Hepatitis Forums
Hepatitis C Main Forums => On Hepatitis C Treatment => Topic started by: Red_Baran on February 23, 2018, 06:10:40 pm
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Hello,
I finished up epclusa 16 weeks about 2 weeks ago. I'm feeling pretty disheartened. My blood work came in and it still says detected but <15 (pre epclusa 1.5 million). Does anyone know what this means? My lever enzymes are all normal now.
I was unable to do the standard 30 day blood test (I think there was another I missed as well) because of an insane billing error on the lab company end. But that kind of got sorted so I was able to get my first post treatment blood work.
Treatment wasn't pleasant for me so I really hope I don't have to do it again.
Thank you for everyone's support!
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Red_Baran, it's still possible to clear the virus after treatment ends, so you might very well be undetected at the test 12 weeks after the end of treatment, which is the official test for a cure. Dragonslayer was still detected after treatment but cleared by the test 12 weeks post, and he has stayed free of Hep C. Even if Epclusa fails to finish off the virus, you probably would be prescribed a different medicine the next time. You are so close to undetected! I also really hope you don't have to go through another treatment.
Gnatty
P.S. The "<15" means that the test's sensitivity allows it to count only if there are at least 15 bad guys in the mL of blood. If the test detects some, but fewer than 15, the result says detected <15. It could be 14, or just 1, or any number in between (the test can't tell).
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Thank you very much for your reply. It makes me feel mildly better. I really do not react to meds well so I really hope that's the outcome. Hopefully I'll get an appointment with my Dr next week.
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I'm sorry to hear that, Red.
I know there are people on this site and at FixHepC who were weakly detected at end of treatment and still went on to SVR. There are some pertinent threads on the FixHepC site on the Forum > Expert's Corner > Viral Load and SVR with links to published articles that reference being detected at EOT and going on to SVR in the trials (not uncommon apparently).
If your doctor is not planning to retest your viral load until 12 weeks post, I would get your liver enzymes checked at 4 weeks post treatment. If they are still low, that would be a good sign. Dr. Freeman at FixHepC said most people who relapse do so in the first 4 weeks after treatment.
Keep us posted! Wishing you the best!
~Ella
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Here's an interesting article from April 2017. It does not include Epclusa specifically (maybe not out then?), but I think it would apply to DAAs generally.
Virological and clinical significance of detectable HCV-RNA below limit of quantification at End-of-Treatment in patients treated with direct antiviral agents
http://livertree.easl.eu/easl/2017/international.liver.congress/168237/ubaldo.visco.comandini.virological.and.clinical.significance.of.detectable.html?f=m3t4035
337 patients enrolled in the study.
16 patients relapsed.
18 patients were detected, not quantifiable (DNQ) at end of treatment (EOT).
All patients DNQ at EOT or 4 weeks post were reanalyzed using an ultrasensitive HCV RNA test (US).
Out of 18 with detectable HCV-RNA with both tests at EOT or PTW4, only 1 experienced relapse.
Out of 16 relapsers, only 2 showed DNQ at EOT (12.5%).
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Here's an interesting article from April 2017. It does not include Epclusa specifically (maybe not out then?), but I think it would apply to DAAs generally.
Virological and clinical significance of detectable HCV-RNA below limit of quantification at End-of-Treatment in patients treated with direct antiviral agents
http://livertree.easl.eu/easl/2017/international.liver.congress/168237/ubaldo.visco.comandini.virological.and.clinical.significance.of.detectable.html?f=m3t4035
337 patients enrolled in the study.
16 patients relapsed.
18 patients were detected, not quantifiable (DNQ) at end of treatment (EOT).
All patients DNQ at EOT or 4 weeks post were reanalyzed using an ultrasensitive HCV RNA test (US).
Out of 18 with detectable HCV-RNA with both tests at EOT or PTW4, only 1 experienced relapse.
Out of 16 relapsers, only 2 showed DNQ at EOT (12.5%).
Thank you! That makes me feel amazingly better. It seems like if it's less than 15 my body should be able to fight off the rest? Maybe?
Anyway much appreciation to everyone who replayed.
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One theory I saw from an article from April 2015 was that the treatment might render new virus incapable of replicating. From a 6 week trial:
The model predicted that people with any detectable virus at the end of 6 weeks of treatment should experience viral rebound, since at that point there would still be a million new viral particles being produced every day. But this usually did not happen. (This study used a more sensitive assay with an LLOQ of 12 IU/ml and an LLOD of 3 IU/ml.)
"There must be other reasons to explain the high SVR," Guedj said. "We think most of the [newly produced] virus may be uninfectious...treatment may have the effect of replacing a working replication complex with a defective replication complex, which explains how most patients could clear the virus in 6 weeks."
http://www.aidsmap.com/HCV-viral-load-levels-during-treatment-and-speed-of-decline-do-not-predict-cure-with-interferon-free-therapy/page/2962856/
Cheers!
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Finally made it to my dr and she said its a 50/50 shot if its cleared. She said she has seen this before and some times it goes away because there were just fragments of the virus left some times you wind up with a full blow HCV
Thank you for the studies they are comforting even though my dr seems to disagree with them.
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We had one person here Dragonslayer who treated with Harvoni and was detected at EOT and at 4 weeks post but at 12 weeks was not detected and remains cured to this day.
The majority of people who relapse will sosoby week 4 post treatment and the viral load won’t come back slowly it comes roaring back with a vengeance.
I relapsed after being on Sovaldi and Olysio for 12 weeks. I was not tested at 4 weeks post but when I was tested at 12 weeks post but my viral load was at 2.4 million while my pretreatment viral load was 2 million. So yeah hep c does not sneak back around. My EOT result was not detected so even with that it doesn’t mean much of anything.
One indication I had was I received my liver enzyme test results before I got my viral load results. My liver enzymes had risen back above normal.
Anyway don’t give up hope there is lots of evidence you are not done yet. Hang in there until you receive your 12 week test. Personally I think your odds are much better than 50/50. More like 99/1.
Are you going to have a viral load test at week 4 post? That would give you a much better idea where you stand.
Best of luck let us know what is going on.
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Just a quick update. I was just at my GI Dr after I got some blood work done. Im clear! Undetectable!
:)
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Fabulous news!!!!!!!!!!!!!!!!!!!!!
Enjoy your new freedom.
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Congratulations -- you are officially CURED!
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YAY RED!!!!! ;D
I'm so happy to hear this! I've been checking in hoping you'd post when you got your 12 week results. Congratulations!!!
~Ella
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Congratulations Red!!! :)
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Thank you everyone! You have no idea how much your support and advice meant to me. It's so great communities like hepmag exist to help people get through things like HCV. I didn't/don't know anyone else who had it, so it comforting to know there was an entire community of people who could I could talk to. One more thing, I am also so appreciative of living in the a time when there is a cure and in the grand scheme of things a treatment that wasn't that bad. Thanks again everyone!
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Alright fantastic news!!!!!
Congrats :)