4 Week Harvoni Lab Results

[steven_myers]

Should I be encouraged by these lab results taken 4 weeks after starting Harvoni? The left column is pre-treatment numbers and the right is 4 weeks after starting.
AST-31
ALT-20

[Mw2324]

I'm no doctor but yes you should. This is a dramatic drop in numbers and shows your body is responding to treatment. Not everyone is undetected at 4 weeks but don't be discouraged!

[steven_myers]

I'm no doctor but yes you should. This is a dramatic drop in numbers and shows your body is responding to treatment. Not everyone is undetected at 4 weeks but don't be discouraged!

Thanks for the encouragement. I've just heard so many people being undetected at 4 weeks so I was a little disappointed. I have an appointment on December 2nd to discuss results with my doctor.

[dragonslayer]

Steven, that's great progress..    But as has been said, not only does not everybody achieve undetected at 4 wks; not everybody achieves it by EOT even, and still they go on to  achieve it at 12 wks post treatment; thats why 12 wks post is the only test that matters.    A lot of folks would be better off just waiting for that since detected results prior to that would knock anybody off their stride, yet in most cases, its totally meaningless.  I was even detected at 8 wks post!   Just focus on the 12 wks post marker!   

Check out my signature to see my rocky road toward SVR

[Mw2324]

Steven,
    I am on my 11th week of epclusa and spent much time reading the forums. There are many people who are not undetected at 4 weeks. The 4 week test is done to determine adherence to the medication, not to encourage or discourage. That's why it is relatively meaningless. If you have a higher beginning viral load, it may take a little extra time. Of course,  undetected is great to see but your progress is awesome. Congratulations to you.

[elias]

I've been seeing a number of people on Forum having low levels at week four.

I read here that a drop of two logs is considered to mean its working. and youve dropped 5 logs!!!

If it were me, I'd ask for a 6 week test for reassurance. It's suggested option here:

http://www.hepatitisc.uw.edu/go/treatment-infection/monitoring/core-concept/all

The role of week 4 HCV RNA testing with the use of DAA-based therapy is not completely clear at this time and recommendations will likely evolve as more data become available. The phase 3 trials of direct-acting antivirals demonstrated that nearly all non-cirrhotic patients achieved a week 4 viral level of undetectable or less than the LLOQ; cirrhotic patients may be more likely to have detectable HCV RNA at week 4. For patients who have low-level detectable HCV RNA at treatment week 4, the AASLD/IDSA guidance recommends performing a repeat quantitative HCV RNA level 2 weeks later (at treatment week 6) and if the HCV RNA has increased by more than 10-fold (1 log10 IU/mL) then HCV therapy should be stopped. Nevertheless, the significance of on-treatment persistent low-level viremia (that does not increase) is not known and there is no clear indication this represents lack of adherence or likelihood of virologic relapse

From what I've seen on this forum so far is that this happens if patient has high viral load  to begin with. As you did at baseline. Or has compensated cirrhosis.

I'm anxious myself about this, since I'll be taking the 4-week test soon. But I'm told here that it has little significance beyond assessing compliance

[steven_myers]

Thanks Elias. Based on what my doctor says on December 2nd, I will probably ask for 8 week labs.

Its also possible that the other prescription medicine I take for seizures(keppra) might be affecting my liver. But I'm going to continue on with the mindset that I'm cured.

[Lynn K]

 I really wouldn't bother with any additional on treatment testing as Paul said he was still detected many weeks posttreatment if you're still positive on treatment all that would do is tend to discourage you really all on treatment testing is meaningless  The one and only test that matters is the 12 week posttreatment test

[steven_myers]

My week 6 lab work came back undetected I will be tested again at the end of treatment, then again 3 months post.

[andrew j]

Excellent news, Steven!

Now you've got this thing by the throat!

Hoping that the rest of treatment is smooth and uneventful for you.

Best wishes,
A.

P.S. How many weeks of Tx have you been prescribed?

[steven_myers]

Excellent news, Steven!

Now you've got this thing by the throat!

Hoping that the rest of treatment is smooth and uneventful for you.

Best wishes,
A.

P.S. How many weeks of Tx have you been prescribed?

Thanks Andrew! I was prescribed 12 weeks of treatment. My doctor said it was necessary with my viral load.

Also, what connection, if any, does our diet play with Harvoni?

[andrew j]

There are people here that know a lot more than I do about dietary matters (e.g. Luna, Kim, and Lucinda).

I have been running a pretty eccentric diet for a long time, mainly because I was symptomatic when I had Hep C, and just couldn't have coped otherwise.
My diet was gluten-free - and majored on E.V. olive oil, which I just about lived on.

Some people here in New Zealand advocated something similar to the Paleo diet for Hep C.
The theory was - is, that animal fat ( and esp. ruminant fat = lamb, beef, goat etc.), and organ meats, fish etc. - are protective of the liver.

Some here would disagree with that, I think.
Many here advocate vegetarian, or semi-veg.

I don't eat much meat.
... Mostly oily fish (tinned salmon and sardines (which are cheap)), veges, and oil.
Salads are good, too.
... Beetroot ... Avocados ...

Now that you are recovering?
I don't know.
Healthy is best, I reckon.
The general principle is: a 'heart-healthy' diet will also be good for the liver.

There are some good resources here (and elsewhere).
Look on the homepage - or Google it.

Above all - be kind to yourself, and gentle with that liver!
No alcohol (needless to say)!

[elias]

Some people here in New Zealand advocated something similar to a Paleo diet for Hep C.
The theory was - is, that animal fat ( and esp. ruminant fat = lamb, beef, goat etc.), and organ meats, fish etc. - are protective of the liver.

Hi Andrew:

Would you know what that theory is based upon?

I'm not sure a "heart healthy" diet would recommend increasing animal fat. Though fish is generally considered a preferable source of fat and protein

[Lynn K]

Thanks Andrew! I was prescribed 12 weeks of treatment. My doctor said it was necessary with my viral load.

Also, what connection, if any, does our diet play with Harvoni?

Hi Steven and welcome

As far your question about diet and Harvoni are you asking if there are any food restrictions while taking Harvoni or are you asking about best diet to help your liver heal?

As far as diet and Harvoni I am not aware of any dietary restrictions as far as any foods contraindicated while taking Harvoni. As far as liver health as others have said a healthy diet and lifestyle is beneficial to your overall good health as well to your liver.

[andrew j]

Thanks Lynn (yet again!) ...

Elias,

All I really wanted say is that there are different points of view - different perspectives, on what constitutes a healthy diet - and to try to differentiate between what might be appropriate during active Hep C infection - and later, during Tx and early recovery.
i.e. The point about the high fat diet (ONLY CERTAIN TYPES OF FAT - and which MIGHT be appropriate DURING ACTIVE HEP C INFECTION), is DIFFERENT to the point about a 'heart-healthy' diet.

A high fat diet to protect the liver: What?!
I know - it's counter-intuitive, isn't it?!

If you are interested: the theory is put forward most notably by George Henderson (who is a friend of mine, actually).
George's blogspot is 'Hopeful Geranium'.
Amazingly, there is good science to support it!

Be that as it may, I could never cope with much meat / fat when I had Hep C, as I said above.
I lived on low protein, but - and perhaps in reln. to the above - a LOT of olive oil.
In fact, that's pretty much what I lived on for years.
... And look at my liver?!
(You can't! - I haven't had a fibroscan since 2013!).

My diet is changing now - but I am [still] v. health-conscious - incl. diet and exercise.

[hguy]

Congrats on the numbers. I just got my 4 week labs and my viral load has gone from 1.4 million to 36. I have genome type 1 a. I am on Harvoni. This is my second attempt at treatment. Just to add something to the discussion on diet and Harvoni, the only thing my Dr. told me was to try and avoid dairy and calcium at least 4 hours before or after taking meds as Harvoni is a little more effective in a more acidic stomach.

[steven_myers]

Thanks for the feedback guys. The only reason I ask is because I often fall victim to my sweet tooth. I try to balance things out with an overall healthy diet and exercise. On average I walk at least 6 miles every shift at work and try to stick with gluten free deserts. I should also add that I'm not overweight and have minimal body fat (6'4", 175lbs).

With all that being said, is it ok to allow myself some treats from time to time while on treatment?

[Lynn K]

No food is contraindicated on Harvoni. You may not want to take Harvoni close to drinking milk.

As far a diet nothing special is needed regarding being on treatment. The only thing you need to consider is your health needs and goals.

[andrew j]

You seem to be a bit concerned about your sugar intake, Steven?

[Without getting into current thinking about low carb diets] - most health profs these days advocate reducing sugar intake - and many people should be drastically reducing their intake.

[However] As Lynn says - there is no special warning attached to sugar consumption while taking Harvoni.

I don't really have a problem with sugar, because I've trained myself to minimise consumption - but I do have a problem with salt ... a big problem, I sometimes wonder?
Most people I've asked about it seem unconcerned, but I think I should take the advise I was going to give you, and talk to my Dr some more about it.

It's hard to get the balance right, isn't it?

[hguy]

http://care.diabetesjournals.org/content/29/5/1140

[hguy]

http://care.diabetesjournals.org/content/29/5/1140                     http://www.healthline.com/health-slideshow/hepatitis-c-and-diabetes#4             Hi all Im pretty new here so I hope its ok to hyperlink. As a type 2 diabetic and chronic hep c patient     I was very curios about the link between the two. I am convinced my diabetes was brought on by the damage to my liver. I found the above articles quite interesting and thoughr I would share them.   

[andrew j]

Thanks for posting, Hguy.

I was wondering about including something about the reln. between Hep C and insulin resistance, but I don't really know enough about it.

Hoping you are managing the diabetes OK?

It's fine to include links.
Lots of people do it, and it's invariably helpful.

Best wishes,
A.