undetectable

[josejuan2013]

How you doing?I did treatment with incivek.First time in treatment 1A 2 stage.I was und at 2 weeks 12 and 24 weeks so my question is what are my chances of svr?Thank you.

[Dee1956]

Hello, I just want to say congratulations for finishing for getting to UND and getting to SVR soon.
I am very happy for you
Dee

[pooh55811]

PS: If you get a viral load test done at 12 weeks AFTER finishing treatment, and it is still Undetectable, then your chances are 99.7% for SVR.

"Sustained virological response (SVR) to hepatitis C treatment is usually defined as continued undetectable HCV viral load 24 weeks after completion of therapy. Michelle Martinot-Peignoux and colleagues from France evaluated whether assessment of serum HCV RNA 12 weeks after the end of treatment was as relevant as 24 weeks for determining SVR.

The investigators analyzed sustained treatment outcomes among 573 chronic hepatitis C patients who received pegylated interferon (Pegasys or PegIntron) plus ribavirin and had an end-of-treatment virological response. Viral load was measured using a sensitive TMA assay with a lower limit of 5-10 IU/mL. Viral relapse was defined as reappearance of detectable HCV-RNA between the end of treatment and post-treatment week 24.

Results
All 573 participants had undetectable HCV RNA at the end of treatment.
At 12 weeks post-treatment, 409 participants still had undetectable viral load.
At 24 weeks post-treatment, 408 participants (71%) achieved SVR.
Looking back at week 12 results, all but 1 of the patients who were undetectable at week 12 remained so at week 24.
Week 12 response had a positive predictive value of 99.7% for predicting Week 24 SVR."

http://www.hivandhepatitis.com/hep_c/news/2010/0611_2010_a.html

[pooh55811]

Welcome to the forum

Your chances are excellent. You attained an eRVR by being UND by week 4. People with an eRVR have an excellent chance for SVR. I have copied and pasted the results of one study which shows your chances appear to be 89% to 92% (because you had an eRVR). There could be other factors which may affect your SVR rate, but overall, the studies show a high SVR rate.

Here are the results of one of the studies:

Hepatology - Management of Hepatitis C Infection
Authors: Jordan J. Feld, MD, MPH, Hemant Shah, MD, MScCH HPTE, Donald M. Jensen, MD

"Treatment-Naive Patients"
"The pivotal ADVANCE trial randomized 1088 patients with genotype 1 HCV to receive standard peginterferon alfa-2a plus ribavirin (PR48) or a regimen of peginterferon alfa-2a and ribavirin with telaprevir 750 mg every 8 hours for the first 8 (T8PR) or 12 (T12PR) weeks of therapy followed by continuation of peginterferon alfa-2a plus ribavirin alone for a total of 24 or 48 weeks (Capsule Summary).[Jacobson 2011a] Rates of SVR were significantly higher in both telaprevir-containing arms than in the control arm: 75% in the T12PR arm, 69% in the T8PR arm, and 44% in the PR48 arm (P < .0001). The study was underpowered for a direct comparison of the T8PR and T12PR arms, although there were trends toward improved efficacy of T12PR dosing in several subgroups. There was also less emergence of resistance in the T12PR arm. Therefore, although the T12PR regimen is the regimen approved by the FDA and the European Medicines Agency and may be preferable to T8PR, the ADVANCE data show that if patients need to stop telaprevir at 8 weeks because of toxicity, high rates of SVR are still likely.

In addition to higher rates of SVR, the addition of telaprevir to peginterferon and ribavirin allowed for a shortening of therapy duration in many patients. In ADVANCE, patients who had undetectable HCV RNA from Weeks 4 to 12, termed extended rapid virologic response (eRVR), were eligible to stop therapy at Week 24. A total of 58% and 57% of patients receiving T12PR and T8PR, respectively, met criteria for shortened therapy. In keeping with their early initial response, these patients typically responded well to therapy, with overall SVR rates of 89% and 83%, respectively.[Jacobson 2011a] To confirm that this response-guided therapy approach is an appropriate strategy when using telaprevir, the ILLUMINATE trial randomized patients achieving an eRVR on telaprevir, peginterferon, and ribavirin to 24 or 48 weeks of dual peginterferon/ribavirin therapy (Capsule Summary).[Sherman 2011a] Of the 540 patients enrolled in the study, 65% achieved an eRVR and entered the randomization. Subsequent SVR rates were high in both the 24- and 48-week arms (92% vs 88%, respectively), indicating that treatment can be shortened in patients who achieve an eRVR on this regimen. "


To see the entire article you need to go to Clinical Care Options, register (it is free), and then seach for the above article.