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TOPIC: SVR 12 vs. SVR 24

SVR 12 vs. SVR 24 2 years 1 month ago #21251

  • Greedfighter
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I found this online:

www.hepmag.com/blog/hepatitis-c-treatment-svr

More than 9 out of 10 people will be cured using the current treatments for chronic hepatitis C virus infection. It is thrilling to be told that hepatitis C is no longer detectable in your blood. However, as much as we yearn for those words, sometimes it takes a long time to believe that hepatitis C is gone forever.




The medical term for a successful hepatitis C treatment outcome is sustained viral response (SVR). Undetectable HCV for 24 or more weeks after the end of treatment is an SVR24. Recently, many studies use the term SVR12, meaning that hepatitis C is undetectable for twelve or more weeks after the end of treatment. For those of us had a hard time believing that being viral-free for 24 weeks meant we were cured, then 12 weeks felt unbelievable. Can we trust this?




For most of us, yes. In the January 2015 Hepatology, Eric Yoshida and colleagues reported that there wasn't much difference between an SVR12 and SVR24 among hepatitis C patients who were treated with regimens using sofosbuvir. It didn't matter if interferon was part of the regimen. Analyzing data from studies using sofosbuvir, researchers looked at response rates for genotypes 1 through 6. There were a total of 327 genotypes 1, 4, 5, 6 (mostly genotype 1); 294 genotype 2s; and 250 genotype 3s.




Results

Before presenting the results, there are a couple more terms that are important to understand:

•Relapse was defined as having a negative hepatitis C viral load (HCV RNA) at the end of treatment and subsequently having detectable HCV RNA above the LLOQ.
•In this case, LLOQ is lower limit of quantification, which is the lowest amount of virus that can be precisely counted.

SVR24 was achieved in 777 of 779 patients (99.7%) with SVR12. This means that everyone but two people who achieved an SVR12 had an SVR24. Here's the kicker: the two patients who didn't achieve an SVR 24 both had genotype 3 (both non-cirrhotic, treatment-experienced). Therefore, if you discarded the data for genotype 3 patients and counted everyone else, 100% of those who had an SVR12 had an SVR24. Using viral sequencing, these cases were relapses and not reinfection.
Gt 1a, F0, VL 6.5 million, AST 59, ALT 62
Started Twinvir 1/15/16
6 wk. labs, VL UND, AST 27, ALT 20
EOT labs, VL UND, AST 23, ALT 19
SVR 16, VL UND, AST 28, ALT 17
SVR 24, VL UND, 10/8/16
SVR 125, VL UND, 9/22/18
Last Edit: 2 years 1 month ago by Greedfighter.
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SVR 12 vs. SVR 24 2 years 1 month ago #21253

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Thanks GF that's good to hear, especially for someone who has just had their blood pulled for SVR12.
Fat lady is clearing her throat.
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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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SVR 12 vs. SVR 24 2 years 1 month ago #21254

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This is more reassuring news and the link is a welcome read. #flower Good topic as in my experience the flow on from EOT even from SVR12 to SVR24 continues in my psyche.
gt 1a VL 6m
F2/3 FibroScan - 9KPa in 2011 and 7KPa in 2015
sof/dac 10 December for 12 weeks
pre tx alt 85 ast 51
4 wk alt 34 ast 31 UND <35
8 wk alt 29 ast 32 UND <15
12wk alt 25 ast 25 EOT 3.3.16
SVR24 UND KPa5.3 F0 in normal range
I am well
.forever grateful to fixhepc
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SVR 12 vs. SVR 24 2 years 1 month ago #21328

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For the number crunchers:
A 4 week post treatment undetected VL (SVR4) is 98.2% predictive that the person will obtain a SVR12 (cured). A SVR12 is 99.8% predictive that the person will obtain an SVR24 (the old standard for a cure).
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
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