Home Forums Main Forum Experts Corner Viral Load and SVR The wait between EOT to SVR

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    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Ok, so you’ve finally finished the tablets. We call this EOT (End of Treatment).

    There is about a 99.5% chance your viral load is zero, and your liver enzymes ALT/AST will probably be normal, or (for cirrhotics) maybe just on the top of normal, but still much better than where they started.

    Over the first couple of weeks the drug levels in your body drop to near zero, so there is nothing to stop the virus reproducing (if it still exists).

    By 4 weeks after treatment most people who are going to relapse will have relapsed. Most patients know this has happened with the return of the familiar symptoms. So if you feel well you almost certainly are well.

    If you are undetected at 4 weeks past EOT we call this SVR4 and there is about a 95% chance this will translate into permanent cure.

    If you can’t get/can’t afford to do a viral load testing ALT level is a very good indicator. If it is no more than 20% higher than on treatment you are fine. If it has risen by 100% that is a worry, so 10->12, 20->24, 40->48 is nothing to worry about, but 10->20 or 20->40, or 40->80 is.

    If you are undetected at 12 weeks past EOT we call this SVR12 and there is about a 99.5% chance this will translate into permanent cure.

    If you are undetected at 24 weeks past EOT we call this SVR24 and there is about a 99.9% chance this will translate into permanent cure.

    We have 20 years of follow-up data from the Interferon days showing that SVR24 is durable, and the virus never comes back. There is no reason to suspect the results will be different for DAAs, after all if there are no drugs in your system and the virus has not grown back…. there is no virus to grow back.

    Of course you will be anxious about the result. This is normal, but the statistics are on your side, and worrying is about as effective as chewing bubble gum while trying to solve and algebra equation.


    YMMV

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