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TOPIC: So, what does UND mean really? (or there's no pleasing some folk

So, what does UND mean really? (or there's no pleasing some folk 1 year 9 months ago #18640

  • beaches
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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?
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
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So, what does UND mean really? (or there's no pleasing some folk 1 year 9 months ago #18642

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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
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
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So, what does UND mean really? (or there's no pleasing some folk 1 year 9 months ago #18651

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Hello Beaches,

There have been many discussions about this, please check "Index"-->Expert corner
fixhepc.com/forum/viral-load-and-svr.html
#flower #flower
Nishkama Karma
Cùng nhau loại bỏ Viêm gan C trên khắp thế giới!
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So, what does UND mean really? (or there's no pleasing some folk 1 year 9 months ago #18652

  • DrJames
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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.
YMMV
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So, what does UND mean really? (or there's no pleasing some folk 1 year 9 months ago #18653

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Deep. Sigh.
Thanks.
Any strategies to prevent relapse?
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
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So, what does UND mean really? (or there's no pleasing some folk 1 year 9 months ago #18659

  • Michael Henry
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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.
Australian
Geno type 1a
Fibrosis 3-4
Treatment experienced Peg-Interferon Ribavirin (Relapsed)
Started 22/10/15 DAA's 24 weeks Sofosbuvir Ledisbovir & 12 weeks Ribavirin
Viral Load at week 4 <15 Detected
Viral Load at week 12 Undetected
Viral Load at week 24 Undetected
Viral Load SVR4 Undetected
Viral Load SVR12 Undetected
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So, what does UND mean really? (or there's no pleasing some folk 1 year 9 months ago #18661

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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. :+1: :cheer:
G3a since '78 - Dx '12 - F4 (2xHCC)
24wk Tx - PEG/Riba/Dac 2013 relapsed
24wk Tx - Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx - 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 - 22/06/17 UND
SRV12 - 27/07/17 UND
SVR24 - 26/10/17 UND
:cheer: :cheer: :cheer:
Last Edit: 1 year 9 months ago by Gaj.
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So, what does UND mean really? (or there's no pleasing some folk 1 year 9 months ago #18674

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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.
YMMV
Last Edit: 1 year 9 months ago by DrJames.
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So, what does UND mean really? (or there's no pleasing some folk 1 year 9 months ago #18675

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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 :)
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
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So, what does UND mean really? (or there's no pleasing some folk 1 year 9 months ago #18698

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So....
Undetected and "Negative" are the same thing?
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
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So, what does UND mean really? (or there's no pleasing some folk 1 year 9 months ago #18705

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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 #duck #duck
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
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So, what does UND mean really? (or there's no pleasing some folk 1 year 9 months ago #18708

  • Michael Henry
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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 #duck #duck

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.
Australian
Geno type 1a
Fibrosis 3-4
Treatment experienced Peg-Interferon Ribavirin (Relapsed)
Started 22/10/15 DAA's 24 weeks Sofosbuvir Ledisbovir & 12 weeks Ribavirin
Viral Load at week 4 <15 Detected
Viral Load at week 12 Undetected
Viral Load at week 24 Undetected
Viral Load SVR4 Undetected
Viral Load SVR12 Undetected
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So, what does UND mean really? (or there's no pleasing some folk 1 year 9 months ago #18713

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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
G3a since '78 - Dx '12 - F4 (2xHCC)
24wk Tx - PEG/Riba/Dac 2013 relapsed
24wk Tx - Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx - 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 - 22/06/17 UND
SRV12 - 27/07/17 UND
SVR24 - 26/10/17 UND
:cheer: :cheer: :cheer:
Last Edit: 1 year 9 months ago by Gaj.
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So, what does UND mean really? (or there's no pleasing some folk 1 year 9 months ago #18715

  • Michael Henry
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Forum Main Forum Experts Corner Viral Load and SVR Understanding SVR - Why don't we call it cure?
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TOPIC: Understanding SVR - Why don't we call it cure?
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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Understanding SVR - Why don't we call it cure? 2 months 4 weeks ago
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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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Understanding SVR - Why don't we call it cure? 2 months 4 weeks ago
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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?
Australian
Geno type 1a
Fibrosis 3-4
Treatment experienced Peg-Interferon Ribavirin (Relapsed)
Started 22/10/15 DAA's 24 weeks Sofosbuvir Ledisbovir & 12 weeks Ribavirin
Viral Load at week 4 <15 Detected
Viral Load at week 12 Undetected
Viral Load at week 24 Undetected
Viral Load SVR4 Undetected
Viral Load SVR12 Undetected
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So, what does UND mean really? (or there's no pleasing some folk 1 year 9 months ago #18717

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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 !
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!!!
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