TOPIC:

Hi everyone,
I've been wondering about this for a while.
Why does the reading not say zero? Are the path labs hedging their bets?
In the future will there be tests that can detect progressively smaller amounts?

Good morning Beaches
I'm guessing you're swimming in the 20 degree water soon lucky duckie it's brrrrrr here woke me up!
Re your query I do recall that this was addressed a while back maybe by James
Praps a mod can find the info and bump the thread so we can read it
I hope I am right lol
Maybe it's an actual conversation I am recalling
Anyway it's an important question so let's wait for the answer again xxx
A

Hello Beaches,

There have been many discussions about this, please check "Index"-->Expert corner
fixhepc.com/forum/viral-load-and-svr.html

Undetected means too low to measure as in <6 or <8 depending on the test and I'd it is plasma or serum being tested. It does NOT mean zero, thus undetected people relapse.

Deep. Sigh.
Thanks.
Any strategies to prevent relapse?

Beaches, all I can add, is to make sure you've treated yourself with the best appropriate DAA's for your genotype, fibrosis & past treatment history.
Once you've done that, "CROSS YOUR FINGERS"
Like us all on here, hope & pray for the UNDETECTED SVR 12 & 24.

Hi beaches, keep up the healthy lifestyle and diet, relax and don't let yourself stress over it while you wait. Your profile suggests that you are at least 97% certain of clearing.

As Gaj says you have odds 30:1 in your favour. If I was a betting man and you were a horse I would definitely have money on the nose for you! Relax, it will almost certainly be fine, and even if you did relapse we have 1 more good treatment available now, with the promise of another 3 in the next few months. Even if you managed to fail all of those there will be new options.

James-Freeman-facebook wrote: As Gaj says you have odds 30:1 in your favour. If I was a betting man and you were a horse I would definitely have money on the nose for you!

Thanks Doc, it's good to know I'm not ready for the glue factory yet

So....
Undetected and "Negative" are the same thing?

Michael Henry wrote: Beaches, all I can add, is to make sure you've treated yourself with the best appropriate DAA's for your genotype, fibrosis & past treatment history.
Once you've done that, "CROSS YOUR FINGERS"
Like us all on here, hope & pray for the UNDETECTED SVR 12 & 24.

I wasn't planning on doing SVR24
Is this necessary?
I was told SVR12 is it by my hospital
My GP and I will follow the protocol suggested here
I'm sorry to hijack your thread here Beaches but I noted this issue and I think others may also want to know the best lab protocols for us going forward
Ty for bringing this up Michael
So please can I have feedback re doing a test for SVR24
Ty
Ariel

Ariel wrote:

Michael Henry wrote: Beaches, all I can add, is to make sure you've treated yourself with the best appropriate DAA's for your genotype, fibrosis & past treatment history.
Once you've done that, "CROSS YOUR FINGERS"
Like us all on here, hope & pray for the UNDETECTED SVR 12 & 24.

I wasn't planning on doing SVR24
Is this necessary?
I was told SVR12 is it by my hospital
My GP and I will follow the protocol suggested here
I'm sorry to hijack your thread here Beaches but I noted this issue and I think others may also want to know the best lab protocols for us going forward
Ty for bringing this up Michael
So please can I have feedback re doing a test for SVR24
Ty
Ariel

Hi Ariel,
in my case the SVR 24 is because I was on 24 week treatment , G1a, F3 / 4 & relapsed on peg interferon / riba.
I'm sure I'll be excited if my SVR 12 results come in as undetected but the SVR 24 will be the icing on the cake.
I may also have a SVR 48 just for peace of mind.

Hi all,

I may be wrong but my understanding is that the SVR24 test came from the old Peg/Riba treatment which had higher late relapse rates. With the DAAs testing at 12 weeks gives similar predictability to the old regimes 24 week test so SVR12 is considered the standard by most authorities these days. Obviously it won't hurt to have a SVR24 test (other than possibly your bank account) so if that gives you confidence further down the track go for it but don't spend the extra three months stressing over it.

Edit: Dr James explains it far better than me.

fixhepc.com/forum/viral-load-and-svr/860...we-call-it-cure.html

Forum Main Forum Experts Corner Viral Load and SVR Understanding SVR - Why don't we call it cure?
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Understanding SVR - Why don't we call it cure? 2 months 4 weeks ago
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SVR means Sustained Viral Response.

When we stop the medications if there is no virus left you will remain undetected and this is SVR.

Undetected at 4 weeks post finishing - SVR4 - predicts a 96% chance of permanent cure

Undetected at 12 weeks post finishing - SVR12 - predicts a 99% chance of permanent cure

Undetected at 24 weeks post finishing - SVR24 - predicts a 99.9% chance of permanent cure

So if you finish treatment and there is virus left it will grow back, your viral load will increase again and you relapse.

If we can not detect any virus you are at SVR and the longer that remains the case the more certain we are it is permanent.

Patients reaching SVR24 post interferon/ribavirin have remained virus free for 18 years of follow up.

With DAAs we don't have that length of follow up but basically with no drugs to hold the virus off if it is still present it grows back, and if it is not still present it can not grow back because it is gone.

You can be confident at SVR4, really confident at SVR12 and pronounce yourself cured at SVR24. There is a strong suspicion that anyone relapsing after SVR24 is not a relapse, but rather a reinfection because if the virus has had 24 drug weeks to grow back and has not.....
YMMV
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So do you recommend being tested at 24 weeks as well and 4 & 12?
Lives in Bendigo, Victoria
No prior treatment Genotype 1b Fibroscan 0 (only showed a bit of a fatty liver) Diagnosed in February 2015 Currently on my last week of treatment taking led/sof Last LFT normal
Insomnia the only side effect
Undetected at 4 weeks
SVR4 - undetected - all bloods good and GP very happy
SVR12 bloods to be done at end of April 2016
SVR12 - undetected!!!
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Yes, it's probably not a bad idea but unless you were one of those asymptomatic people with normal liver functions if you did relapse you would expect to feel sick and this to be obvious on your liver function tests.

After SVR24 maybe check it in a year to satisfy paranoia and declare yourself cured beyond all reasonable doubt.
YMMV
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Forum Main Forum Experts Corner Viral Load and SVR Understanding SVR - Why don't we call it cure?

My .02 cents as a very new person on this forum:
It is hard enough going through treatment and hoping that you are cured, with the chance to be cured, rather than sit around saying even if you go through treatment if you don't get to SVR 24 you will relapse or have the possibility of relapse. I was always taught to appreciate the opportunities you're given and try to make the best of them and then when issues come up take care of them at that time. Why look at a bad ending when you're not even done with treatment, or not even at SVR 4 then start looking at 24 and getting worried. I say we do the best we can, live life to the fullest and hope for the best.... it's more that are insurance companies gave us this is a great place to be !
Or did I miss something? I hope I came across has looking at the glass half full !