End of Treatment Blood Draw Question

[BG42]

Hi Everyone,

I finished my 8 week treatment of Harvoni on 4/25/15. Pre-treatment my VL was 4.6 million.

My 4 week labs showed that my VL was <12. At the time, my doc sent me a letter saying it was "non-detectable". I was a bit confused then, but figured I had  4 weeks to go.

I received another letter a week after treatment (this passed Tuesday), in very colloquial language saying "The Hepatitis C virus is gone!".

However, I checked my labs through Labcorp, and it still shows <12, but then under that, "HCV RNA Detected".

I called the doc's office and the MA on the phone couldn't give me an explanation and is waiting for the doctor to get back to me.

My question is, if the HCV RNA is "Detected", then I am technically not cured right? I am so scared and don't want to settle for "Close enough" or "Good enough".

Is it even possible to have SVR if the RNA is present?

Thank you!

[dragonslayer]

Thats a really good question.  Generally, the first prize  in vl testing is Undetected... Gilead in their trials, however, used any value beneath their test's lower level of quantification which, in their test, was 25 to deem SVR.   Now, I havent found any information to explain whether this result was an Undetected <= 25 or Detected <= 25.. All Ive read and was told by them was that a value of < 25 was used. 

On-treatment blood tests are not useful for predicting SVR.. However post treatment tests are. My calculations are that now, you are about 2 wks post treatment.. Generally, 4 wks post treatment is  used as a first measure for SVR with about a 98.5% certainty as to eventual svr... 12 wks post treatment and that score rises to about 99.8% predictive.  So, quite honestly, in your case, its too early to tell.  However, keep in mind that some folks here tested Detected with a low level score at end of treatment, and went on to achieve SVR at the 12 wk mark.. So have faith.

[lporterrn]

The answer to your question, "Is it even possible to have SVR if the RNA is present?" is yes. However, only time will tell. The only way you will know the answer is to wait until post-treatment week 12. One possible indicator of the durability of your post-treatment week 4 results is if your ALT has increased a great deal - this would make me less optimistic. But as for the rest, yes, you could still have an SVR, even with those results - I've seen it a few times, and they all ended in an SVR. Please keep in touch with the final outcome. In the meantime, be sure not to drink and give your liver every chance of finishing this job. Also, try not to let every ache and pain scare you that hep C is coming back. I know someone in exactly your shoes, and she was 100% sure her hep C had returned when she felt fatigued, and thankfully, she was wrong.