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Author Topic: 12 weeks Harvoni-Still detected at 8 weeks  (Read 13092 times)

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Offline Karen3717

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  • Posts: 28
12 weeks Harvoni-Still detected at 8 weeks
« on: May 08, 2015, 09:46:09 pm »
Got my 8 week HCV PCR results today...<15 detected. I' m a little bummed about it although not panicking at this point.  I have read others posts about this as well as being detected at EOT but still achieving SVR12.   I'm just wondering if adding Ribavirin at this stage of tx would have any value at all?  Thoughts?
Transfusion 1982; Multiple accidental needlesticks; healthcare worker
(+) HCV antibody 1991
Genotype 1a
2001-Pegintron/Ribavirin 48 wks. Relapse 2mo post tx
2015-VL 316,000
Fibrosure-F2
Started Harvoni 3/13/15
2 weeks:  HCV PCR <15-DETECTED
4 weeks: HCV PCR <15-DETECTED
8 weeks: HCV PCR <15-DETECTED
12 weeks:  HCV PCR: NOT DETECTED!
4 Weeks EOT: HCV PCR:  NOT DETECTED!
12 Week post TX:  HCV PCR NOT DETECTED!

Offline Espo2

  • Member
  • Posts: 30
  • Needle stick at work 1987, 1b
Re: 12 weeks Harvoni-Still detected at 8 weeks
« Reply #1 on: May 08, 2015, 11:23:03 pm »
Virus dying, don't give up hope. Doc will advise. Hang in there Karen! God bless

Offline DisabledHepcat

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  • Posts: 44
Re: 12 weeks Harvoni-Still detected at 8 weeks
« Reply #2 on: May 09, 2015, 05:06:05 am »
You said your test reads <15 Detected.
meaning LESS THAN 15 DETECTED

The test cannot read below 15 so consider yourself UNDETECTED above 15

The test is saying that we cannot find anything above 15
It's confusing but think of it this way.
If the test cannot read below 15 how can it say it detected something less than 15.
The wording is confusing - you are probably cured - just do the next 4 weeks to murder any virus that might be hiding.
Here's another way to look at it, if it read less than 15 Undetected it wouldn't even make sense since it cannot read below 15.
« Last Edit: May 09, 2015, 05:12:13 am by DisabledHepcat »

Offline dragonslayer

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  • Posts: 873
Re: 12 weeks Harvoni-Still detected at 8 weeks
« Reply #3 on: May 09, 2015, 08:28:28 am »
Not true, Disabled....  < 15 detected is different than < 15 undetected.   The number 15, in this case, is the test's Lower Level Of Quantification (LLOQ).   This means that below 15 IU/mL, the exact quantity is beneath the tests ability to quantify, however its presence can still be detected.

There is also a Lower Level Of Detection (LLOD) value with each test.. What is even more confusing is that often times, the LLOD and the LLOQ for the test is the same.. And even so, the test results can come in < 15 Detected!  In these cases, you have to ask, if the LLOQ and the LLOD are the same value, and the result is < LLOQ, then by definition, it should also be beneath the LLOD.. So how can it be reported as Detected?!!!

Being < LLOQ detected usually leads to an Undetected result, but technically, its not the same.

Read more about it here:

http://forums.hepmag.com/index.php?topic=2413.msg17174#msg17174

Seems like a paradox. 
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline Karen3717

  • Member
  • Posts: 28
Re: 12 weeks Harvoni-Still detected at 8 weeks
« Reply #4 on: May 09, 2015, 11:12:39 am »
Dragonslayer & Disabled,
Thanks for replies & posting the links regarding the nuances of these tests.  I apparently missed these articles earlier.  DS, my doc too seems to imply that <15 detected is the same as undetected.  He is a renowned doc in his field, professor at UTSW medical school in Dallas, etc etc. So, Im gonna trust him & stop worrying about this (maybe! Lol!).  If I understand the article correctly, bottom line is Abotts RT PCR assay is simply a more "sensitive" test?  I probably couldn't get RIBA anyway with the Harvoni because I don't have cirrhosis.   Another ?, Would it be worthwhile to get the Fibroscan test and does anyone have knowledge about costs, insurance coverage of it?  A big thank you to everyone for sharing such valuable information & support.
Karen
Transfusion 1982; Multiple accidental needlesticks; healthcare worker
(+) HCV antibody 1991
Genotype 1a
2001-Pegintron/Ribavirin 48 wks. Relapse 2mo post tx
2015-VL 316,000
Fibrosure-F2
Started Harvoni 3/13/15
2 weeks:  HCV PCR <15-DETECTED
4 weeks: HCV PCR <15-DETECTED
8 weeks: HCV PCR <15-DETECTED
12 weeks:  HCV PCR: NOT DETECTED!
4 Weeks EOT: HCV PCR:  NOT DETECTED!
12 Week post TX:  HCV PCR NOT DETECTED!

Offline DisabledHepcat

  • Member
  • Posts: 44
Re: 12 weeks Harvoni-Still detected at 8 weeks
« Reply #5 on: May 09, 2015, 01:03:39 pm »
  DS, my doc too seems to imply that <15 detected is the same as undetected.  He is a renowned doc in his field, professor at UTSW medical school in Dallas, etc etc.

congrats

Offline DisabledHepcat

  • Member
  • Posts: 44
Re: 12 weeks Harvoni-Still detected at 8 weeks
« Reply #6 on: May 09, 2015, 01:16:49 pm »
Don't worry about a fibroscan etc. You have cleared the virus - take the next 4 weeks of Harvoni since you have it (What's another $33,000) lol and than get retested in 12 weeks afterwards. You can get tested sooner than 12 weeks, like 5 or 6 weeks afterwards. If you relapse it will show that you are back up to your original 316,000.
Afterwards when the virus has cleared as long as you don't give your liver any toxins such as alcohol etc. The liver can rebuild itself in 2-3 months. According to your past you were cleared after 2 weeks which means you are already regenerating since that first less than 15 result.

BTW you received 12 weeks for less than 6 million IU like me, I was only 1.2 million and got 12 weeks. Our therapies were overkill's especially yours being 316,000 - no wonder you cleared it in 2 weeks. Mine went down to 190 after 8 pills from 1.2 million -Harvoni is truly amazing !!! Both of us should only have gotten 8 weeks of Harvoni approved.
« Last Edit: May 09, 2015, 01:25:18 pm by DisabledHepcat »

Offline Kate101

  • Member
  • Posts: 18
Re: 12 weeks Harvoni-Still detected at 8 weeks
« Reply #7 on: May 09, 2015, 04:07:55 pm »
Dear HepCat,

Why do you say, or where does it say your liver will heal in 2-3 months after treatment? I am not questioning you but I would like to read the info. I have 7 weeks to go and have been fantasying about some well deserved vino. Of course if it is proven to be accurate I will abstain. I figured once the virus is gone the ability to heal will be ongoing given you do not attack it.

Kate101

Offline DisabledHepcat

  • Member
  • Posts: 44
Re: 12 weeks Harvoni-Still detected at 8 weeks
« Reply #8 on: May 09, 2015, 05:52:35 pm »
Dear HepCat,

Why do you say, or where does it say your liver will heal in 2-3 months after treatment? I am not questioning you but I would like to read the info. I have 7 weeks to go and have been fantasying about some well deserved vino. Of course if it is proven to be accurate I will abstain. I figured once the virus is gone the ability to heal will be ongoing given you do not attack it.

Kate101

I may have researched myself into confusion, Cirrhosis cannot be reversed but Fibrosis can be reversed over time (how much time I don't know) according to this: http://www.liverfoundation.org/abouttheliver/info/progression/
Where I confused the 2 is a NORMAL liver can regenerate in 2-3 months whereas scar tissue is not normal.
My Bad !

Can liver damage be reversed?
The liver is a unique organ. It is the only organ in the body that is able to regenerate. With most organs, such as the heart, the damaged tissue is replaced with scar, like on the skin. The liver, however, is able to replace damaged tissue with new cells. If up to 50 - 60 percent of the liver cells may be killed within 3 - 4 days in an extreme case like a Tylenol overdose, the liver will repair completely after 30 days if no complications arise.
Complications of liver disease occur when regeneration is either incomplete or prevented by progressive development of scar tissue within the liver. This occurs when the damaging agent such as a virus, a drug, alcohol, etc., continues to attack the liver and prevents complete regeneration. Once scar tissue has developed it is very difficult to reverse that process. Severe scarring of the liver is the condition known as cirrhosis. The development of cirrhosis indicates late stage liver disease and is usually followed by the onset of complications.
from: http://www.uihealthcare.org/liver-disease-frequently-asked-questions/

P.S. A little Vino won't cause anymore damage as long as you don't drink over 5 drinks at one time or drink everyday not giving the small amount of damage to heal.
« Last Edit: May 09, 2015, 06:11:57 pm by DisabledHepcat »

Offline Kate101

  • Member
  • Posts: 18
Re: 12 weeks Harvoni-Still detected at 8 weeks
« Reply #9 on: May 09, 2015, 08:48:57 pm »
Thanks HepCat,

My stage was F2 and I am going to ask my Dr. to order another scan at the end of treatment.If the scaring is lower I will then celebrate for sure. if not I will wait the 3-4 months and recheck. I think I will feel safer knowing it is headed in the right direction.
I have packed on 10lbs in recent months as I quit my vino and sweet/carb cravings are through the roof. I think it is healthier to have s few drinks rather than ruin my #'s by getting fat. They are the highest they have ever been but so is my weight. Menapause at its finest!

Kate101

Offline dragonslayer

  • Member
  • Posts: 873
Re: 12 weeks Harvoni-Still detected at 8 weeks
« Reply #10 on: May 09, 2015, 10:25:58 pm »
Kate, if youre doing to do fibroscan, remember, in the mid ranges, ie F2-F3 generally, accuracy is not its strong suit.  Noticing a small drop or increase in the mid ranges should not be taken as gospel.
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline motor

  • Member
  • Posts: 58
Re: 12 weeks Harvoni-Still detected at 8 weeks
« Reply #11 on: May 10, 2015, 12:03:52 am »
I just asked my doc 4/29 at my EOT appt about FibroScan and he said he liked to wait a year for this, as the liver takes 1-3yrs to recover.  I don't know if that was a generalization or aimed at me with my age and liver state.
Age 66male GT 1a/CT  Dx 5/19/14
Likely infected early 70's
VL 3.7mil FibroScan F2 FSure F2
ALT 84(12-78) AST 56(3-36) High
Tx naive
8wks Harvoni start 3/3/15 VA
4wks ALT 25(12-78) AST 22(3-36) Normal 
        VL  <15  NOT DETECTED
8wks ALT 24 AST 19 
EOT  VL   <15  NOT DETECTED
SVR12 VL <15  NOT DETECTED

 


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