Viral load after 3 months of tx

[agent211]

My viral load went from 2.8 million to 460,000, but my hep c doctor says that my chances are around 5% since it has not reaced SVR.
He said I could go to the six month point and if I haven't reached SVR then I might as well stop tx.

Does this make sense?

[newleaf09]

I think the log equivelant tables are on both the Janis hep C site and on Hepatitis central site.  The Janis site is extremely helpful if you have not yet found it and looked at it.

[GreatBird]

Each log is a 0, essentially so if you started at 2,800,000 two logs would take you to 28,000--which is the first number without two 0's on the end.

Or you could find a logarithm calculator on the web. As a log, 2.8 million becomes: 7.447. You want to get down to 5.447 by week 12. That converts to 28,000. Either way it's the same decrease.

[agent211]

Thank you for your responses. I am a 48 weeker. And your comments were helpful.
I am a genotype 1B. I take 120 mcg @ 0.4 ml of the pegintron and high dosage of the Riba.
What does the 2 log drop mean?

[annieCinMD]

I'm going to chime in and agree with the others. I'm not responding well to SOC either but I'm on a trial for a new protease inhibitor. I've decided I'm probably going to take myself off after the 12 weeks of the PI are over. I'm having too many sides effects and don't like my numbers I got from the SOC only phase of the trial. Not worth possible long term problems from extended time on interferon and Riba. I often write about one of my best friends who treated back around 2001 and enjoyed 8 yrs. of remission. She just found out that the virus is back. It turns out she didn't clear for over 6 months and that was her second attempt. I don't what her 12 week numbers were, but I'm guessing they just didn't have the statistics they do now on the chances of clearing by how early you first show UND, and the 2 log drop stuff. I might add that I have very little damage so feel good in the decision to terminate treatment at 28 weeks no matter what. My friend was sick when she treated, had no choice but to treat, and it obviously bought her some time, because she has been well during her rather long remission.

[nygirl7]

Agree unfortunately with the guys above.  I didn't clear by week 12 but I had a two log drop (actually was almost UND) by week 4.  I did clear by six months but then I had to extend treatment to 72 weeks to improve my odds - it did get me to SVR though so it was worth it.

Did you have a 4 week PCR? If you had seen then that you were not responding very well you could have upped the dosages and tried to tweak it up a bit to get a better response. When you treat again that is something I would make sure I did (if you haven't).

Are you being seen by a heptologist or just a GI?  Sometimes this late it's best to stop and start over again with a more aggressive approach and hit it fast and hard in the beginning. Of course none of us are doctors and we don't know any of your details (even if we did we're not qualified to give you real medical advice of course) but in personal expreience only.

I too am curious to know if you had enough meds to begin with (how much riba, was it weight based?) and things like that as well.

Good luck to you - I wish there were more positive news however the best thing I can say is if you are not having a very hard time you could up the meds and then have a pcr in 4 weeks and see where you've gotten. I'm kind of crazy like that myself is the only reason I can say it the guys in here know I took way too MUCH medication myself but it worked in the end.

[GreatBird]

Yes, it makes sense. You have not had a 2 log drop. You need to have one by 12 weeks.

What are your dosages and other statistics (genotype, staging, weight etc.)?

You are going for UND (undetectable). SVR (sustained viral response) is something that is determined 6 months after the EOT (end of treatment) if there is still no trace of the hepatitis C virus.

[newleaf09]

I'm sorry to say that it does.  There have been many studies looking for 'positive predictive value' gained by looking at how long it takes a patient to clear.  Odds of staying clear (SVR) are much greater the earlier you clear the virus.  If you don't clear by 24 weeks (some doctors set the decision point at 12 weeks), you are not responding to the interferon enough to justify the damage that the interferon may do to other body systems.  Stopping before damage happens and waiting for the release of new drugs in 2011 may be justified.

[montanabln1]

hey if you are able to deal with the therapy and its sides then I would continue with therapy right up and beyond 6 months. we have one life and in my view do everything possible to get rid of this nasty bug.