Replies to post #189792 on Biotech Values

[justrpaul]

HCV viral load fluctuation -

This has been known for years. I noted back in October of last year in post #182652.

[willyw]

Viral loads fluctuate greatly and should not be inferred to indicate damage (I sometimes see this connection suggested).

When I screened for my trial my viral load was greater than 6 million/IU/mL.
2 weeks later before dosing it had dropped to 3 million/per unit.

I never quite understood the notion that with DAA's a lower viral load was easiest to treat (therefore shorter treatment times).

In my observation it isn't the "count" but which virus sub-species being treated with what type of compound(s).

I've seen some low viral loads that resist treatments, and some very high viral loads that fall like dominos.

Quite often, right before a patient "clears" they also may stall for a week or two. That is where the treatment has killed off all the easier to kill subtypes and only the most resistant (to the treatment compounds) remain.
In my situation I started w/ a 3/mill/unit viral load, did Harvoni for one week and was below quant at one week; same for week 2.
A 4 week PCR confimed clear/undetected, where I remained ever since.

[dewophile]

HCV VL

agree that is why i listed it. I am not sure what current standards are - perhaps docs recognize this and test 2-3 times and if consistently low then Rx the 8 week regimen. i certainly wouldn't want 8 weeks based on one VL assessment (SVR if i recall was 91% for high VL w 8 weeks)
I also listed the real world 8 week outcomes abstract - if the data shows a drift lower in SVR then this too could make docs question the 8 week regimen, which wouldn't be problematic except most payers that have contracted w GILD won't cover 12 weeks for a non-cirrhotic naive unless they have a documented high VL. In the co-preferred plan i can see some docs and pts opting for 12 weeks of viekira in this case.