Correction made

[hcvJames]

Two and a half weeks post Incivek .. Was told I was completely UND at 4 wks. Turns out that wasn't true. It was <42 detected. Doc said that meant a full 48 wk tx. BFD doc, says I, since I already pushed you for 48 wks cuz of being a relapser and cirrhotic. Full tx length isn't a problem, what is, is how does this affect my chances of eventual SVR?

[frijole]

It is a disappointment, James, and a common mistake, I am afraid.  I don't think a lot of the doctors, especially GI's can read those tests correctly.

I am glad you were already resigned to 48.  I cannot add anything else about your chances, just wanted to say to you and all the other 48'ers on this post -- hang in there.  I am at week 38.  It is like slogging through butter, but it is possible.  I am doing VIC so the results don't match -- I had 3920 IU/mL at week 4, but that was the lead in, and after 2 weeks of VIC i was UND with a sensitive test.

good luck,
bean

[Revalation]

Live in the moment and don't look too far forward or back for that matter.
You'll probably be undetected a 8 weeks.
Besides be thankful for even the chance with triple tx.
It wasn't long ago many us  would not even be in the game
I think you will be just fine. I remember when I couldn't stand to look at the stats on the forun. That was some years ago and it's so much more rewarding now.So many more SVR.

Reva

[hcvJames]

Uhmmm ... doesn't sound good. Under SOC odds were ~45%. Odds which I'm unsure included cirrhotics, so may have been lower. Being a natural skeptic it took a long time to accept under 3x tx, odds, even with cirrhosis, were ~85%. Now it's been reduced to ~64% ... maybe ... only 20% higher than otherwise. Honestly, relapsing last year didn't bother me too much. Maybe cuz the new 3x tx was available. This bothers me.

Sigh. Nothing to do but finish out the string. I can put this out of mind till EOT. The six months after is going to be one fretful grind.

Thanks everyone for your input.

[ceanothus]

I'm also in this same boat, a previous relapser, cirrhotic, and didn't reach UND until week 8.  I knew my odds went down when I was slower to get to UND, but I only recently found that number, 64%. It was a steeper drop than I had been envisioning and I have to admit, I do find it depressing to know that my odds are that much lower. I'm just starting week 30 out of 48 and it is a LOT harder to stay positive about this tx with this new knowledge, especially since I'm having bad sides. I really appreciate can-do's optimism regarding UND at week 8 giving better odds than week 12 anyway. Those of us in this somewhat more shaky boat really need a little extra encouragement!

[can-do-man]

James even being that your cirrhotic your odds should be some what better then 50%. As pooh stated the Overall SVR rates was around 64%. One would guess that being und at week 8 would have to boost those odds. Myself I would feel that those who was und by week 8 and treat for 48 weeks with no breakthrough the odds would be around 70%.

Just keep up the good fight and I'm sure things will work out in you favor. Best to you.

BTW, there was not many cirrhotics treated in those trials so any odds would really be just a guess.

[pooh55811]

I guess we are all in the same boat. I had detectable virus at 4 weeks (less than 43) but was UND at week 8.

Here are the trial results those who did not attain UND status at 4 weeks:

"The response-guided therapy strategy with telaprevir is based on the results of 2 phase III trials in treatment-naive patients. Results from the ADVANCE trial strongly suggested that 24 weeks of therapy is sufficient for patients with eRVR.[29] In the T12PR48 arm of this trial, patients with an eRVR received 12 weeks of triple therapy followed by 12 weeks of pegIFN/RBV, whereas patients without an eRVR received 12 weeks of triple therapy followed by 36 weeks of pegIFN/RBV. Among patients who achieved an eRVR and received 24 total weeks of therapy, the SVR rate was 89%, confirming that this strategy results in a very high SVR rate (Figure 11). The robustness of response-guided therapy was confirmed by the ILLUMINATE trial, in which treatment-naive patients with genotype 1 HCV who achieved eRVR after 12 weeks of telaprevir were randomized to receive either 12 weeks or 36 weeks of pegIFN/RBV, for a total therapy duration of 24 or 48 weeks, respectively (Capsule Summary).[30] Among patients with eRVR, 92% achieved SVR with 24 total weeks of therapy vs 88% with 48 total weeks of therapy. Patients who did not achieve eRVR all continued pegIFN/RBV through Week 48, and 64% attained SVR (Figure 12)."

If you go down to figures 11 and 12 there are charts.

http://www.clinicaloptions.com/Hepatitis/Treatment%20Updates/HCV%20New%20Agents/Module/Practical_Guide/Pages/Page%204.aspx

So I am hoping for at least a 64% chance (or more, since I was UND at week 8 and the reseach did not do stats for those DET at week 4 but UND at week 8. They did stats for people DET at week 4 and UND at week 12.)


James, relapsers had very good response to triple med treat, about the same as treatment naive. However, I think the SVR rate is a little lower if one has cirrhosis due to increased relapse rates in cirrhotics.  

Scroll down to table 4 in the following link and you can see what they say about SVR and fibrosis stage.

http://www.clinicaloptions.com/Hepatitis/Treatment%20Updates/HCV%20New%20Agents/Module/Practical_Guide/Pages/Page%203.aspx


I seem to recall an article that actually gives stats for cirrhotics, but I cannot locate it at the moment. I will post it when I find it.

[Idyllic]

Aaargh! Miscommunicating lab results as serious as that ought to be a crime! OH and a few others have the exact stats of what your % of SVR is since many of them are in the exact same boat.

I am a prior partial responder who has to treat 48 weeks as well, I was detectable (with the same lab result you had) at four weeks and UND at weeks 8 & 12. So our paths will cross quite often!! Hang in there and sorry about the lab snafu!