Aa
Advice
Hi. I'm a 55 yrs. male, geno 3a, treated 2006 w/ Pegasys/Copegus 23 weeks, SVR at 12 weeks + 6 months post tx and 1 year post tx. Relapsed at 2 yrs. post tx. New biopsy last March (this year): Fibrosis F3 w/ bridging, VL 200 000.
Doc wants me to start new tx w/ Pegintron/riba, increase dosis, do 36 or 48 months. I'm reluctant to do another treatment w/ interferon and riba, as last time sx nearly killed me, had to stop taking it after 23 weeks (one week premature) due to side effects. Sides stayed really heavy at least 2 yrs. after finished tx.
Was hoping to wait for new drugs w/ less side effects/shorter tx/more efficient, but realize the new drugs (tela-/boceprevir) don't work on geno 3. New drugs w/ polymease inhibitors that work on geno 3 may be due in maybe 3 yrs. time or longer? Too long to wait?
I think I read somewhere that RVR (4 weeks) is really important for success w/ my geno, and also that there is very little difference in success rate between 24 and 48 weeks for geno 3. Was thinking to do 4 weeks now and hope for RVR, and if unsuccessful, stop and wait for new drug?
Any advice appreciated.
Doc wants me to start new tx w/ Pegintron/riba, increase dosis, do 36 or 48 months. I'm reluctant to do another treatment w/ interferon and riba, as last time sx nearly killed me, had to stop taking it after 23 weeks (one week premature) due to side effects. Sides stayed really heavy at least 2 yrs. after finished tx.
Was hoping to wait for new drugs w/ less side effects/shorter tx/more efficient, but realize the new drugs (tela-/boceprevir) don't work on geno 3. New drugs w/ polymease inhibitors that work on geno 3 may be due in maybe 3 yrs. time or longer? Too long to wait?
I think I read somewhere that RVR (4 weeks) is really important for success w/ my geno, and also that there is very little difference in success rate between 24 and 48 weeks for geno 3. Was thinking to do 4 weeks now and hope for RVR, and if unsuccessful, stop and wait for new drug?
Any advice appreciated.
Thanks for advice. Will check up on them.
Re-exposure is pretty much out of the question. My doc said I'm among the 2% who relapse after more than 6 months post.
Prior to first time I did the tx, my VL was 2 mill. Now it's about 200 000. That's a 1 log diff. Does that mean success odds are better now? Or chances to achieve RVR?
Re-exposure is pretty much out of the question. My doc said I'm among the 2% who relapse after more than 6 months post.
Prior to first time I did the tx, my VL was 2 mill. Now it's about 200 000. That's a 1 log diff. Does that mean success odds are better now? Or chances to achieve RVR?
Relapse at 2 years? That's almost unheard of. That's also a low viral load.
Two studies that will provide info on RVR and 24 vs 48 for 3a and 2b are the Mangia study and the VonWagner study. You can buy these online, or possible get them free from their authors or a local library might have access to an on-line medical journal that provides them free. You will want the full study to get to the nitty gritty.
Hope that helps.
Two studies that will provide info on RVR and 24 vs 48 for 3a and 2b are the Mangia study and the VonWagner study. You can buy these online, or possible get them free from their authors or a local library might have access to an on-line medical journal that provides them free. You will want the full study to get to the nitty gritty.
Hope that helps.
Very unusual to relapse after 1 yr svr yet alone 2 yrs later. Is there any chance you could have been exposed to the virus again?
If I was you I would pre dose with aliana and/or Ribavirin for a month or two. Then add the interferon along with the ribavirin & aliana for four weeks then check VL.
If clear at 4 weeks then continue with all three drugs checking VL every four weeks.
Best of luck
If I was you I would pre dose with aliana and/or Ribavirin for a month or two. Then add the interferon along with the ribavirin & aliana for four weeks then check VL.
If clear at 4 weeks then continue with all three drugs checking VL every four weeks.
Best of luck
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