6 weeks in on viekiera w riba.. Still have viral load?

[Luxe91]

My viral count at start of treatment was 3.5 million.. 6 weeks in and I am down to 17. When I was read the test results, the nurse was pretty.. Negative.. Seems to be of the opinion its a good possibility I won't be cured. My alt enzyme in April was 220 and it is now 11. I am trying really hard to stay positive but I am really freaked out the treatment is going to fail. It was not easy to get access to the meds and this is probably my only chance to get cured. Has anyone still had a detectable virus in their blood almost halfway through treatment and still beat it? Thankyou in advance for reading.. I'm trying not to freak out its just scary.

[dragonslayer]

Lux,  I was detected 29 at EOT, and still detected at 8 wks post treatment. But at 12 wks post treatment, the only date that really matters, I was undetected and have stayed that way for over a year..  I wouldnt worry about your low level detected while on treatment. It really doesnt matter. .Wait for the 12 wks post test and you most likely will have cleared.

[Philadelphia]

Lux, I did VP+ riba. At 4 weeks I was still showing a vl of 40. At my next test 4 weeks later it was undetected. The 12 week post treatment test is the one that matters, all the others are just markers along the road.

[HazelAustralia]

Hi Luxe 91,

Your VL has decreased so much! Maybe the nurse is new or was in a bad mood. I had the same treatment and still had a viral load - I think it was 5 weeks into treatment as i tested late. Like the others I completely cleared the virus. Didn't I read something about it being more important to clear the virus slowly so that all of the virus bound up in scar tissue had a chance to be killed off? That may have just been a theory, but no matter what, there's absolutely nothing to worry about now. Best wishes!

[Luxe91]

You guys have no idea how relieved I am..well I'm sure you have a good one.. Idk why there was so much negativity.. I guess so many are having no VL after 4 weeks.. Everyone is different though! These medical professionals sometimes have no idea how they can really take the wind out of your sails before there is a good enough reason. Thanks for the encouragement!!

[FutureThinker]

Hi Luxe91, I, too, did NOT clear the virus on my 4 week labs, came back at 30, down from 3 million.  I know how disappointed you feel! But on my 8 wk labs, I DID clear the virus, and went on to reach SVR 12 in August.  I've read numerous times that as long as your VL goes down at least 2 logs along with decreased ALT/AST numbers, that is considered good and the drug is working! Some people just take a little longer.

Maybe you were the first patient this nurse had seen who didn't clear at 2-4 weeks.  Fact is, there are many of us out there, and we went on to be deemed "cured". Look especially at dragonslayer's post -- he was still detected at EOT but went on to be cured.  There are many scenarios w/ this treatment, so hang in there.  THE test you want/need to be undetected is at 12 weeks after your last pill.  Keep us posted! FT

[JoeB]

On another hep forum I frequent, we speculated that the copies that are left are not viable and the treatment period is so short compared to INF/Riba that the body hasn't cleared the debris away yet and still comes up detected. Later the virus 'bits' are  cleared and 'undetectable' then shows. Definitely not the time to be disappointed at this stage; you are still in with a good chance.

[elias]

This might be a source for the above comment about non-infectious virus particles

From:
http://cid.oxfordjournals.org/content/60/12/1743.full

These data indicate that viral eradication may be attained even when HCV RNA is suboptimally suppressed by DAA therapy. We offer 2 possible explanations for this novel observation. The presence of quantifiable or detectable virus at EOT in patients who achieve SVR12 may be explained by a role of the host immune system that persists after cessation of therapy. It may also be explained by the detection of noninfectious viral particles synthesized in the presence of agents that disrupt HCV replication complex formation.

I wonder if such "non-infectious viral particles" may account for some of the detections at the 4-week since beginning treatment as well?

[Lynn K]

The only test that has meaning is the 12 weeks post treatment test. On treatment testing is of little to no value.

If not detected it means nothing if weakly detected as in your case it only scares the patient and causes needless concern. In fact being weakly detected on treatment means nothing relative to the end result of your treatment.

[JoeB]

This might be a source for the above comment about non-infectious virus particles

From:
http://cid.oxfordjournals.org/content/60/12/1743.full

I wonder if such "non-infectious viral particles" may account for some of the detections at the 4-week since beginning treatment as well?

Nice one for finding evidential support for my comment,   

Yes, they could; the PCR can't discriminate between viable and non-viable. It relatively new and recent territory, the advent of DAA's, so there's still probably a lot to learn about them. I also think people will calm down when we saw more non-responders and relapsers on the DAA's; they are fallible.

[JoeB]

The only test that has meaning is the 12 weeks post treatment test. On treatment testing is of little to no value.

If not detected it means nothing if weakly detected as in your case it only scares the patient and causes needless concern. In fact being weakly detected on treatment means nothing relative to the end result of your treatment.

Yes, you are right. There a battle going on between the virus and the body during treatment and probably swings both ways at times during treatment; detectable then non-detectable then detectable again or vice-versa, depending at what stage in the battle the PCR is taken.

[Lynn K]

We here have seen on treatment either not detected, weakly detected that goes to not detected on treatment, weakly detected that stays weakly detected until EOT that at 12 weeks post goes to not detected and unfortunately a few who were not detected on treatment who relapsed at 12 weeks post.

I think that would describe mostly what I have seen folks here describe as far as their experiences with viral load testing results.

I don't recall anyone who became not detected on treatment who became detectable again while still on treatment but I could be mistaken about that   

[JoeB]

We here have seen on treatment either not detected, weakly detected that goes to not detected on treatment, weakly detected that stays weakly detected until EOT that at 12 weeks post goes to not detected and unfortunately a few who were not detected on treatment who relapsed at 12 weeks post.

I think that would describe mostly what I have seen folks here describe as far as their experiences with viral load testing results.

I don't recall anyone who became not detected on treatment who became detectable again while still on treatment but I could be mistaken about that   

Sorry, I should have said " ...an unseen battle going on between the virus and the body during treatment".

[BillT]

Hi Luxe,
           Persistent little buggers ain't they. As everyone has said you're looking great so don't worry about it.Those of us that have been here for awhile have seen it all,and we still can't figure it all out.Don't worry about anything until there's something to worry about.How long is your treatment?

[Luxe91]

Thankyou for all  the encouraging responses.. They mean the world to me. Wish me luck..just finished my 8 week treatment yesterday. Will be getting labs soon. I did miss one day on week 7 which I'm praying doesn't affect it.. I came down with the flue and couldn't even hold down a sip of water all day.. I took it as soon as I could hold anything down ..so hopefully it will be ok.

[JoeB]

Thankyou for all  the encouraging responses.. They mean the world to me. Wish me luck..just finished my 8 week treatment yesterday. Will be getting labs soon. I did miss one day on week 7 which I'm praying doesn't affect it.. I came down with the flue and couldn't even hold down a sip of water all day.. I took it as soon as I could hold anything down ..so hopefully it will be ok.

don't worry about missing that tab. The component with the shortest half-life in viekiera is 25 hours and you would have still had at least half of it in your system along with its other components which are longer I think. Riba is 40 days.

It takes 5 or 6 months for Riba levels to drop to below 5% so don't stress if you feel a bit run down still for a few months. It took 4 1/2 months me to feel normal after treatment stopped. I was on it 6 months with interferon so you might not be that long recovering but you never know...

Chill