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Author Topic: one more thing to obsess about... yay!!!  (Read 8532 times)

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Offline drummerman

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  • Posts: 538
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one more thing to obsess about... yay!!!
« on: September 09, 2015, 10:29:55 pm »
One more thing... my EOT blood draw is scheduled for one week after my final dose.  Shouldn't this be done closer to EOT so in case there is an increase in the vl (course I know huge increase would mean to stop tx) but if there were a slight increase might it be better to know earlier when there is still plenty of meds in your blood and then perhaps extend treatment 12 more weeks?

Seems like you would want that test as close to the last dose as possible.

dm
Diagnosed07
Interferon/riba 2008 - non-responder
5/16/15 - AST -34
ALT - 35_ HCV RNA - 10,783,000
 7/6/15 - started viekira/riba
8/11/15  Week 5 <15 vl,  AST 18, ALT 18
9/11/15 Week 9  "HCV NOT DETECTED"!
AST 16, ALT 11.  10/16/16 - 2 weeks post EOT = "HCV NOT DETECTED!   AST - 18,  ALT 14
12/29/15 -12 wk EOT-HCV NOT DETECTED! AST 23, ALT 15
3/26/16 - 24 wk post EOT - HCV NOT DETECTED!! AST 19, ALT 21
1 yr eot - AST 20, ALT 17

Offline lporterrn

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  • LucindaPorterRN
    • LucindaPorterRN
Re: one more thing to obsess about... yay!!!
« Reply #1 on: September 10, 2015, 05:37:10 pm »
Won't make a bit of difference.
Lucinda Porter, RN
1988 Contracted HCV
1997 Interferon nonresponder
2003 PEG + ribavirin responder-relapser
2013 Cured (Harvoni + ribavirin clinical trial)
https://www.hepmag.com/blogger/lucindakporter

Offline Philadelphia

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Re: one more thing to obsess about... yay!!!
« Reply #2 on: September 10, 2015, 06:57:12 pm »
My EOT is a week after the cessation of my treatment. I was nervous too, but as I've already done 24 weeks there was never an option to extend, and I bargained with the anxiety by saying it would give me a bit of a heads up as to how treatment had gone to be done after a week with no meds in my system.
CURED SVR24  Class of 2015
Wk 12 post EOT 30.11.15: ALT 14 AST 22 GGT 22 VL UND
Week 19 07.08.15: ALT 17 AST 23 GGT 25
Week 12 18.06.15: ALT 21 AST 23 GGT 28
Week 8 25.05.15: ALT 23 AST 27 GGT 30 VL UND
Week 4 20.04.14: ALT 30 AST 36 VL 40
Treatment start 23.03.15: ALT 137 AST 185 VL 342,600
Cirrhosis Child-Pugh A, Genotype 1a - Viekira Pak + riba 24 weeks
Total failure interferon/ribavirin/boceprovir Mar 2013
https://www.hepmag.com/blogger/grace-campbell

Offline lporterrn

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Re: one more thing to obsess about... yay!!!
« Reply #3 on: September 10, 2015, 07:14:09 pm »
I was rushing out of the house when I wrote that - what I meant was that even if there was detectable virus at EOT, there is no reason to extend. Treatment length is determined at the start - it isn't dependent on the viral load. There are people who have had detectable virus at EOT and have still gone on and had an SVR - what matters is the results from the post-treatment labs.
Lucinda Porter, RN
1988 Contracted HCV
1997 Interferon nonresponder
2003 PEG + ribavirin responder-relapser
2013 Cured (Harvoni + ribavirin clinical trial)
https://www.hepmag.com/blogger/lucindakporter

Offline Bree

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  • "Today is a good day for a great day!"
Re: one more thing to obsess about... yay!!!
« Reply #4 on: September 10, 2015, 07:46:44 pm »
My doc already has lab request in for EOT - he said go in anytime from 1 to 7 days (within one week) EOT for labs. So, it sounds like 1 day to 1 week is standard.

Drummerman - we started same day - I'm hoping we are double winners!!!  (And, everyone too, of course!)  You're doing great, keep the faith!

Dx 1997 Geno 1a
2002-2003 PEG Intron/riba (48 wks) respond/relapsed
Pre-Harvoni - Viral Load: 13.5 M - Log 7.1
Fibrosure Score F1-2  Pre-Treatment:  AST 73 / ALT 88

7/6/15 Started Harvoni (12 weeks)
10/5/15 HCV NOT DETECTED (One week post EOT)
11/9/15 NOT DETECTED!!! (6 wk post)
12/21/15 NOT DETECTED (12 wk post) 
3/14/16  NOT DETECTED (24 week post)AST 26 ALT 18
SVR ACHIEVED!!! 
CURED YES!!!

Offline gnatcatcher

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Re: one more thing to obsess about... yay!!!
« Reply #5 on: September 10, 2015, 08:05:04 pm »
. . . what matters is the results from the post-treatment labs.
-which is why my hepatologist and his colleagues don't even do EOT labs, just 4 weeks into treatment and 12 weeks after EOT. It so happens that my PCP ordered a slew of labs for my regular six-month follow-up, so I'll be taking those near the end of the tenth week of treatment, but otherwise I'd be in the dark for a total of 20 weeks.
9/29/71 transfusions
HCV genotype 1a
7/09/15-9/30/15 Harvoni

Before treatment:
Viral Load 9,490,582
FibroScan 19.5 kPa [F4]
ALT 262
AST 217
ALP 183

Most recent:
VL still UNDETECTED (SVR 102)
FibroScan 7.6 kPa [F1-2]
ALT 15
AST 20
ALP 85

Offline drummerman

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  • For those regarded as warriors....
Re: one more thing to obsess about... yay!!!
« Reply #6 on: September 10, 2015, 09:42:24 pm »
My EOT is a week after the cessation of my treatment. I was nervous too, but as I've already done 24 weeks there was never an option to extend, and I bargained with the anxiety by saying it would give me a bit of a heads up as to how treatment had gone to be done after a week with no meds in my system.
Thanks Philadelphia,
that makes me feel better to know that others are tested a week after EOT.  I thought everyone was treated AT EOT.

thank you!
dm
Diagnosed07
Interferon/riba 2008 - non-responder
5/16/15 - AST -34
ALT - 35_ HCV RNA - 10,783,000
 7/6/15 - started viekira/riba
8/11/15  Week 5 <15 vl,  AST 18, ALT 18
9/11/15 Week 9  "HCV NOT DETECTED"!
AST 16, ALT 11.  10/16/16 - 2 weeks post EOT = "HCV NOT DETECTED!   AST - 18,  ALT 14
12/29/15 -12 wk EOT-HCV NOT DETECTED! AST 23, ALT 15
3/26/16 - 24 wk post EOT - HCV NOT DETECTED!! AST 19, ALT 21
1 yr eot - AST 20, ALT 17

Offline drummerman

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  • Posts: 538
  • For those regarded as warriors....
Re: one more thing to obsess about... yay!!!
« Reply #7 on: September 10, 2015, 09:46:08 pm »
I was rushing out of the house when I wrote that - what I meant was that even if there was detectable virus at EOT, there is no reason to extend. Treatment length is determined at the start - it isn't dependent on the viral load. There are people who have had detectable virus at EOT and have still gone on and had an SVR - what matters is the results from the post-treatment labs.

Thanks Lucinda,

Now that I read this... I remember reading it before...my brain is not working at all.  I blame it on Riba totally...
I even sit and think... did I just take those pills (riba)?? and can't remember.

Not so with the vikera cause its in that fancy punch pak and you can tell if you took those.

Gotta keep it together for 2.5 weeks!

Anxious, excited, forgetful.

thanks again, you have brought me calm!

dm
Diagnosed07
Interferon/riba 2008 - non-responder
5/16/15 - AST -34
ALT - 35_ HCV RNA - 10,783,000
 7/6/15 - started viekira/riba
8/11/15  Week 5 <15 vl,  AST 18, ALT 18
9/11/15 Week 9  "HCV NOT DETECTED"!
AST 16, ALT 11.  10/16/16 - 2 weeks post EOT = "HCV NOT DETECTED!   AST - 18,  ALT 14
12/29/15 -12 wk EOT-HCV NOT DETECTED! AST 23, ALT 15
3/26/16 - 24 wk post EOT - HCV NOT DETECTED!! AST 19, ALT 21
1 yr eot - AST 20, ALT 17

Offline drummerman

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  • Posts: 538
  • For those regarded as warriors....
Re: one more thing to obsess about... yay!!!
« Reply #8 on: September 10, 2015, 09:49:58 pm »
My doc already has lab request in for EOT - he said go in anytime from 1 to 7 days (within one week) EOT for labs. So, it sounds like 1 day to 1 week is standard.

Drummerman - we started same day - I'm hoping we are double winners!!!  (And, everyone too, of course!)  You're doing great, keep the faith!

Thanks Bree... and we end on the same day!!!!
this makes me feel better.  Nice to know there is a window for testing after EOT and, I guess, if there is no option to extend tx (Thanks Lucinda)  then they could test, 2, 3, 4 , whatever weeks after EOT

Now I can find something else to obsess over... although at this point it is still... can my quantitative test give a UND reading?  Or do I need qualitative test?  Will definitely bring this up with doc at next appt.

dm
« Last Edit: September 10, 2015, 09:53:12 pm by drummerman »
Diagnosed07
Interferon/riba 2008 - non-responder
5/16/15 - AST -34
ALT - 35_ HCV RNA - 10,783,000
 7/6/15 - started viekira/riba
8/11/15  Week 5 <15 vl,  AST 18, ALT 18
9/11/15 Week 9  "HCV NOT DETECTED"!
AST 16, ALT 11.  10/16/16 - 2 weeks post EOT = "HCV NOT DETECTED!   AST - 18,  ALT 14
12/29/15 -12 wk EOT-HCV NOT DETECTED! AST 23, ALT 15
3/26/16 - 24 wk post EOT - HCV NOT DETECTED!! AST 19, ALT 21
1 yr eot - AST 20, ALT 17

Offline lporterrn

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  • Posts: 1,969
  • LucindaPorterRN
    • LucindaPorterRN
Re: one more thing to obsess about... yay!!!
« Reply #9 on: September 10, 2015, 10:43:00 pm »
I totally relate - ribavirin and obsession go together like thunder and lightening. One of the Hep bloggers wrote about this recently, and you can see my reply (along with others) at http://blogs.hepmag.com/davidpieper/2015/09/9_september_2015_a_m.html

The qual test is more sensitive, but at this point, it really won't matter. Either you are detectable or you aren't, and at EOT it won't mean much unless it was wildly high. In that case, obviously the virus is returning.
Lucinda Porter, RN
1988 Contracted HCV
1997 Interferon nonresponder
2003 PEG + ribavirin responder-relapser
2013 Cured (Harvoni + ribavirin clinical trial)
https://www.hepmag.com/blogger/lucindakporter

 


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