Hep C Discussion Forum

Thank you Jill.  Some very significant information there! The part below is surprising and very good news. Do you think it should be posted on the Harvoni train?

The NIH funded a small study (114 participants), Utility of Hepatitis C Viral Load Monitoring on Directly Acting Antiviral Therapy, where "the goal was to see if HCV RNA levels (viral load) at the end of treatment (EOT) negatively or positively predicted sustained virologic response (SVR12)". 

Quoting from Lucinda Porter - -

"Here is the most important part: Six patients with HCV RNA greater than or equal to LLOQ at EOT achieved SVR12 (NPV: 0%).

The Bottom Line: In the past when using interferon-based treatments, a detectable viral load at EOT meant that treatment wouldn't be successful. With Harvoni-based HCV treatment, this rule no longer applies -- a detectable viral load at EOT DOES NOT mean that treatment will not be successful.

Editorial Comment: This research leads me to two points. First, don't despair if you have detectable virus during or at the end of HCV treatment. Second, be sure your doctor doesn't stop treatment just because you have detectable HCV RNA. The HCV guidelines recommend viral load testing after 4 weeks of therapy and at 12 weeks following treatment completion.  If quantitative HCV viral load is detectable at week 4 of treatment, repeat viral load testing at treatment week 6. If viral load has increased by greater than 10-fold on repeat testing at week 6 (or thereafter), then discontinuation of HCV treatment is recommended. There are no other recommendations to stop or extend therapy based on viral load results."