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Dealing with the EOT to SVR period 7 years 11 months ago #15798
So you've taken the pills and the last one is down the hatch. You now enter the stressful time when we have to wait and see if the response is durable - SVR Over the first few days the medications rapidly wash out of your system (except Riba which is slow). Sofosbuvir's active metabolite - GS-331007 - has a half life of 24 hours, for daclatasvir it is 12 hours, and for Ledipasvir it is 48 hours. The half life is the time taken for your body to get rid of 1/2 the current quantity it contains. Across days 1-7 the levels of the active Sofosbuvir metabolite GS-331007 reduce by half every day so you have 1/2, 1/4, 1/8, 1/16, 1/32, 1/64, 1/128 etc So by the end of 7 days off treatment you have 1/128th as much (~ 1%) as you did at EOT. For daclatasvir you reach that point in 3.5 days and for ledipasvir 14 days due the difference in wash out rates (1/2 life). Most medications have side effects of some description so it's reasonable to assume these will dissipate. Mental side effects can range from high to low - consider alcohol - it can be pretty good while taking it and pretty bad after. Anyway over time we get to the point where there is effectively no medication left in your system and therefore no side effects relating to it being there. Within a couple of weeks at the most there will not be enough medication left in your system to suppress viral replication so the virus will grow back. The incubation period for a new infection is 2 weeks to 6 months with 6-9 weeks being average, thus the use of SVR12 - 3 weeks washout, 9 weeks to grow. That said the experience from trials like: www.ncbi.nlm.nih.gov/pubmed/25314116 www.natap.org/2013/AASLD/AASLD_26.htm indicate the the vast majority of patients with SVR4 (~98%) will also go on to SVR12 and SVR24 (we are seeing this as well) So the shortest wait time is 4 weeks post treatment to get a good idea about ultimate cure. PCR is expensive and if you were in the vast majority with elevated ALT at baseline relapse will show up as an out of range elevated ALT days before the PCR is availabke so the "poor man's SVR4" is just to do an ALT and save the PCR for 12 weeks. Being anxious during this period is normal. Checking your ALT (remember it's OUT OF RANGE not a tiny blip up) may help, but then again a tiny blip up (normal) may worry you for no reason. There are a few people at SVR who worried about the usual wandering up and down of ALT. Anyway here's the sunscreen song..... YMMV | |
Dealing with the EOT to SVR period 7 years 11 months ago #15802
Thanks much for this, sums it up so well Treatment naive F 3/4 Genotype 1 a & b V/L 17 MILLION Started Harvoni 11th Dec 2015 for 12 weeks 4 weeks VL UND 6 WEEKS ALT 32, AST 34 EOT 03/03 2016 ! UND ALT 34, AST 26 04.04.2016 SVR 4 26.05.2016 SVR 12 16.08.2016 SVR 24 The following user(s) said Thank You: Ariel | |
Dealing with the EOT to SVR period 7 years 11 months ago #15807
"So the shortest wait time is 4 weeks post treatment to get a good idea about ultimate cure." - Dr Freeman That's made my day. Having achieved SVR4 and into week 6 post tx I feel new already. Summaries like these answer so many questions succinctly ty very much. Ty for the song too. Splashing happy vibes here with such great prospects Ariel Gen 1a Peg/inf/riba 2012(!) stop @ Wk 43 potassium low +issues (rlps week 4 post tx, VL120,000) scnds eg. adenomas. pre sof/led VL 240,000 Fibsc F0 Day 25 <30 Day 32 UND Week 10 UND EOT UND ALT11AST17GGT19 SVR4 UND ALT10 AST16 GGT13 SVR8 UND ALT <9 AST16 GGT15 SVR12 UND ALT14 AST19 GGT12 Bili 5 EOT +18 ALT13 AST20 GGT9 Bili 5 EOT +21 ALT11AST15 Cured SVR12 Dysplasia Adenomas RemvdAug '16 SVR24 UND ALT11AST16 ColonoscopyClear Nov17 LumpectomyClear ‘18 LithotripsyCytoscopyBiopsy 4/18 | |
Dealing with the EOT to SVR period 7 years 11 months ago #15825
Thanks Dr James for clarifying so many questions. I am going for the "poor mans SVR 4" this week It's good to read of peoples experiences on this forum, because we are all different. Geno 1a, F1, tx naive, had it 35 yrs. Started Cipla HepcvirL on 12/01/16 Starting VL 490,000 At 16 days in <15 4 week results: UND 8 week results: UND 5 weeks EOT alt 25 SVR 15 - Not Detected 6 months EOT - Not Detected | |
Dealing with the EOT to SVR period 7 years 11 months ago #15826
Doc, You are, and continue to be "The Greatest". Mr. Ali can be the "Second Greatest"... m This email address is being protected from spambots. You need JavaScript enabled to view it. forums.delphiforums.com/generichcvtx G 1a F-1 Started tx 10/23/15 (Meso sof & led) ALT 48 AST 28 v/l 1.6 mil 11/17/15 4 wk lab ALT 17 AST 16 <15 11/18/15 Started Harvoni 12/16/15 8 wk lab ALT: 15 AST: 13 V/l UND 1/14/16 Fin. Tx 7/07/16 UND SVR 24 | |
Dealing with the EOT to SVR period 7 years 11 months ago #15833
I might get a 2 week ALT this week- but I must compartmentalise because I genuinely aren't worried either way. I ask myself- Would I have done anything different? is there anything I could do, now, that worrying might alert me to? Is it the end of the world if I have to retreat? No to all the above- and I am lucky to be feeling so good, as not everyone does either on tx or after, I am just spending time with that feeling. Genotype 3 30 years, 2x treatment interferon/ribavirin non responder. Cirrhosis 17 years. Fibroscan, decompensating, 40 down to 22 by 29/3/16- now down to 6.5, normal, no cirrhosis. Started Buyers Club Sof/Dac 14 Nov 15. SVR 12 29/0716 | |
Dealing with the EOT to SVR period 7 years 11 months ago #16398
Thanks Dr.Freeman, great info. After UND at EOT 5 weeks ago, I've done poor mans SVR1, and the LFT's were all great, but will do another one at SVR5 or 6. I will probably have to wait for PCR at 12 weeks because my public hospital Doc is doing monitoring on his own initiative. Sadly Ledipasvir is not yet approved in Serbia so officially I cant be monitored in public hospital, but Doc is a good fellow and also very interested in outcome of generic tx. I have all the prerequisites for a SVR like F0, low VL, Fibroscan below 7, but my double genotype and possible further genotype mutations worries me. Anyway hoping for the best and feeling great just remembering where I was last May after unsuccessful pegi/riba tx when I stumbled on the Greg's blog. Genotype 1b & 4, F0/A1, failed Peg&Riba TX 2015, 22 Jan. 2016 - Back from Delhi with 12 week Ledifos supply Started TX on 27.Jan.2016 - AST 41, ALT 59, GGT 39, ALP 74, VL 500.000, Fibroscan 6.8 19. Feb 2016 - ALT 14, AST 14, GGT 19, ALP 107 19. Apr 2016 EOT - Undetected 26. Apr 2016 (1 week after EOT) - ALT 14, AST 17, GGT 12, ALP 77 28. Aug 2016 (17 weeks after EOT) - UND, ALT 15, AST 12, GGT 5, ALP 39 | |
Dealing with the EOT to SVR period 7 years 5 months ago #22725
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Oh men, another good post that I missed to read when the time was right for me to know this In fiecare an HCV ucide peste 500000 oameni.Medicamentele generice pentru hepatita C functioneaza. Nu deveni statistica! Cauta pe Google “medicamente generice pentru hepatita C”. HCV kills more than 500000 people every year. HCV generic drugs work. Don't become a statistic. By sharing this Youtube video you might save someone’s life! My TX: HEPCVIR-L[generic Harvoni]-India SVR52 achieved |
Dealing with the EOT to SVR period 7 years 5 months ago #22736
Glad you revived this thread, RHF. Coming up on SVR 12 labs next week, and have been doing my best not to think too much about it. For the most part doing a fair job of it, but those nagging doubts do eat at us a little, don't they? Failed Interferon 96', G1a, VL = 9 - 5.5 Million, F3/A3, AST 111, ALT 190, Generic DAA treatment Sof/Led (Mylan - India MYHEP LVIR) - 8 June, 2016 2 Week Results 20 June, 2016 AST 19, ALT 32 4 Week Results 06 July, 2016 AST 22, ALT 30, VL = 35 6 Week Results 20, July 2016 VL only = HCV RNA Detected, Non-Quantifiable <15 8 Week Results 04 August 2016, Labs, LFTs Normal, VL = UND 12 Week Results 31 August, 2016 LFTs Normal, VL = UND EOT + 4 Weeks, LFTs Normal, VL = UND, "SVR4" SVR12, 21 Nov 2016. CURED!!! | |
Dealing with the EOT to SVR period 7 years 5 months ago #22738
Fitz you got this, I can feel it in my waters Genotype 1a Diagnosed in 2004, had HCV for all my adult life. Until 2016!!!! Harvoni treatment, started 19 March 2016 4 week results Bilirubin 12 down from 14 pre treatment, Gamma 25 down from 52, ALT 19 down from 63, AST 19 down from 47, VL <15 down from a lazy 6 million or so EOT Results Bilirubin 10, GGT 18, ALT 19, AST 21, VL UND 12 Weeks post EOT Bilirubin 11, GGT 16, ALT 22, AST 20, VL UND Cured baby | |
Dealing with the EOT to SVR period 7 years 5 months ago #22739
I'm glad I logged in I will wait at the finishing line Fitz Mermaid splashes too added to Beaches waters coming your way Yes yes you got this Gen 1a Peg/inf/riba 2012(!) stop @ Wk 43 potassium low +issues (rlps week 4 post tx, VL120,000) scnds eg. adenomas. pre sof/led VL 240,000 Fibsc F0 Day 25 <30 Day 32 UND Week 10 UND EOT UND ALT11AST17GGT19 SVR4 UND ALT10 AST16 GGT13 SVR8 UND ALT <9 AST16 GGT15 SVR12 UND ALT14 AST19 GGT12 Bili 5 EOT +18 ALT13 AST20 GGT9 Bili 5 EOT +21 ALT11AST15 Cured SVR12 Dysplasia Adenomas RemvdAug '16 SVR24 UND ALT11AST16 ColonoscopyClear Nov17 LumpectomyClear ‘18 LithotripsyCytoscopyBiopsy 4/18 | |
Dealing with the EOT to SVR period 7 years 5 months ago #22750
Fitz - it's been a while, I hope this short post out finds you well. My post is to say, as you would to me, "you've got this". In good health my friend Contracted HCV 1980's Geno Type 1a F3 ( doc says once treated I'll be F2 maybe F1) Meds shipped 6/17/2016 arrived early 7/2016 Viral count - 3,471,080 4 week quantitative bloods: August 17, 2016. I have been diagnosed as <15 (told undetected) 8 week quantitative bloods: September 14th. I have been diagnosed as <15 (told undetected) 11 week PCR RNA Qualitative bloods: September 26th 2016 - Undetected December 19th 2016: Cured! Viral count: zero!!! 2018 viral count: still zero! Cured! | |