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blood tests required during treatment - Sofo/Dac? 6 years 11 months ago #895

I had a liver function test to make sure I was OK. That was at two weeks. I was having some sides that worried me. All is good now and the results showed I was responding well..... My liver showed great improvement immediately.

I will be getting viral load done at one month. Unless there is issues with your health monthly should be fine as far as I know. I am no doctor of course.

Good luck.
G1 58yo F1 54,000 viral load Relapser 2003/4 Sof/Dac started 21/9/2015

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blood tests required during treatment - Sofo/Dac? 6 years 11 months ago #901

Hi Gary,i cant help much with detailed feedback about blood tests but i can tell you about my experience with harvoni.i am 57 was genotype 1a for about 38 years and got on one of the first trials 2 years ago.
I had not previously treated as i didnt want to do interferon.As it was a trial i was tested at 1 week 2 weeks 4,6 8 and 12.it was a 24 week regimen but for the last 12 weeks i was tested monthly.
The thing i wanted to highlight to you is that although i had absolutely no side effects that i could feel, at my first weeks blood test my liver enzymes were very elevated to the point of concern to the doctors.They said i may have to stop the trial but i pleaded with them not to as i was feeling fine.They let me carry on and by the time i had my 2 week test the liver enzymes had dropped back to normal and my viral load had gone from 5 million to 5 hundred.
i wanted to share this with you as i think it is common for the enzymes to be briefly elevated and you should ask your doctor to get informed about this.Good luck,David

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blood tests required during treatment - Sofo/Dac? 6 years 11 months ago #912

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Thanks David. I will probably go with the 2 week, 4 week and 12 week tests. Regards, Gary

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blood tests required during treatment - Sofo/Dac? 6 years 11 months ago #913

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Thanks Johnboy. Good luck with your treatment. Gary

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blood tests required during treatment - Sofo/Dac? 6 years 11 months ago #914

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Thanks Gary for the information!
I'm starting as well, can you info me about your encapsulation experience...

Thanks! Good luck!!

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blood tests required during treatment - Sofo/Dac? 6 years 11 months ago #1051

In the absence of Ribavirin and with you feeling well:

Baseline: FBC, Cr&E, LFTs and Viral load are sufficient

4 weeks into treatment: LFTs and Viral load (expecting normal LFTs and zero viral load). This proves you have the right medication and that things are progressing as expected.

If your liver function is better and your viral load zero at 4 weeks into treatment you can stop testing. If not a repeat in 2 weeks would be sensible.

There is very little point in doing further testing once you are VL 0 until after you finish treatment unless you are unwell.

More monitoring won't hurt (other than your pocket) but is not likely to add any actionable information.

Post treatment we wait to see if you VL 0 was a real zero or if you still had some HCV below our limit of detection (which is where recurrence comes from).
  • A viral load of zero at 4 weeks (SVR 4) predicts a 97% chance of being SVR24
  • A viral load of zero at 12 weeks (SVR 12) predicts a 99.7% chance of being SVR24
  • A viral load of zero at 4 weeks (SVR 24) predicts a 100% chance of being SVR24

SVR24 means < 1% chance of ever seeing the virus again.
YMMV
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Last edit: by DrJames.

blood tests required during treatment - Sofo/Dac? 6 years 11 months ago #1055

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Thanks very much, Dr. Freeman. I really appreciate the feedback. Regards, Gary

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blood tests required during treatment - Sofo/Dac? 6 years 11 months ago #1067

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What is Cr&E?

The same procedure for Sofusbuvir+ledipasvir?
Male, Fibro F1. Geno 1b. ALT 67 before treatment Viral load 5 million. My huge viral load replicates in my nervous system as I suffer anxiety.
Started Twinvir 12/12/15.
Two weeks
ALT 17 at 2 weeks
Viral Load UND at 2 weeks
ALT 13.5 at 7 weeks EOT
ALT 10.5 at 15 weeks EOT
ALT 13 at 27 weeks EOT, VL UND, Cured

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blood tests required during treatment - Sofo/Dac? 6 years 11 months ago #1091

Cr&E = UEC

Urea
Electrolytes
Creatinine

Yes, it is the same for all new DAAs
YMMV

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blood tests required during treatment - Sofo/Dac? 6 years 9 months ago #4816

Just wondering if the LFT's are not normal at 4 weeks but have improved, halved would this still be within normal limits for treatment, still awaiting viral load.

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blood tests required during treatment - Sofo/Dac? 6 years 9 months ago #5002

Yes, provided the trend is towards better be happy. Trending worse is bad, trending better is good.

When we look at liver function tests what we are looking at is things like AST, ALT, GGT and LDH that should not normally appear in the blood in high levels. These enzymes are present inside liver cells and when a cell is damaged and die they get released. Now if I stop damaging liver cells right now - what are the levels of AST, ALT, GGT and LDH?

Yes that's right they have not changed. They fall only as our bodies break them down, and our bodies break them down at known rates, in fact exactly the same as for drugs they have a 1/2 life - the time they take to fall by 1/2 if no more is added. Here is the detail:

www.ncbi.nlm.nih.gov/pmc/articles/PMC545762/

Enzymet 1/2
ALT47 hours
AST17 hours
GGT4 days
LDH10 hours to 3 days

In my experience we see ALT and AST fall faster and earlier than GGT and LDH which makes sense given the half lives.

Bilibubin and ALP are indicators of poor drainage from the liver and this relates to inflammation and fibrosis so they tend to resolve more slowly.
YMMV
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blood tests required during treatment - Sofo/Dac? 6 years 9 months ago #6182

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Maybe a dumb question, and probably answered before, but (Dr. Freeman) as I see your reference in post above to "Zero" levels, and since my tests appear to only go to the undetectable below 15 mark, is there another more specific test that can identify an actual ZERO level as opposed to just not showing an undetected below 15 marker? I've been wondering about this since I got my "undetected" below 15 at 4 weeks.
GT 2b; since 80's, no prior tx, sofosbuvir and daclatasvir compounded from API's at Kingswood Pharmacy in Sydney, started tx nov 6,2015, undetected at 4 wks, UND at 8 weeks, UND at 1 week after EOT, UND at 4 weeks after EOT and UND at 8 weeks after EOT. " I feel GOOD!! I knew that I WOULD!"

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blood tests required during treatment - Sofo/Dac? 6 years 9 months ago #6183

I would be interested in this too...my test just had HCV undectable.......not sure where to look on the tests for VL0.
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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blood tests required during treatment - Sofo/Dac? 6 years 9 months ago #6185

I think they can detect lower that 15 ... they just can't quantify accurately below 15 ... undetected means they didn't find any at all ... doesn't mean there is zero, just that they can't detect it.

That's why you keep treating after you hit undetected, to pick off the stragglers.

And that's why you have to test 12-24 weeks after eot ... if there are too many for your immune system to finish off they'll show back up before that time ... if they don't show back up by then you can assume they were all finished off.

Dr. James wrote a post here somewhere that gives probabilities ... I'll have to look in the expert's corner and see if I can find it.
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blood tests required during treatment - Sofo/Dac? 6 years 9 months ago #6187

Hi 2b,

There are several different ways results are reported.

If a QUALITATIVE HCV RNA is requested the what you get back is a simple DETECTED/UNDETECTED

If a QUANTITATIVE HVC RNA is requested then the results may look like

< 15
Detected

<15
Undetected


N (where the <15 would go)
N=HCV RNA not detected

Where there is a <15 the is also often a < log 1.2 reported.

If you post the data bits of your results I will tell you what it means.

If it says undetected somewhere that means we can't see it (as well as it being <15)
YMMV

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