Major VL change before tx

[jules2551]

Hi everyone!  I went today to get all of my baseline work done for tx.  My original VL was around 750,000 and this report says 35,645?  Could this possibly be right?  That is more than a log drop correct?  My mind is baffled here.  All I have done is 9 phlebotomies nothing else.  The last two weeks I haven't had to even do them because I was back down to normal range.  I just don't understand this.

Have a great day!
Jules

[Dee1956]

Hi, I had a similar occurence, before my first tx my VL was 7M, the day I started it was 12M

Then my second tx I was 7M and right before I started it had gone down to
35K which I thought was a very big deal.  It was after I started the Metformin for diabetes, not sure if that made a difference or not

Good luck with your treatment.
Best
Dee

[jules2551]

Just received a fax from Quest Diagnostics with test results for HCV RNA, PCR, Quant  708,850.  So bascially there is no difference from the 750,000.  I don't know where the other number came from must have been an error with the hospital.  So the mystery is solved....no change!

Thanks to everyone for your comments I appreciate it!

Have a great day
Jules

[rivll]

It sounds like you are in good hands.
Go with your doc and all the best to you!

[jules2551]

Thanks Will and everyone else!  I think his concern is because of my drinking history.  My history is I drank and drank...and then had another drink.  I am sure he will want to re-run the test from Quest just to make sure.  If I could do 24 weeks w/o Vic I would be on cloud 9.  So I will call Monday and see.  I doubt if he even has the reports yet. The ladies who take care of me at Hemotology really look out for me and fax me the reports as soon as they get them.  

[willbb]

OP may think about doing Vic.as it has a lead in and if RVR'd then because the chances of success by study data shows that doing 48 is insignificantly no different in success than doing 24.
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Meant to add   "with just SOC "

[willbb]

I beieve some may have missed the point on this. You would never treat or not  treat or do 24 vs. 48 because of VL( unless possibly  other factors came in to play)

The OP is naive,  has  very low VL, the CT allele and  geno 1b.
The  point cando made and I concurred  with was with those paradigms the OP may think about doing Vic.as it has a lead in and if RVR'd then because the chances of success by study data shows that doing 48 is insignificantly no different in success than doing 24.

However it was mentioned to the OP that the ST 3 if nearing cirrhosis may be of concern to the treating doctor ..

best..
Will

[dingdinground2]

I agree, my VL was 2 mil, and between state 1-2 liver damage-I did treatment for 48 weeks ribo/peg to eliminate further damage,  UD between week 4-8. Rid the virus and save your liver,

[jules2551]

OH i am definitely going to do tx.  I have been waiting so long but 24 vs 48 sounds great!  I am not going to argue!  I am just not convinced with todays VL.  I have to redo it to make sure

[orphanedhawk]

In  my opinion one should not base treatment decisions on viral load, ever.
The decision should be based primarily on liver damage.
I know I'm a bit biased as my viral load was 750,000 when diagnosed with decompensated cirrhosis.
Others with higher viral loads had no, or little damage.

[jules2551]

Could the phlebotomies have done this? In the last 11 wks I have had 9 pints of blood taken out.  Could there be a correlation?

[willbb]

so with 4 wk lead in I could get by with 24 wks
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With the 4 week lead in with just Peg/Riba(that is standard when doing Vic..it starts on the 5th week) you would need to be UND. at week 4 (RVR)  to possibly do 24,,however it sounds like your doctor is very experienced with treating HCV  and he seems to be recommending 48 (possibly because of the fibrosis damage)

Will

[jules2551]

I think I will call Dr next week to write order for Quest Labs just to see if there is any difference.  I don't care I will pay for it if insurance doesn't.  But if it comes back the same I would be estatic!  24 instead of 48 OMG.  

We expect the worst and hope for the best!  Man that would be fantastic.  

Stupid Question...so with 4 wk lead in I could get by with 24 wks?

[willbb]

Hi jules...sorry I had to step away    I do that on rare occasions. :)
cando nailed what I was thinking... with a very low VL  and a CT  and the 1b  that is usually a tad easier then if you did the SOC and RVR'd( UND. at wk 4) then  you would have a good chance without the P.I.  and  for just 24 weeks as studies show there is insignificant difference between 24 and 48 with the RVR.

However the caveat may be  the St.3 and this is why your doctor is recommending 48 anyway if he feels you are close to being chirrotic.

Yes ..one of the tests may be a miscue on the labs part ,however they are usually quite accurate and you should always have a quantitative test at baseline(starting tx) anyway so you will know then your VL..

Vic sounds like a good choice with the lead--in  again as cando mentions and  see how the 4 week test goes...

best..
Will

[jules2551]

No prior tx I am seeing a Hepa from Temple University in charge of transplant division.  At that time he said 48 wks and Vic due to skin conditions.  He thought i was cirrhotic but he was wrong due to biopsy.  I have hemocromatosis and PCT also.  Phlebotomies have taken those numbers done to normal range now after 9.  My HGB is 11.8 and Ferritin is 13.9 as of today.  Believe me I would take 24 vs 48 any time of the day.  I just want this %^&* out of my system!

Faith....thanks I will check it out

[FaithforHealing]

There was just a great discussion posted on this the other day with lots of good detailed info from Hector and many other vets on here. Check it out.  

http://www.medhelp.org/posts/Hepatitis-C/Why-did-my-viral-load-increase-/show/1710062#post_7826153

[can-do-man]

What am i missing with 48 weeks? Because of prior treatment.

[jules2551]

The plan was 48 wks with Vic.  I don't know I think we should re-do the test.  The first one was with Quest Labs and today with my local hospital.  They have a good lab but can't believe it would be that far off if there was error

[can-do-man]

Not sure if this is what wills talking about. Being your a CT and 1b and such a low viral load you might ask your doctor about doing a 4 week lead in before starting whatever PI you decide and if und at week 4 just do SOC for 24 weeks... Your odds would be just as good then and doing one less drug..... Best to you girl.

[jules2551]

LOL I guess they know that the Drs are calling insurance company to get tx approved.  Just blew my mind!

[flcyclist]

Them virons are runnin for the hills cause they know some serious viral butt kicking is about to occur.  Or maybe like they said above.......  :-)  Good luck.

[working dog]

my went from 5million to 18,000 back to 10 million...before tx

[jules2551]

yes CT Gt 1b

[willbb]

Have you had the IL28B gene test?

Will

[jules2551]

I am wondering if this is an error.  I realize I still have Hep C and am Grade 2/stage 3.  Will why would that influence your tx choice?  (somewhat)?