HCV RNA below 15 IU/ml

[Shyrlgame]

I'm a 52 yr old female recently diagnosed  with genotype 3.  My viral load before tx was 1,130,000.  At week 4 of interferon and RBV, my tests came back detected, but too low to calculate.  I am very relieved that tx seems to be effective.  But was just wondering if anyone has similar results and gone on to clear it.
My blood work is low and had to reduce my RNV, but still on a high dose1200mg, and added Eprex to fix blood counts, there're all out of wack but after 3 wks improving slightly and energy coming back.  
I've lost 10 lbs in 6 weeks,  I weigh now 140, I'm 5'5 so I don't want to loose much more.
I can't help but worry, so would appreciate any support.  It's all new to me and the Internet has become my friend.

Thank you in advance to this forum, glad I found you!

[Cheesegrater]

I have to admit ActingBrandNew is correct.
The patient only dropped 5 Log, some virus was still detected but it was below the limit of quantification. What's that limit, about 15 IU/mL or so?

I think things still look pretty good.

[ActingBrandNew]

A rapid virologic response, or RVR, is defined as an undetectable HCV RNA at week 4

http://depts.washington.edu/hepstudy/hepC/mgmt/viroresponse/discussion.html

[Cheesegrater]

I am not sure on this, but what I have found seems to indicate that the IL28B polymorphism predicts  spontaneous clearance of HCV infection and also response to Peg-INF/Riba treatment.

You have dropped 6 log in 4 weeks. I call that RVR.
If you RVR you are responding very well to treatment.

I would not worry too much about if you are CC CT or TT. The drugs are working.

There is always the question as to whether to treat now or wait for a more sure thing.  How sick is chronic HCV making you feel and how will your health decline if you do not treat but wait.

If for some reason you do not SVR, there are several DAA's around the corner that will cure.

If I were in your shoes I would continue on with the treatment and not worry too much about IL28B.

Best wishes.

[ActingBrandNew]

Its real simple and even a laymen HCV patient can read and understand it...I find it irritating when doctors dont recognize the fact that the IL28B doesn't only pertain to a G1

"In patients who received 24 weeks of antiviral treatment, the probability of achieving an SVR in those who did not achieve an RVR, was higher in those with the CC allele (74%) than with the CT (59%) or TT alleles (29%). Mangia et al. [21] reported that IL28B influenced treatment outcome in patients who did not achieve an RVR, with SVR rates of 29%, 67% and 87% in patients carrying the TT, CT or CC alleles at rs12979860 respectively. "

http://hepatitiscresearchandnewsupdates.blogspot.ca/2012/01/treatment-of-patients-with-genotype-3.html#.UdcYTG0gvFK

[ActingBrandNew]

"I know this is nuts, but when I bring that question to the table, whats my IL28B. His only response is, "at this point it is irrelevant." He states to me it really has no bearing on my Tx at this point. I wonder is that because I am going the full 48 weeks?"

I think it would be safe to assume that. Even if you were CT or TT I dont believe your doctor would go any longer than 48 weeks especially since your treatment naive. The studies Ive read show that the IL28B does directly effect G3's who do not have an RVR. Although they recognize the impact of the IL28B and a G3, theres not much clinical data supporting the idea that longer treatment duration is warranted. The longer treatment duration for a G3 up to this point has usually been based on...

"steatosis (often associated with Genotype 3 infection), fibrosis stage two or more, high BMI and high viral load. In patients who do not achieve a rapid viral response (RVR) with combination therapy, an extended course up to 48 weeks should be considered."

....and those that relapsed after 24 weeks of TX who decided to retreat. The recommendation to treat longer with unfavorable IL28B genotypes is based only on an "idea" that longer treatment duration would benefit the patient.

If I were in your shoes...Id feel comfortable with the 48 weeks of TX.

Its real simple and even a laymen HCV patient can read and understand it...I find it irritating when doctors dont recogni

[nuhepper]

HI,

i am a Gen 3a also.  Before TX my VL was 7 million plus.  At 4 weeks my VL was @ 1.7 million.  But, @ 12 weeks my VL was undetected.  My Doctor was set on 48 weeks from the beginning because of my stage 2/3 liver, my weight and being 59 years old.  

There is no other tx available yet, so it was easy to decide to except his 48 week call.  Only on week 23 now of 48 weeks.  

I just wanted you to know, that I did not even come close to clearing @ 4 weeks but did clear by week 12.  

The odds are in our favor for SVR.  Please stay in touch.  We will all be pulling for you.

nuhepper