viral load

[trapper]

what does a very-high viral load mean as far a treatment goes.  do you have to take meds longer than 12-weeks (s/o).  everybody's viral load seems to be below 10 mil.  Mine is 26 mil.  Thanks  trapper

[jberlin]

Trapper,

Nice to meet you...  Likely this is a question to discuss with your MD, but as I understand it your treatment response means more than viral load.  I also understand that viral load naturally goes up and down some anyway.  But, that is a high number and indicates to me getting treated sooner than later is justified, but my guess is if you get UD fast enough, the treatment times will be what they are.  Exceptions to this will be if you have relapsed or been unresponsive in previous treatments, or if your liver is deteriorating badly - in those cases the MDs typically treat longer just to make sure.  Hope this helps a bit, and I hope you will inform/correct me as you learn more.  Good luck!  -jack

[trapper]

jack  thanks for the info.  If a person still has a viral load at week say 11 on a 12 week plan  will they extend the therapy to 24 weeks to make sure.  I haven't treated before. 

[Mike]

Hi Trapper,

A couple things about viral load: First, it does not correlate with liver damage. You can have a high viral load and no liver damage and a low viral load and extensive liver damage. Second, viral loads fluctuate and can go up and down. Third, a high viral load use to be a significant factor in treatment outcome. This, in general, is not the case anymore with the new, powerful antiviral drugs.

Regarding treatment: The effectiveness of the new antivirals is that they knock out the virus quickly and don't give the it time to rebound. With these antivirals - the quicker the virus is knocked to an undetectable level (1-8) weeks - the better. This is because once the virus is undetectable, the drugs can work on any hard to find remnants. Since Hep-C is an RNA virus, it only takes one virus to replicate itself, and in time it can replicate into millions.

Generally speaking, if a person is on a 12 week treatment protocol and fails to clear the virus, it would be considered an unsuccessful treatment. A doctor may try to extend treatment; but the statistics would not favor a successful outcome (i.e., the chance of full clearance and a SVR would be greatly lowered).

Since these antivirals are so new, there is scant research on how to proceed if viral clearance is not achieved during a specific treatment protocol.

This will change, however, in the near future with continued advancements in antiviral medication. In addition, there are a whole lot of folks that began treatment in January 2014 and have finished. Of these, 80-90% will have been cured; but, unfortunately, some will not achieve a SVR or clear the virus at the end of treatment. It will be this group of individuals who will provide the research/data for the next generation of drugs targeting Hep-C.

Best wishes, Mike

[trapper]

thanks mike  goog info  good luck trap