Afraid to be encouraged....

[Kim63]

I am hoping to get some opinions, as I am reluctantly encouraged with my latest labs. I am Genotype 1 stage 2. This is week 13 of treatment. My viral load started at 748,000, alt 129, ast 47,alk phos 69. At week 4, my viral load dropped to 133,000. My latest load is "43." (week 12) . The cut-off for detection is 43. my alt is 43, ast is 32, and alk phos 61.  I am continuing on with my treatment. Do you think that this is good news for me ? Does anyone know what my chances are for a total susutained response ? Thank you.

[Kim63]

It seems that everyone has such varied experiences, and outcomes. I feel that I have to take that chance (even if its only 30-40 % ) to get rid of this rotten disease. I have come 13 weeks, and I can't see stopping. My Dr.s opinion is to keep on going, and I think I am inclined to agree. I knew starting out, that my chances weren't great, but....I didn't come this far to give up the ship now. Although, I have to admit, I can't begin to imagine how I will feel, as it is pretty rough already....But, one foot in front of the other..

[frijole]

Perhaps you can get another test run but it does sound like you were detectable.  I know 43 sounds good -- or you really may have been at 10 - who knows--  But detectable is detectable.  I had 40 IU/mL at week 12 -- the test was sensitive to 2 -- and was disappointed that I was not clear but still didn't think I had to extend.  I did not do 72 weeks and now have to look at retreating.

I am afraid you will need to start thinking along those line.

good luck
frijole

[zazza]

You got a borderline result. That is exactly what it said on my lab report when I tested detectable but not quantifiable at week 12. Thus I was a slow responder, and decided to treat for 72 weeks. I am now SVR.

I have seen that kind of borderline result many times, nothing strange about it. Your viral load test can only quantify down to 43 IU/ml, but it can detect virus below 43 IU/ml. Thus the viral load test has detected that there is still hep C virus in your blood.

[Marc1955]

I actually had the same result on a test and ultimately chalked it up to a problem with a corrupt sample. It is very confusing and there could be a number of different explanations based on the particular test you were taking.

If you have an accommodating physician and reasonable insurance, you might ask them for an order for LabCorp's Quantasure or Quest's Heptimax. These both have extremely low cut-off points and they would give you a more accurate sense of where you stand. It shouldn't be any skin off the doctor's back to do this so long as you have decent insurance. The tests cost about $500 each but they are usually covered. I might consider testing again right away because the 12 week juncture is so critical in making treatment decisions.

[Kim63]

Thanks for the information. My HCV RNA says " detected, but < 43. Then it says the HCV RNA quantification level is 43 IU/ml to 69,000,000.   Then it says "HCV is detected but " the present level is less than the lower limit of this assay. " "possible causes include, early infection, or absence of the HCV infection. ( ie impression of assay ) .   So, I'm not sure where I am  ??? It seems like I am right at the borderlines ??

[Marc1955]

Realistically it's o.k. news but not fantastic. To be an early responder and have a high chance of success, you want to be entirely clear of the virus by week 12. I'm having a little trouble interpreting your note – did you actually test positive for virus at week 12 or were you under the threshold of sensitivity? If you still have detectable virus, then you don't fall into the category of an early responder.

If you are Genotype 1, have a two log drop by week 12 and clear by week 24 your chances of SVR are roughly 50%. That seems to be your category. This is a scenario when some people suggest extending treatment to 72 weeks but the current research is mixed on that. Because you've responded pretty well your chances might actually be higher than 50% but there isn't research to make them significantly higher than that.