Hmmm my plan is still to go quantitative at 4wks, then again at EOT because I’m providing info for Redemption-2 (though it turned out I couldn’t be an “official” trial participant after all lol I am submitting the stats) Qualitative at 4/8/12 SVR (with luck)

As GAJ says, don’t think you have anything to be concerned about Jaz…a 6wk test sounds like a good idea. You’re going to be going in the right direction, whatever the specific numbers.

Hey great to hear you’re off and running now, Chejai! Look forward to hearing how you get on

It was me that was still detected at late week 5 there was concern with my profile I was behaving
like a f4 I decided to extend treatment due to factors outside my control I could not take bloods till
week 10 at that point I was UD who knows when I became UD.

Personally, knowing what I know now I would only do bloods at week 4/8 and 12,its to easy
to get caught up with other results which is not healthy or fair on ourselves.

Jazz, F0 is a very low score you’re perfect for treatment ,Geno types also play into the equation
I would not worry at week 4 you’re not clear……….

Question One:

“What does this test mean?” This question is accompanied with test results such as:

HCV Viral Load (Log IU/mL) <1.18 NOT DETECTED

Answer: This is the very best news.

Undetectable means that hepatitis C is gone, and presumably all gone. The confusion over this test is because viral load tests don't measure down to zero. Further, viral load tests vary. For instance, the Abbott RealTime HCV assay (assay is a fancy word for a test that determines and measure the ingredients of something) measures down to 12 IU/mL in a 0.5 mL sample of blood. This means that if you have 12 IU/ml of hepatitis C (HCV RNA) in your blood, the test will detect it and count it. If you have less than 12, the test might not see it, and if it does, it won't be able to count it. .

Each test has its own detection range, some lower than others. The main thing is this:

"Not detected" = negative for hepatitis C
"Detected" or an actual number of how much HCV RNA you have = positive for hepatitis C

If you are concerned that you may have some residual HCV swimming around in your body, hoping to set up shop in your liver, rest assured, as this is quite unlikely. Hep C replicates a trillion times a day, so "not detected" might as well be zero. It is extremely unlikely that a small amount of HCV will remain alive in your body without having replicated to much higher amounts. In fact, viral load tends to replicate at much higher numbers when treatment fails.

Question Two:

I am on treatment with Harvoni. My pre-treatment viral load was X million. My week 4 (or week 8 or week 12) viral load came back detectable. I am devastated. Should I be?

Answer: No.

In the old days, back when treatment was long and used interferon, there were clear milestones that helped us know what our chances were of permanently clearing hepatitis C. Ignore all of that. New research funded the NIH Clinical Center showed that low levels of HCV RNA at the end of treatment are not predictive of treatment response among patients with hepatitis C virus treated with interferon-free regimens. (Clinical Infectious Diseases, March 2, 2015) In fact, low levels of HCV RNA detected at the end of treatment, and even post-therapy, do not signify treatment failure.

Here is a bit more information. Sidharthan and colleagues enrolled 114 subjects with chronic HCV/genotype 1 and no prior treatment. Six patients with detectable viral load at the end of treatment achieved a sustained virologic response (SVR12). You can read more about it: Utility of Hepatitis C Viral Load Monitoring on Directly Acting Antiviral Therapy - S Sreetha Sidharthan, et al.

The bottom line is that a detectable viral load at the end of treatment DOES NOT mean that treatment failed when using Harvoni-based treatment.

Important:
Don't despair if you have detectable virus during or at the end of HCV treatment.
Be sure your doctor doesn't stop treatment just because you have detectable HCV RNA. The HCV guidelines recommend viral load testing after 4 weeks of therapy and at 12 weeks following treatment completion. If quantitative HCV viral load is detectable at week 4 of treatment, repeat viral load testing at treatment week 6. If viral load has increased by greater than 10-fold on repeat testing at week 6 (or thereafter), then discontinuation of HCV treatment is recommended. There are no other recommendations to stop or extend therapy based on viral load results.

I thought all tests come up with a number other wise they have no idea if you’re
VL is going down.

The only time its suggested you stop treatment is when you’re VL increases.

What test did they preform exactly I agree its important you know its working.

That’s a pointless Test I’m lost why they would bother its not helpful.

Errrrm, yeah! Who knows? (we really need an animated shrug) The frustrating bit is that with Xmas/New Year and people on leave, etc. I didn’t get that result for over three weeks, unable to determine what went wrong and now waiting on retest results.

Hi Jaz,
We both have a big viral load, 9 mil.
Unhappy your 4 weeks viral load is not the desired UND.
But as Sirchinenge pointed out there is no problem for reaching SVR12!
Thanks Sirchinenge for your well documented post.
I also wait my 4 weeks viral load, this monday.
Wish you UND as soon as possible!