CockSparrow]

Jankar - Pre -treatment I was log 5.36, after 4 weeks I had more than a 5 log drop making the virus almost undetectable but not quite.

Let me show you something

Your VL is 229000 IU/mL which = 5.36 Logs

Now for you to have had a 5 log drop then guess what your viral load would be?
2 IU/mL. and then you would have had a 5.06 log drop.

So it appears that either your nurse has misread the test result or you are in fact UND.
But only if you had the <2IU test. All other tests produce less than a five log drop.

You should get hold of the test results yourself so you can see what has actually occurred
It could be better than you think or maybe not quite as good.

Wish you Well
CS

[geterdone]

A 5 log drop is a very good drop not RVR but it means you still have some very tough virions in the house and that the meds are working hard for you and EVR is better than NVR. You’re working in the right direction but stay positive and if you can get passed 24 weeks 48 weeks just keeps getting shorter and shorter, it ain’t easy, but you can do it.

jasper

[jankar]

I agree - I want to be as sure as I possibly can that I have done everything within my power to kick it this first time - I will go 48 definitely if I have a better chance - not going to go half way now that I have started.  Plus it is a very empowering thing doing this treatment - control over my health and future life when before it was all a bit wishy washy and hopeful -

jankar

[epiphiny]

I'll look forward to hearing which test and the sensitivity.  You can also request copies of all your results, VL, full blood counts and chemistry.  I find it helpful to have them on hand, and I file them in a folder to take with me every time I go in.  Just good to have the reference.  My nurse now has them ready for me, I don't need to ask for them!

That's the only way I found out about my VL rebound at week 8, on the phone I was told I was still UND but actually from week 4 to week 8 the virus managed to multiply, grrrrr, pesky thing.  It was a tiny amount BUT it was still detectable.  So that changed my status from RVR to EVR (I was UND again at week 12 and have remained so).

When I found out that info I really pushed to go for the 48 weeks and I know that if I hadn't found out about the rebound I would probably just have done the standard protocol of 24 weeks and may or may not have relapsed...

I accept that may still happen to me BUT I know I will have put up the very best fight I could and given myself all opportunities available to achieve SVR!

Knowledge is power!!

Epi.

[jankar]

Thanks, Epiphany for the advice about the test results - I will follow that up.  I am beginning to become interested in the science - becoming educated as a result of the treatment!  My practitioner did  not tell me how far off I was but I will see her 28 Nov and will get the actual results - got the news is a text message yesterday. She did say the test was sensitive - i will ask your questions.  jankar

[jankar]

Hiya,  You are all kind of saying what I thought but wasn't really sure - I was hoping I guess to be UND Week 4 as I was hoping not to go 48 weeks if possible. Of course! Close but not close enough!  O well, onwards and I hope to be UND by Week 12 for the next best result and outcome.  Thanks

[jmjm530]

Being "almost undetectable" is a little like being almost pregnant. Either you're UND or not, and at the end of the day it doesn't matter how much of a log drop you've had.

That said, a five log drop at week 4 is relatively good news, just not as good as being UND. The goal now is to become UND ASAP, and hopefully before week 12 for a better chance of SVR.

-- Jim

[epiphiny]

Ooops, I meant to say I got the above info from gaufs journal, which is jolly good reading if you are interested in the science of beating this beast!

Btw,  achieving EVR is a good thing and probably means you will treat for the full 48 weeks DEPENDING on when you achieve UND.

Epi.

[epiphiny]

Concerning logs, the interesting thing during treatment is not how many thousands or millions of international units of virus our viral load has decreased with so far, but how many percentages.

A 1 log drop equals a 90% decrease of viral load.
A 2 log drop equals a 99% decrease.
A 3 log drop equals a 99.9% decrease.
A 4 log drop equals a 99.99% decrease.

What you need by week 12 is thus a 99% decrease.

[Rockerforlife]

If you didnt clear at wk 4,its means you are not a RVR(rapid viral responder)...its means yiu are an EVR(early viral responder)

[epiphiny]

A 5 log drop is AWESOME!  It means your viral load has decreased by 99.9% so congratulations!!

Have they given you a result that tells you you how far off UND you are?  For example 29IU/mL or 49IU/mL.  And what test have they used and what is it's lowest detection limit?

You need to know those results to get more specific answers to your questions as how long it takes you to get to UND will govern your treatment protocol.

Epi