Viral Load tests necessary during treatment?

[DeathtoHep]

Hello, Ive been taking viekira pak for 4 weeks now. I had some bloodwork done last week and was excited to hear the results today when I saw my doctor. When I asked about my viral load he said its not necessary to test for it yet. After being on this forum I assumed it to be a customary practice. After arguing several points he wouldnt budge and told me not to worry. Which I am not. But it still would be nice to know where Im at. If im undetected I would like to know.

So, is the viral load test just for peace of mind or does it even matter what my load is at this point? My ALT/AST levels are down and everything is in normal range but my platelets. When I asked the nurse from Proceed, she said it was very important that I get VL checked. So now im confused and wondering if I should get a second opinion. On the other hand, I have a very confident and bright doctor who I should probably just listen to.

[KimInTheForest]

Hi DeathtoHep. I think the only viral load test that matters or is even necessary is the one that comes 12 weeks after end of treatment. And if no virus is detected at that time, you are officially cured. I think the earlier VL tests are often done for peace of mind. For those of us on clinical trials, the drug company wants to track progress more closely, as part of its research for future customizing of treatments. So we get a lot of VL tests. But the drug company (in theory) is footing the bill for those. VL tests are not cheap, and so having unnecessary ones does drive health care costs. However, we are all so eager to know if "it's working" that I understand where you are coming from.

As for the nurse's statement that it is important to get VL checked, that was certainly true in old days with Interferon where treatment was response-based - i.e., if you are responding you stick with it, if not, no need to brutalize your body with a long course of INF. But new all-oral treatments don't seem to work that way. Basically the cure rate is so high with the new drugs that almost everyone will be cured, so VL tests throughout treatment become less relevant. There have even been some terrible stories here of people's insurance companies terminating their Harvoni mid-treatment if a VL test showed them as still detected at Week 4, even though that person had every likelihood of being cured if they had been allowed to finish treatment. So sometimes doctors elect to not give VL tests during tx for that reason - so as to not give insurance company an excuse to halt tx.

best of luck to you!
kim

[DeathtoHep]

Thanks for your response. Like I said I have a good doctor and will do whatever he says over everything else. But its nice to be "in the loop". Thats horrible that an insurance company would interfere with someone treatment like that. I really hope we see some changes in the future. Luckily, all my medication was shipped before treatment. Nothing like $90k worth of meds in my closet lol. Im still wondering if I shouldve sold it off