Thank you for your thoughts on Viral Load, I appreciate that you take the time to share what you've learned about HCV over the years, it really is invaluable. (Written from the perspective of being recently diagnosed).
In my case, even though I've had HCV for over 40 years and did drink moderately (sometimes more) that whole time, I feel fortunate that my Fibrosis score (FibroTest-ActiTest) is currently 0.59 (F3) with an activity score of 0.32 (A1). My medical insurance currently will only treat advanced fibrosis or cirrhosis. I am fortunate the damage is not greater, considering the length of time I've had this. I wonder if this has anything to do with the fact that I have Genotype 2b, I thought I read somewhere that G-2 appears to progress at a different rate than some others.
Fibrosure score range
0.59 - 0.72 (F3) advanced fibrosis
In other words I qualify for treatment (according to local Medicaid guidelines) yet I am (according to the FibroTest) at the very bottom of the range ... this, along with my initial high VL which qualifies me for 12 weeks tx ... Bingo! (I think I'll get the right drugs at the right dosage to fully eradicate this stealthy and insidious virus).
I feel confident that I can turn that score around if I can get the meds.
Quitting alcohol and a thoughtful diet can only help.
Linuxter
mallani said
Dec 20, 2015
Hi Linuxter,
Viral Load is still a mystery to me, even after researching HCV for 25 years.
In May, 2006, I had blood drawn twice, one week apart. On the first sample my Lab. did the E/LFT's and VL but forgot the FBC. On the next sample for the FBC, they mistakenly did another VL. The two readings (for the VL) were 6.2 million ME/ml and 1.4 million ME/ml. This puzzled me and my Hepatologist at the time.
It was always assumed that a low VL at start of treatment meant a better chance of SVR. It was also assumed that patients with a low VL would have less liver fibrosis (by low I mean <700k).
I now think that the VL at start of treatment means very little. Gilead are going on the ION-3 Clinical Trial, where patients with an initial VL of <6 million, did slightly better in the 8 week treatment arm. Their Prescribing Information for Harvoni (in Rx-naive, non-cirrhotic Geno 1's) states that an 8 week course may be considered if the VL is <6 million.
HCV is a progressive disease in >90% of patients. Most progress to cirrhosis but the time frame depends on many other factors, and could be anything from 10 to 40 years.
Cirrhotics traditionally are harder to treat and need longer drug exposure.
I now think that the starting VL is not important but am still concerned about staging fibrosis by tests like FibroSure. You really need to know if you are cirrhotic, both for treatment options and follow-up. Cheers.
Linuxter said
Dec 19, 2015
Hi All,
Looks like pre-treatment Viral Load varies a lot between people and doesn't appear to be a determining factor of SVR.
My Doc did say that since I have a Viral Load of ~10 Million it qualifies me for 12 weeks treatment vs 8 weeks if lower.
Does anyone know the reasoning behind the longer treatment for a higher Viral Load?
(I'm glad to go with the longer of the two regimens, but it makes me wonder why).
What about how long one's had HCV ... I've had it for ~40 years, do you think this makes it any more difficult to cure?
I'm just curious, the answers aren't real too important to me because I realize that what I want to see is a dramatic drop in Viral Load after 4 and/ or 8 weeks and hopefully Undetectable at 12 weeks (EOT).
Oh ... and Congrats on your SVR!
Looks like you traveled a long rough road getting there but won the battle ... a job well done!
Congrats also to Australia as well!
Merry Christmas,
Linuxter
Hi Mallani,
Thank you for your thoughts on Viral Load, I appreciate that you take the time to share what you've learned about HCV over the years, it really is invaluable. (Written from the perspective of being recently diagnosed).
In my case, even though I've had HCV for over 40 years and did drink moderately (sometimes more) that whole time, I feel fortunate that my Fibrosis score (FibroTest-ActiTest) is currently 0.59 (F3) with an activity score of 0.32 (A1). My medical insurance currently will only treat advanced fibrosis or cirrhosis. I am fortunate the damage is not greater, considering the length of time I've had this. I wonder if this has anything to do with the fact that I have Genotype 2b, I thought I read somewhere that G-2 appears to progress at a different rate than some others.
Fibrosure score range
0.59 - 0.72 (F3) advanced fibrosis
In other words I qualify for treatment (according to local Medicaid guidelines) yet I am (according to the FibroTest) at the very bottom of the range ... this, along with my initial high VL which qualifies me for 12 weeks tx ... Bingo! (I think I'll get the right drugs at the right dosage to fully eradicate this stealthy and insidious virus).
I feel confident that I can turn that score around if I can get the meds.
Quitting alcohol and a thoughtful diet can only help.
Linuxter
Hi Linuxter,
Viral Load is still a mystery to me, even after researching HCV for 25 years.
In May, 2006, I had blood drawn twice, one week apart. On the first sample my Lab. did the E/LFT's and VL but forgot the FBC. On the next sample for the FBC, they mistakenly did another VL. The two readings (for the VL) were 6.2 million ME/ml and 1.4 million ME/ml. This puzzled me and my Hepatologist at the time.
It was always assumed that a low VL at start of treatment meant a better chance of SVR. It was also assumed that patients with a low VL would have less liver fibrosis (by low I mean <700k).
I now think that the VL at start of treatment means very little. Gilead are going on the ION-3 Clinical Trial, where patients with an initial VL of <6 million, did slightly better in the 8 week treatment arm. Their Prescribing Information for Harvoni (in Rx-naive, non-cirrhotic Geno 1's) states that an 8 week course may be considered if the VL is <6 million.
HCV is a progressive disease in >90% of patients. Most progress to cirrhosis but the time frame depends on many other factors, and could be anything from 10 to 40 years.
Cirrhotics traditionally are harder to treat and need longer drug exposure.
I now think that the starting VL is not important but am still concerned about staging fibrosis by tests like FibroSure. You really need to know if you are cirrhotic, both for treatment options and follow-up. Cheers.
Hi All,
Looks like pre-treatment Viral Load varies a lot between people and doesn't appear to be a determining factor of SVR.
My Doc did say that since I have a Viral Load of ~10 Million it qualifies me for 12 weeks treatment vs 8 weeks if lower.
Does anyone know the reasoning behind the longer treatment for a higher Viral Load?
(I'm glad to go with the longer of the two regimens, but it makes me wonder why).
What about how long one's had HCV ... I've had it for ~40 years, do you think this makes it any more difficult to cure?
I'm just curious, the answers aren't real too important to me because I realize that what I want to see is a dramatic drop in Viral Load after 4 and/ or 8 weeks and hopefully Undetectable at 12 weeks (EOT).
Thanks for any insight on this.
Linuxter