higher riba dose dosn´t effect hgb

[comeagain]

hi dr D I´m a mail 54years from Sweden  have had HCV for 35 years, geno 3.
Relapsed at my first tx sep 2006 to februar 2007, 24week on peginteferon 100mgl and riba 800mg weight was 91 kg, kept the weight al through treatment.

Now on sec tx in a danish studie for relapsers 180mgl pegasys 1200mg copegus gonna do 48w
Started on 89kg after 12weeks 82kg still there at week 32.

My baseline hgb was both times around 15 after 2 weeks went down to 12.5 after 8weeks and stays there.
Its almost the same pattern both txes, hgb in fact a little lower first tx although 400mg less riba and 9kg more weight.

My 4week pcr was detectebul <15iuml taqmantest ( a so called bordrline result), baseline 3.8 milj.
I have done one dose reduction the second dose 135mgl.
Did a biopsy in nov. 2007 3.5cm sample showed grade 1 stage 0 no steaotis no iron.

Since I´m a relapser once was UND 12w and at EOT first tx I´m worried that this high hgb is an indication I´m not gonna make it this time either, do you have any thoughts about that?

ca

[comeagain]

Thx all kind people there was a purpose why this post ended up here, you have given me a lot of encouragement, I went in a wall shot 30 been there until yesterday even been having nightmares about being cirrhotic and that my bx was false.

Unfortunately I wont get any result from vl until the studie is finished a year or two after I finish, I will get a post 6 month result though.

ca

[Trinity4]

My 4week pcr was detectebul <15iuml taqmantest ( a so called bordrline result), baseline 3.8 milj.

Why borderline?  We call that UND in the states.  If I get that at 24 wks -  as far as I'm concerned that's good enough for me.

[portann]

I'm SURE I also posted to the Medical Forum this morning and it automatically showed up in this forum. Probably a glitch that automatically re-directed the posting here.

Later, when I tried again (on Trinity's advice), the medical forum was full for the day.

[FlGuy]

under 15, but detectable at week 4.  Now at week 32?  Have you have another pcr, for which you know the results, since week 4?  If it was me, I'd stay the course for the 48 and be pretty optimistic.  What would make me a little shakey is if I were still detectable at week 12.  By now you relaize that you were pretty low on the riba dose in tx#1.  Now that you weigh less, eat more riba, had a good 4 week response and going 48 things seem to be going as they should. Hang in there CA.  Anemia is not all that it's cracked up to be.

[nygirl7]

The more riba the better.  The fact that I don't know what you weight makes it impossible to guess if the 1200 is enough.  I am quite thin and was only supposed to get 800 riba however I begged the doc for 1000 and he agreed to it.  12.5 isn't really all THAT high for a man - it's actually a pretty darn good number. It would be like a woman being at 11.5.  you are almost undetectible at week 4 which as you know supposedly gives you EXCELLENT results as far as SVR.  Unfortunately geno 3a is a tough cookie for some people - I've never met a 3b though. I think maintainning your dosages and making sure you are getting that riba to bind inside you is crucial right now.

Doing 48 weeks is definitely the way to go and I totally believe it will make all the difference for you.  

Are you taking your riba with your meals with plenty of fat to make sure the riba is binding to it and not being washed out in your urine?  having a good serum level is extremely important and although we all assume that having the anemia is a good indicator of that - there is no proof of this that I know about and it is not as if your hgb is still at 15!

All in all I think you are doing everything you can and you will SVR this time.  In America we have a saying "the second time is a charm" so let's believe it is true.

Good luck!

[jmjm530]

You're in the wrong forum. Questions to Dr. D. are here:
http://www.medhelp.org/forums/show/272

That said, since you did post here, pesonally I'd be more concerned about a Peg reduction so early in treatment. Maybe you can expand on that to Dr. D. and see what he says if the Peg reduction was necessary.

[comeagain]

I was posting this at the expert forum why does it show up here?