Aa
6 months treatment but result is still positive
I had a 6 month long treatment for Hepatitis C genotype 3A, but even now my result is positive.The treatment included 24 injections of pegasys and every day 3-4 ribavirin tablets.During this treatment my hemoglobin and white blood cells count (neupogen-twice a week) went quite low.
My treatment has stopped now.
So i wanted to know if there are any suggestions as to what i should do now?
thanx
My treatment has stopped now.
So i wanted to know if there are any suggestions as to what i should do now?
thanx
I have checked it out and it doesn't seem that there are any ongoing trials in the UAE. But you can ask your doctor anyways.
http://www.clinicaltrials.gov/ct2/results?term=hcv+united+arab+emirates
http://www.clinicaltrials.gov/ct2/results?term=hcv+united+arab+emirates
Yes, you should ask you doctor, if they are conducting or planning to conduct any trials in the UAE for genotype 3 who have already treated before.
thanx epi!
i am form Dubai, United Arab Emirates. Yes i shall talk about this with my doctor.
Do I need to wait for a while before starting my treatment again?
i am form Dubai, United Arab Emirates. Yes i shall talk about this with my doctor.
Do I need to wait for a while before starting my treatment again?
Hmmm, I notice there was a stop start for you in the first 12 weeks, not ideal. ANyway, here's some info on the trial:
"Roche has started a 24 weeks Phase 2b study with RG7128 in combination with pegylated interferon and ribavirin in treatment-naive patients with HCV genotypes 1 and 4 to evaluate the safety and efficacy of RG7128 in combination with standard of care for longer durations.
Roche is expecting to complete patient recruitment for the trial in its second quarter. Additionally the company also said that the study could provide flexibility for combining RG7128 with direct acting antivirals which is currently in development with varying durations of therapy.
Earlier, RG7128 has showed antiviral activity with a 90% RVR in HCV genotypes 2 and 3 prior non-responders in a 28 day clinical study. Now, Roche is intending to begin Phase 2b study of RG7128 in combination with pegylated interferon and ribavirin in patients with HCV genotypes 2 and 3 later in 2010"
http://clinicaltrials.pharmaceutical-business-review.com/news/roche_completes_enrollment_of_rg7128_phase_2b_clinical_study_100218/
You can only get on a trial via a doctor so you need to be seeing a hepatologist who is involved in research, look around your area. I don't know where you are based but others may be able to help if you post your locale. I am in New Zealand so probably not much help to you in that area.
It would be a good idea to start putting feelers out now.
All the best :)
"Roche has started a 24 weeks Phase 2b study with RG7128 in combination with pegylated interferon and ribavirin in treatment-naive patients with HCV genotypes 1 and 4 to evaluate the safety and efficacy of RG7128 in combination with standard of care for longer durations.
Roche is expecting to complete patient recruitment for the trial in its second quarter. Additionally the company also said that the study could provide flexibility for combining RG7128 with direct acting antivirals which is currently in development with varying durations of therapy.
Earlier, RG7128 has showed antiviral activity with a 90% RVR in HCV genotypes 2 and 3 prior non-responders in a 28 day clinical study. Now, Roche is intending to begin Phase 2b study of RG7128 in combination with pegylated interferon and ribavirin in patients with HCV genotypes 2 and 3 later in 2010"
http://clinicaltrials.pharmaceutical-business-review.com/news/roche_completes_enrollment_of_rg7128_phase_2b_clinical_study_100218/
You can only get on a trial via a doctor so you need to be seeing a hepatologist who is involved in research, look around your area. I don't know where you are based but others may be able to help if you post your locale. I am in New Zealand so probably not much help to you in that area.
It would be a good idea to start putting feelers out now.
All the best :)
Thankyou alot Marcia for the information.
My doctor has said that in 2-3 years a new course is going to start which will be a month long treatment. So he has told me to wait for it. Is this the PI you are talking about?
And is it possible to get any information on the trail for 3a?
My doctor has said that in 2-3 years a new course is going to start which will be a month long treatment. So he has told me to wait for it. Is this the PI you are talking about?
And is it possible to get any information on the trail for 3a?
First we have to look at why your treatment failed.
It looks like you were under dosed on the Riba. It would have been advisable to have been on 1000mg of Riba per day. I know that the cutoff for 65kg is 800mg, but you were close to that. (I weighed around 56kg when I started and the docs didn't agree to 1000mg. I think I would have cleared at 4 weeks, if they had let me. I was on 800mg for the full time of 32 weeks)
Also, as said, since you did NOT clear by week 4, as a geno 3a your chances of clearing in 24 weeks went from 95% if RVR (clear by 4 weeks) to 45% by only clearing at 12 weeks. These are the statistics for geno 3a.
According to your outcome, you should have been given the choice to either stop treatment or to continue to 48 weeks. That would have brought your chances up again. (I don't know the percentage)
This is now in the past.
You have several options now:
1. Treat again... this time weight based. 1000mg per day and 180mcg Peg
See when you are undetected and adjust length of treatment accordingly. You HAVE to have a PCR at 4 weeks. If you can get them to do one at 2 weeks that would be even better.
2. Wait until the PI's are on the market (this will take some years)
3. Get into a trial for 3a's. Personally I believe that this would be the best option for you, if you would like to treat fairly soon.
Hope this helped a bit.
Marcia
It looks like you were under dosed on the Riba. It would have been advisable to have been on 1000mg of Riba per day. I know that the cutoff for 65kg is 800mg, but you were close to that. (I weighed around 56kg when I started and the docs didn't agree to 1000mg. I think I would have cleared at 4 weeks, if they had let me. I was on 800mg for the full time of 32 weeks)
Also, as said, since you did NOT clear by week 4, as a geno 3a your chances of clearing in 24 weeks went from 95% if RVR (clear by 4 weeks) to 45% by only clearing at 12 weeks. These are the statistics for geno 3a.
According to your outcome, you should have been given the choice to either stop treatment or to continue to 48 weeks. That would have brought your chances up again. (I don't know the percentage)
This is now in the past.
You have several options now:
1. Treat again... this time weight based. 1000mg per day and 180mcg Peg
See when you are undetected and adjust length of treatment accordingly. You HAVE to have a PCR at 4 weeks. If you can get them to do one at 2 weeks that would be even better.
2. Wait until the PI's are on the market (this will take some years)
3. Get into a trial for 3a's. Personally I believe that this would be the best option for you, if you would like to treat fairly soon.
Hope this helped a bit.
Marcia
My weight is 62kg and i had 600-800mg Riba tablets every day
Pegasys was 180mcg
Yes my viral load did get zero after 12 weeks
My treatment dates and viral load results are as follows:
> > 01-May-2009 viral load - 2,420,000 IU/ML (LOG 6.3838)
22-June-2009 - treatment started with pegasys
17-July-2009 - I was hospitalized and the treatment was stopped for 2 weeks as WBC & Hb count severely dropped
> > 30-July-2009 viral load - 11700 IU/ML (LOG 4.07)
1-August-2009 - treatment started again
> > 30-Sep-2009 viral load - NOT DETECTED [12 WEEKS LATER]
21-Dec-2009 last ribavirin dose treatment stopped
> > 31-Jan-2009 viral load - 700000 IU/ML
Pegasys was 180mcg
Yes my viral load did get zero after 12 weeks
My treatment dates and viral load results are as follows:
> > 01-May-2009 viral load - 2,420,000 IU/ML (LOG 6.3838)
22-June-2009 - treatment started with pegasys
17-July-2009 - I was hospitalized and the treatment was stopped for 2 weeks as WBC & Hb count severely dropped
> > 30-July-2009 viral load - 11700 IU/ML (LOG 4.07)
1-August-2009 - treatment started again
> > 30-Sep-2009 viral load - NOT DETECTED [12 WEEKS LATER]
21-Dec-2009 last ribavirin dose treatment stopped
> > 31-Jan-2009 viral load - 700000 IU/ML
I too am a 3a & did same 24wks + 4 Riba, sadly that didnt kill the dragon but I have just finished my 2nd bite of this cherry with 48wks & 7 Riba ... Just like a few have said here weight based Riba is better ... Oh BTW I am Undetectable since wk12 & waiting now for time to pass so I can have that big SVR result ...
I was a Geno 3a non responder to 24 weeks of weekly Peg injections and 4 Riba pills daily.
I was able to get on a trial for a new plymerase inhibitor now known as RG7128 for 28 days and then I carried out SOC for a total of 48 weeks with the same Peg but a higher dose of Riba (I went up to 6 pills or 1200mgs a day). This combo approach did the trick for me and I have been SVR for approximately 5 months now.
As NYGirl said, G3 can be a bugger to get rid of if you don't get it first time but it can be done you just need a progressive thinking Doc who is prepared to retreat with a new improved arsenal. By that I mean you will need to add another drug and more SOC.
Teleprevir and Boceprevir are not looking good for G3 non responders so don't waste your time there. Try to get on a RG7128 trial with Roche and Pharnasset., There is a new trial recruiting for your geno later in 2010, try to get a jump on that, it's worth it.
All the best!
Epi :)
I was able to get on a trial for a new plymerase inhibitor now known as RG7128 for 28 days and then I carried out SOC for a total of 48 weeks with the same Peg but a higher dose of Riba (I went up to 6 pills or 1200mgs a day). This combo approach did the trick for me and I have been SVR for approximately 5 months now.
As NYGirl said, G3 can be a bugger to get rid of if you don't get it first time but it can be done you just need a progressive thinking Doc who is prepared to retreat with a new improved arsenal. By that I mean you will need to add another drug and more SOC.
Teleprevir and Boceprevir are not looking good for G3 non responders so don't waste your time there. Try to get on a RG7128 trial with Roche and Pharnasset., There is a new trial recruiting for your geno later in 2010, try to get a jump on that, it's worth it.
All the best!
Epi :)
I forgot to say welcome to the forum and I am sorry about your negative outcome.
I was a geno 3a myself and only cleared 8 weeks into treatment. I ended up treating 32 weeks. I was on weight based Riba (800mg) 123 lbs/ 56 kg. and 180mcg Pegasys.
I was a geno 3a myself and only cleared 8 weeks into treatment. I ended up treating 32 weeks. I was on weight based Riba (800mg) 123 lbs/ 56 kg. and 180mcg Pegasys.
Usually you would have to treat again, but do something different the next time.
To be able to figure that out, it would be interesting to know exactly what dose of Riba and Pegasys you were on and how that corresponded with your weight.
When did you become undetected? For a geno 3, if one is not undetected by 4 weeks, one should prolong treatment. If one is not undetected by 12 weeks, treatment should be stopped.
Other factors like Insulin Resistance should be checked. If there is a case of this, one should get it under control first, as it can severely interfere with having a positive outcome.
The one can also help by taking certain supplements and avoiding others. Some inhibit viral replication and other enhance viral replication.
To be able to figure that out, it would be interesting to know exactly what dose of Riba and Pegasys you were on and how that corresponded with your weight.
When did you become undetected? For a geno 3, if one is not undetected by 4 weeks, one should prolong treatment. If one is not undetected by 12 weeks, treatment should be stopped.
Other factors like Insulin Resistance should be checked. If there is a case of this, one should get it under control first, as it can severely interfere with having a positive outcome.
The one can also help by taking certain supplements and avoiding others. Some inhibit viral replication and other enhance viral replication.
Unfortunately sometimes Geno3 can be every bit as hard (if not harder) than a geno1 - the toughest genotype. That is why if I had geno 3 I would have begged to do weight based ribavirin. It's nice that it's considered a lucky geno but if like you you are one of the 20% that don't respond it sure isn't very lucky.
There is good news though. There are people on this forum who failed the first attempt then waited a little while to recover and treated a second time with more meds and for 48 weeks, just like FLGuy said.
There are medications you can take to help with the white and red blood cell problems if they get severe enough.
You don't say what your viral load was during treatment (ie: at baseline, week 4 and week 12) so it's impossible for any of us to tell how well you responded in the first place. If you can come up with those numbers it would be useful for us to give you some advice.
Remember geno3 can be a bear but you can beat it.
There is good news though. There are people on this forum who failed the first attempt then waited a little while to recover and treated a second time with more meds and for 48 weeks, just like FLGuy said.
There are medications you can take to help with the white and red blood cell problems if they get severe enough.
You don't say what your viral load was during treatment (ie: at baseline, week 4 and week 12) so it's impossible for any of us to tell how well you responded in the first place. If you can come up with those numbers it would be useful for us to give you some advice.
Remember geno3 can be a bear but you can beat it.
During the course of the 6 months did your viral load get to zero? The "3-4" riba dose seems unusually low.
There are some doctors who belive that if a patient can get to undetected, they can get to SVR (cure). For geno 3A (and I suppose the others) a more aggressive (longer and stronger meds) could be worth a try. However, that approach would require not only close monitoring but expereince medical advice from a doc who has considerable knowledge.
There are some doctors who belive that if a patient can get to undetected, they can get to SVR (cure). For geno 3A (and I suppose the others) a more aggressive (longer and stronger meds) could be worth a try. However, that approach would require not only close monitoring but expereince medical advice from a doc who has considerable knowledge.
Have an Answer?
You are reading content posted in the Hepatitis C Community
Learn about this treatable virus.
Getting tested for this viral infection.
3 key steps to getting on treatment.
4 steps to getting on therapy.
What you need to know about Hep C drugs.
How the drugs might affect you.
These tips may up your chances of a cure.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
