Aa
Geno type 2 ?
Just got back from the Nurse Practitioner today and she said to me that since I didn't clear the virus until week 6 that I will have to stay on treatment for 48 weeks not 24, have any of you genotype 2 people had your treatment extended because you didn't clear at week 4?
I just have one concern. I have been conversing with fdog and he is on old SOC, flat dose 800mg riba at baseline weight of almost 81kg. (ca 10mg of riba per kg body weight) Go figure he didn't RVR. I promised to try dig up some studies he can show his GI that support the new weight based SOC, but am too fogged to find them. I don't know, if you could help out there. He is also considering to move docs.
I hate when this happens!
On top of it, he has gender and race against him, age is a pro. No biopsy, but not cirrhotic.
I hate when this happens!
On top of it, he has gender and race against him, age is a pro. No biopsy, but not cirrhotic.
Just letting you know that my doctor will have me on treatment until March as long as I stay UND.
Your NP gave you good advice. I would follow it. I am a g2 on my second round and having to do "48 plus" this second time- and I did 3 months of pre dosing before tx actually started...It goes fast. 24 weeks is NOTHING and right now I am on week 32 of SOC and it is going pretty fast,,,,so really, I would listen to the NP and just go for it.
Good luck,
MO
Good luck,
MO
Zazza
I thought you did 24 weeks. If UND do 48. Appears I am wrong.
Below is from the roferon data sheet
Patients should be treated with Roferon-A RBV combination therapy for at least 6 months. Patients with HCV genotype 1 infections should receive 48 weeks of combination therapy.
In patients infected with HCV of other genotypes, the decision to extend therapy to 48 weeks should be based on other prognostic factors (such as high viral load at baseline, male gender, age > 40 years and evidence of bridging fibrosis).
CS
I thought you did 24 weeks. If UND do 48. Appears I am wrong.
Below is from the roferon data sheet
Patients should be treated with Roferon-A RBV combination therapy for at least 6 months. Patients with HCV genotype 1 infections should receive 48 weeks of combination therapy.
In patients infected with HCV of other genotypes, the decision to extend therapy to 48 weeks should be based on other prognostic factors (such as high viral load at baseline, male gender, age > 40 years and evidence of bridging fibrosis).
CS
Depending on prevailing conditions like liver damage, med tolerance, amount of riba, med compliance and a few others I'd talk to the doc about a number less than 48. Extending 24 weeks seems like a significicant penalty for a geno 2 clearing at week 6.
Scruples, I sent you a private message.
CS, am I understanding you correctly that all studies backing up non-pegylated interferon say to go 48 weeks? What are the guidelines today for non-pegylated interferon and geno 3s?
Scruples, I am not that knowledgeable about non-pegylated interferon, except that the SVR rates are lower, so just the fact that you are on that is a reason to try to talk your doc into 48 weeks I presume. Unless there is a chance to retreat with pegylated interferon if you relapse. Is that not a possibility in your country?
CS, am I understanding you correctly that all studies backing up non-pegylated interferon say to go 48 weeks? What are the guidelines today for non-pegylated interferon and geno 3s?
Scruples, I am not that knowledgeable about non-pegylated interferon, except that the SVR rates are lower, so just the fact that you are on that is a reason to try to talk your doc into 48 weeks I presume. Unless there is a chance to retreat with pegylated interferon if you relapse. Is that not a possibility in your country?
As far as i know 24 weeks came about because of the Pegasys registration trial.
Until then we all did 48 weeks.
If they are treating you with 24 weeks with NPIA they dont have a study to back it up with that I am aware of. Which is not to say i think non Peg is necessarily inferior to Peg. You just have to stab yourself more often.
TIW is definately inferior to either Daily non peg or Peg IFN.
Doesnt matter in a way cause if you are not UND by week 4 you should be doing 48 weeks.
So should i take a chance and let it finsihed on 24 weeks ( 6 months)
You could do this and hope it works.
If you relapse then treat again for 48 weeks with either daily non Peg or PegIFN.
or volunterily go for 48 weeks ????
Thats your other option assume you were not UND at 4 weeks.
are there any indicators which guide me for this decision???
Not really Only the 4 week PCR test.
CS
Until then we all did 48 weeks.
If they are treating you with 24 weeks with NPIA they dont have a study to back it up with that I am aware of. Which is not to say i think non Peg is necessarily inferior to Peg. You just have to stab yourself more often.
TIW is definately inferior to either Daily non peg or Peg IFN.
Doesnt matter in a way cause if you are not UND by week 4 you should be doing 48 weeks.
So should i take a chance and let it finsihed on 24 weeks ( 6 months)
You could do this and hope it works.
If you relapse then treat again for 48 weeks with either daily non Peg or PegIFN.
or volunterily go for 48 weeks ????
Thats your other option assume you were not UND at 4 weeks.
are there any indicators which guide me for this decision???
Not really Only the 4 week PCR test.
CS
I didnt think Non Peg IFN had been studied with 24 weeks. Thought you just got 48. Might be different with Infergen.
----------------------------------------------------------------------------------------------------------------------
you made me confused as according to my knowledge the tx recomended all over the world for Geno 2 & 3 is of 24 weeks (6 months) and not the 48 weeks whether its Peg-interferone or simple interferone.
I agree UND at 16 weeks doesnt tell anything exactly. I am also annoyed why my doc recomeded PCR at 16 weeks but at this stage i can't do anything to fix this .
So should i take a chance and let it finsihed on 24 weeks ( 6 months) or volunterily go for 48 weeks ???? are there any indicators which guide me for this decision???
----------------------------------------------------------------------------------------------------------------------
you made me confused as according to my knowledge the tx recomended all over the world for Geno 2 & 3 is of 24 weeks (6 months) and not the 48 weeks whether its Peg-interferone or simple interferone.
I agree UND at 16 weeks doesnt tell anything exactly. I am also annoyed why my doc recomeded PCR at 16 weeks but at this stage i can't do anything to fix this .
So should i take a chance and let it finsihed on 24 weeks ( 6 months) or volunterily go for 48 weeks ???? are there any indicators which guide me for this decision???
I didnt think Non Peg IFN had been studied with 24 weeks.
Thought you just got 48. Might be different with Infergen.
in any case unless you are UND at 4 weeks you probably should be doing 48 weeks anyway.
Not sure where that leaves you, as you did'nt get the 4 week test until week 16.
Your LVL is a good start but you still need to respond to the drugs.
And you dont know how well you responded. Und at Week 16 tells you nothing.
I'd be trying to talk your doc into 48 weeks.
CS
Thought you just got 48. Might be different with Infergen.
in any case unless you are UND at 4 weeks you probably should be doing 48 weeks anyway.
Not sure where that leaves you, as you did'nt get the 4 week test until week 16.
Your LVL is a good start but you still need to respond to the drugs.
And you dont know how well you responded. Und at Week 16 tells you nothing.
I'd be trying to talk your doc into 48 weeks.
CS
also forget to mention that i was first dx in 2001 and started tx in 2008. My VL at the start of tx (2008) was 262,000 iu/ml
I am Geno 3, I have completed 21 weeks of tx . My doc advised me at the start of tx that it will go for 24 weeks . My VL at the start of tx was 262,000 iu which according to my doc can be considered as low and my biopsy & ultrasound reflected no signifiacnt demage to liver. . After starting tx , my first PCR (qualitative) was done after 16 weeks which shows UND. I dont know whats the reason to do first PCR after 16 weeks, may be because i am on standard interferone ( non pegylated interferone) and 1200mg Riba per day. My weight at the start of tx was 83kg. My ALT is in 40's and never gone over 63 ( normal value is 10-43)
I am not very much down with sx and my sx are quite manageable except hair thinng which started in full swing from week 19th of tx and still continues, other than that i can easily tolerate sx like fatigue, chill, indigestion.
whats your advice, whether i should go for extended tx for 48 months or follow my doc's opinion who still says that he thinks 24 months are sufficient.
I am not very much down with sx and my sx are quite manageable except hair thinng which started in full swing from week 19th of tx and still continues, other than that i can easily tolerate sx like fatigue, chill, indigestion.
whats your advice, whether i should go for extended tx for 48 months or follow my doc's opinion who still says that he thinks 24 months are sufficient.
No question about it then. With a viral load of 3000 at week 4, you need to extend. That is my firm opinion.
Are you on weight based interferon and ribavirin? If you want to, give me your doses and your weight and I will help you calculate this.
I totally agree with zazza - I'm a G3 previous non responder who was UND at 4 weeks, rebounded again at week 8, was UND again at week 12 and I am going for 48 weeks and I'm happy about it. I actually requested the extension after reading about all the relapsers on this site who had only done 24 weeks. Believe it or not, the time really does go quickly...
All the best!
All the best!
This is excellent advice. You should listen to your NP. I don't think there is anyone on the forum with geno 2 who has extended treatment, but Comeagain and Jools are geno 3s who have done that. Jools had a viral load of 2000 IU/ml at week 4, was UND by week 12, and just recently got her SVR (cured) after doing 48 weeks.
If you are detectable at week 4 as a geno 2 or 3, your odds of SVR drop to 50% if you only do 24 weeks. Studies are being done at present to confirm if 48 weeks help these patients. In your situation I would do 48 weeks without hesitation. I have seen geno 3s detectable at week 4 relapse after doing only 24 weeks. Make sure this does not happen to you. If you do 48, you know you will have done everything in your power, and I bet it will give you an SVR.
If you are detectable at week 4 as a geno 2 or 3, your odds of SVR drop to 50% if you only do 24 weeks. Studies are being done at present to confirm if 48 weeks help these patients. In your situation I would do 48 weeks without hesitation. I have seen geno 3s detectable at week 4 relapse after doing only 24 weeks. Make sure this does not happen to you. If you do 48, you know you will have done everything in your power, and I bet it will give you an SVR.
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.
