Bob your doctor is wrong.I was under 43 but detectable for my 4 week VL. Meaning I could be 5 or 35 they could not pin point.Never less if you are under 43 you are still detectable and should be doing 48.I became undie at week 8

Thanks guys.

Here's what I found on the Incivek website. (You may have to click on the box that says your a doctor to see it)

http://www.incivek.com/hcp/treatment-duration-treatment-history


Patients with detectable HCV RNA (1000 IU/mL) at Weeks 4 or 12 will continue pegIFN-RBV to 48 week.

So that confirms what everyone is saying. But when I asked my doc, he said that the most important issue was the fact that I had a strong response at week four.

Sounds like I need to call him back to confirm.

Bob

Straight from the Incivek guide:

5.5 Laboratory Tests
HCV RNA levels should be monitored at weeks 4 and 12 and as clinically indicated. Use of a sensitive real-time RT-PCR assay for monitoring HCV RNA levels during treatment is recommended. The assay should have a lower limit of HCV RNA quantification equal to or less than 25 IU per mL and a limit of HCV RNA detection of approximately 10-15 IU per mL. For the purpose of assessing response-guided therapy eligibility, an undetectable HCV RNA (Target Not Detected) result is required; a confirmed detectable but below limit of quantification HCV RNA result should not be considered equivalent to an undetectable HCV RNA result (reported as "Target Not Detected" or "HCV RNA Not Detected").

oSo Get a second opinion! Don' waste what you already did !
Praying for you!
bill

Another article in the New England Journal of Medicine that says 24 weeks is for patients who are undetected at 4 AND 12 weeks.

http://www.nejm.org/doi/full/10.1056/NEJMoa1014463

Conclusions

In this study, among patients with chronic HCV infection who had not received treatment previously, a regimen of peginterferonribavirin for 24 weeks, with telaprevir for the first 12 weeks, was noninferior to the same regimen for 48 weeks in patients with undetectable HCV RNA at weeks 4 and 12, with an extended rapid virologic response achieved in nearly two thirds of patients. (Funded by Vertex Pharmaceuticals and Tibotec; ILLUMINATE ClinicalTrials.gov number,

This sucks. I've been trying to find a study that shows the difference of success rates ( 24 vs 48 weeks of tx) for those who are undetected at 12 weeks, but not at 4. So far no luck.

The emotional side of my brain is saying "screw it, just quit now and take your chances. Newer drugs will be out soon if the damn virus comes back."

Which of course would mean that all I've gone through so far would be for naught.

Someone please talk me off the ledge!

Bob

I still think your doctor is wrong.I went from 5.5 million to under 43 but detectable at exactly 4 weeks.Now if I took the VL test say 3 days later its possible I went undie.But still had to do 48

Mr O, I'm talking you off the ledge. I'm doing this to. If they said
I have to do 48 I'll do 48. We'll do it together. There are people
on here who have done it and doing it. Please don't give up now.
Send my a pm. And we'll exchange numbers and talk. I know this
sucks bad. But were knee deep in it. Your a little deeper. Lets take
it to the end!!!! And be done with it!!!

Oz

To infinity and beyond!!

Well a conversation needs to be had. Seriously I never knew how long I was going until 8.5 weeks in. Had I known I had to go 24 weeks beyond my first undie I would've requested weekly labs. I never got a 6-week but I might have been undie then resulting in 2 less weeks. When you're on that brutal poison, and it truly is toxic poison, one week less or more makes ALL THE EFFING DIFFERENCE IN THE WORKS BELIEVE YOU ME!! Those that have done an interferon regimen will agree I have no effing doubt!!

Edit - WORLD. ALL THE EFFING DIFFERENCE IN THE WORLD BELIEVE YOU ME!!!!

Theres a lot of people and maybe some doctors think less than 43 is undectable BUT IT IS NOT!!!!!

My vl was under 25 @ 4wks, and undie @ 24. My dr told me she thought I would be doing 24 wks, but when she decided to look @ my biopsy report... (from the gastro 2 1/2 yrs earlier) she said I would have to do 48 wks because of liver damage (stage 3-4 cirrosis).

Yah!! Everyone knows it's bad stuff!! You don't have to keep
reminding us over, and over and over. What else are we suppose
to do? Your doing more harm than good AGAIN!!!

Your doctor is NOT wrong!

I was DBLOQ at Week 4 (VL between 7-25); UND at Week 8; UND at Week 12; and UND at Week 24. That was it! I was still UND at 3 and 6 months post-treatment.

I think that the original protocols were rigid for good reason, but as doctors gained more experience with the treatment, they found that there is room for a judgement call. A few unlucky folks have been UND at Week 4, only to see HCV come back by Week 8; and a few folks like myself were DBLOQ at Week 4, UND thereafter, and UND at the six month post-treatment SVR point.

Strictly following the numbers is no guarantee, because technically a VL of 6 - which is below the limit of most tests - makes you UND even though you still have the virus. So would a VL of 7 make such a huge difference that you have to do 48 weeks? No one is willing to be that absolute.

I think that doctors look at your general health; your ability to stick with a challenging treatment; and the general trend of your VL when making the 24 vs. 48 week call. I went from 12 million at diagnosis; to 5 million at start of treatment three years later; to less than 25 at Week 4. No, it wasn't "UND" at Week 4, but he was comfortable enough with that trend to do a 24 week treatment, and it worked out just fine.

Bivalve, that does make sense. If you're VL is 7 at week 4, it doesn't seem logical that it would require twice the treatment length of someone who has a VL of 5. The later would come back as undetected by today's tests.

That was the reasoning my doctor gave me. I've yet to find a study that supports that though.

Bob