TOPIC: Started Epclusa about 6 weeks ago

My blood test did not come back negative. I've reached out for an interpretation of these results past 6.47 on the Quantitative log and current <1.18. The HCV RNA shows detected at <15.

2/22/18 11/5/19 12/20/19
HCV Quantitative Log
NOT DETECT Log IU/mL
6.00 6.47 <1.18 DETECTED
HCV RNA, PCR, QN
NOT DETECT IU/mL
2,980,000 <15 DETECTED

Hi Sherif and welcome

That is a low reading part way through treatment- I did 24 weeks, I wasn't undetected until 18 weeks on treatment, I still cleared, it is not at all unusual to get your result of . Looks to me, patient not doctor, like you are on track really well.
Taking your meds with some food? Keeping hydrated and feeling ok?

Thanks for the info Hazel. I've not had any side effects from the medication except for some days slight fatigue and a couple of days I got a headache, but that's not unusual from the norm for me until yesterday I got Tinnitus in my left ear ringing for two days now and I'm not sure that's a side effect but I will need to see a doctor if it continues.

Hello Sherif,

About 20% of patients are still detected at week 4 so, while undetected is more reassuring, this is not that unusual. Cure rates remain very good.

Do you know your genotype and level of fibrosis? AST and platelets would be good to know too.

Hi Dr. James, a liver Elastography showed corresponding metavir fibrosis score: F2 + some F3. I am Genotype 1a. Platelets were 207, AST 28 in 2019 but as high as 64 in 2016 and ALT was 50 before starting treatment and was ALT was 122 in 2016. I've likely had the virus for 20-30 years. I have not missed a dose I'm currently starting week 7 of the 12 Epclusa week course. I read that the HCV RNA levels detected <15 were the lowest on the scale and I'm not sure what the Quantitative log <1.18 means. Thanks for the honest info though it's disheartening that I'm in a 20% group still detected, I'm hopeful the next test in Feb will show undetected.

You should be fine Sherif - those results show you liver is in ok shape.

The <15 and log <1.18 represent the same number.

1000 = 10*10*10 = 10^3 = log 3 - a convenient way to talk about viral load so 1,000,000 is log 6 and 100,000 is log 5 and 10,000 is log 4 and 1000 is log 3 and 100 is log 2 and 10 is log 1 and...

15 = 10^1.18 = log 1.18

Thanks for explaining my results to me Dr. James. My doctor & pharmacist still have not replied but I believe you've given me clarity to the results so hoping I'm close to being virus free.

To assess response-guided therapy eligibility, an “Undetected”
result is required, and a result of “<15 IU/mL (<1.18 log IU/mL) should not
be considered equivalent to an “Undetected” result.

Hello Sherif,

The old standard was <25 and undetectable was <15.

The more sensitive <15 test can detect down to about 10 so you would have been undetected with the older tests.

Things are on track. Take the full 12 weeks and trust in the statistics...

Best Regards

James