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215858 tn?1420171556

What causes a "Viral Breakthrough"?

Is this an unanswerable question?  

Has it been researched?  

And does it happen more often on or off TX?

I haven't found too much information regarding this topic.  Any links appreciated.

V.
11 Responses
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173975 tn?1216257775
Awwwww.....

I really needed that cyber reassurance, NYgirl.

I know YOU know how rough it is in the homestretch.

Thanks,

wyn
Helpful - 0
179856 tn?1333547362
You will, don't even think about it.  end of THAT story, why I've already put your name in my SVR column my head  :)
Helpful - 0
173975 tn?1216257775
It was less than half a log, which, according to what I've read, is considered statistically insignificant.

Can't remember the exact numbers but it was something like 17,000 up to 37,000.  My Dr. went to great lengths to reassure me that those numbers didn't constitute much to be alarmed about.  

If it had gone up 1 log or more, to 170,000+, I imagine his reaction would have been different.  I reached UND between weeks 16 to 18 and have remained UND for the past 32+ weeks.   I'm hoping like heck I stay that way until May 2 and then get SVR.

wyn
Helpful - 0
179856 tn?1333547362
I don't exactly fancy that though.


I did high dose riba for 46 of the 72 weeks (Doc. J ordered me back to weight based at week 46 because of the amount of Epogen I had to be on in order to keep my hemo over 10) it was HELL but I do believe it worked.  Just be prepared for the anemia and the rash in advance and be loaded up on that Procrit!

Dr. J. told me that one of the most IMPORTANT things to do was not to disrupt the flow of the riba by lowering the meds during treatment (although he did agree that at 46 it was fine since techinically I was 2 weeks from being "done" with treatment) - he said out of everything I'd suffered through (when I had the drastic anemia drop and the guys HERE made me not give up) that that was the thing that would save my SVR.

He was right.

I pity you having to do it but I do believe it is valuable...especially during the first 24 weeks (forget the first 12 I'm way too aggressive to say just that ;)
Helpful - 0
233616 tn?1312787196
what size were your small spike wyn??  I'm curious whats considered small.\\
thanjs mary
Helpful - 0
215858 tn?1420171556
Wyn, You're past halfway!   Can you see the light at the tunnel's end?  I'll be watching and rooting for your SVR!

Dointime,  Sorry to hear about your breakthrough, that's really cr@ppy.  So, it sounds like what you are saying is that the breakthrough usually occurs because of "unbalanced" meds or non-compliance.  But do you know if it's possible to have a breakthrough while not on TX?   And lastly, when you had your breakthrough did you correct the ribavarin dosage and stay on TX?  Hope your next TX goes better.

Thanks,  Anna.
Helpful - 0
Avatar universal
In most cases, viral breakthrough is thought to be caused by not enough ribavirin in the blood serum.  Reasons for this could be that the ribavirin dose is too low, ribavirin absorbtion by the body is poor, or non-compliance with taking it.  Some people get their ribavirin dose reduced because of anemia.  Unfortunately there's no readily available test to find out if the blood serum has enough ribavirin in it.  

I took my full weight-based riba dose with a fatty meal and was fully compliant but still had breakthrough.  My doc says he'd want to high-dose the riba next time.  I don't exactly fancy that though.

Hope this helps,
dointime

  
Helpful - 0
173975 tn?1216257775
You can always try to flag Hepatitis researcher.  He often pops up and gives advice.

I have 22 more weeks of my 72 week TX and I am PRAYING for SVR.

wyn
Helpful - 0
215858 tn?1420171556
Talk about a euphemisim, huh?  It almost sounds like a good thing.  Yes, Lonestar, this is my understanding as well but I don't know any more than that either.  I didn't know this condition was treatable; I thought TX was stopped when this occurs but I don't know.
No, Wyntre, this is not happening to me but thanks for your concern.  I'm still on the fence on whether I should treat and really want to understand all the risks involved.  I'm very glad your spikes have turned out to be nothing.  

Hopefully some really smart reasearch-minded forumer will come by and fill us in.

Anna.
Helpful - 0
173975 tn?1216257775
I'm not sure.  I'm on week 50 and before I reached UND at week 17 or so I had a couple of mini-spikes upward.  Scared the cr*p outta me but my Dr. said it was probably a fluke and that my numbers would drop again and thank god he was right.

I hope this isn't happening to you?

wyntre
Helpful - 0
Avatar universal
I saw your post earlier and was hoping someone a heck of a lot smarter than I am would answer.  I think once on therapy and the viral load is dropping then rebounds means  the virus may have become resistant to the therapy and then mutates into a stronger strain.  The stronger strain gains control of the battle.  Changing interferons or adding extra gun power then becomes necessary.  Hope I'm right in this very simplistic explanation.
Helpful - 0
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