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5979406 tn?1378064701

Genotype 3 anyone?

I have been looking for posts that might discuss or identify folks with type 3. I was recently diagnosed with that but have not seen anything here about this type. Thanks for reading.
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5979406 tn?1378064701
Timothy,

I was wanting to accept your invitation but cannot find the invite. Can you re-invite? Thanks, Lili
I am new here and not up on how to get around the site etc.
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5979406 tn?1378064701
JDB,
I am in NC waiting for Duke to confirm my referral appointment up there in Durham and hoping for a clinical trial. Send me what you can. BTW, I see you have geno 3a. I only know I am geno 3 and don't know about a or b... Hoping to hear from you soon.
Lili
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1644356 tn?1349783211
I was geno 3a. and attained a cure with a clinical trial in winston Salem . Are you in NC? Message me and I will  send you the information.  do not despair, learn all you can and know that we ARE NOT defined by a disease !
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4113881 tn?1415850276
I'm a genotype 3a as well who did 28 weeks of Pegasys and Riba. I agree with desrt and shyrl about the IL28-B genotype test. Sofosbuvir and Ribavirin have only shown a 61% response rate for G'3s as posted above. If you get the test and have the favorable IL28B genotype CC, then the current SOC may be a better option if you can  tolerate the treatment.

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148588 tn?1465778809
See if you can get the IL28B genetic test and a fibrosure panel while you're at Duke. Even if you have to pay for these yourself, it's information I would want before I decided how and when to treat.
Welcome to the forum.

desrt
(former g3)
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4705307 tn?1447970322
  I am a GT3a, and am currently in my 40th week of a 48 week treatment protocol.interferon-alfa2a 180 mcg ( Pegasys ) weekly & Ribavirin  800 mg ( Copegus ) a day.
  Welcome to the MedHelp, this is a great forum, there a few of us GT3's here, it seems not many, we seem to to stay in the background.  a lot of insightful people with a lot of information,
  I would only encourage to not let it become overwhelming.
  Speak to your Dr.'s about your status, if possible go with the the new meds!!! There has been great progress in ridding yourself of this virus without subjecting yourself to the possibility of the side effects many have suffered, I wish I would have waited for them.  
  Best wishes,
Tim
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5720485 tn?1373563055
Hi Lilli,
I have copied you an article that references current standard of care (SOC) for genotype 3.  

New treatment trials so far are not as effective as current SOC, depending on IL28b ellele.  CC ellele are easier to treat, so if you could find out if you have the more favorable gene pattern you may prefer to treat on current SOC or wait if CT or TT ellele as then new treatments coming are similarly effective.
(See previous articles posted)
I hope this helps.

http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02715.x/full

Genotype 3 is a common type of HCV infection, and standard therapy using pegylated interferon (PEG-IFN) and ribavirin (RBV) is quite effective in these patients. While a short course of 16 weeks may result in comparable end of therapy responses, relapse rates are often high. A 24-week course is therefore preferable, and is expected to result in sustained virological response (SVR) rates of more than 70%. The 24-week course is especially recommended in the presence of steatosis (often associated with Genotype 3 infection), fibrosis stage two or more, high BMI and high viral load. In patients who do not achieve a rapid viral response (RVR) with combination therapy, an extended course up to 48 weeks should be considered. While not as definite as for genotype 1 patients, the presence of the CC variant of IL28b could help in the initial prognosis and the need for additional treatment, if an RVR is not achieved. The role of directly acting antiviral agents (DAA) has not been fully evaluated in treatment naïve, non-responders and relapsers in genotype 3 patients. Initial results with the cyclophilin inhibitor Debio-025 are quite encouraging. There is an urgent need for large clinical trials using DAA and host modulators in patients with G3 infection.

Present treatment for hepatitis C genotype 3
According to the recent AASLD guidelines [15], PEG-IFN α-2b (1.5 μg/kg/week) plus RBV (800–1400 mg/day) or PEG-IFN α-2a (180 μg/week) plus RBV (800 mg/day) for 24 weeks are the established SOC regimens for patients with chronic hepatitis C genotype 2 or 3. However, optimal administration of PEG-IFN/RBV, in particular, the duration and the dosage have still not been clearly established in relation to outcome in rapid and slow responders. Based on the concept of ‘response guided treatment,’a recent meta-analysis evaluated the issue of decreasing the duration of treatment to improve tolerance and cost effectiveness, and most importantly to decrease viral resistance to the standard bitherapy [16]. Treatment with PEG-IFN and weight-based RBV for 16 weeks in patients a with rapid virological response (RVR) resulted in an SVR of 76.3% and 86.4% with 24 weeks of treatment, unlike genotype 2 which was 83.8% and 89.3% respectively. This was because of increased relapse rates in patients with genotype 3. Manns et al. [17] showed that the relapse rate was 26% after 16 weeks of treatment and 18% after 24 weeks in genotype 3 patients. The increased relapse rates could be because of steatosis, and as already mentioned, the increased rate of fibrosis in thes patients. In a cohort of 932 treatment-naïve patients, investigators of the ACHIEVE-2/3 trial [18] showed that hepatic steatosis significantly increases the risk of relapse independent of HCV RNA levels in patients with genotype 3 who achieve an RVR with IFN-based regimens. This may be because of altered IFN-α signalling, increased intrahepatic RNA levels or increased quasispecies diversity. Other known risk factors for relapse are male gender, black race, age over > 40, increased viral load, presence of fibrosis, body weight > 85 kgs and presence of diabetes mellitus.
Helpful - 0
446474 tn?1446347682
You don't have to enter a trial to treat your hepatitis C without peg-interferon. In early 2014 there should be new treatment available for persons infected with genotypes 2 and 3. Gilead's treatment will consist of only Sofosbuvir and Ribavirin. All oral treatment. Side effects are minimal and treatment duration is for only 12 weeks as compared to current 24 week treatment with peg-interferon and ribavirin.


"After three months of combined therapy with sofosbuvir and the antiviral drug ribavirin, the patient response rate for those with genotype 2 was 93 percent, and 61 percent in patients with genotype 3.

This new study is one of several testing new hepatitis C drugs that were published April 23 in an online edition of NEJM. The journal publication coincides with the International Liver Congress 2013 in Amsterdam, the Netherlands, where the results also will be presented.

"The new sofosbuvir therapy offers a much-needed alternative to standard therapy with interferon, which can cause significant side effects for hepatitis C patients," says the study's lead investigator, Dr. Ira Jacobson, chief of the Division of Gastroenterology and Hepatology and Vincent Astor Distinguished Professor of Medicine at Weill Cornell Medical College.

"We have dreamed for years of being able to eliminate interferon from our hepatitis C regimens and this study is one of several that are finally bringing us very close to realizing that goal," says Dr. Jacobson, who is also a gastroenterologist at the Center for Advanced Digestive Care at New York-Presbyterian Hospital/Weill Cornell Medical Center and medical director of the Center for the Study of Hepatitis C, a collaboration between Weill Cornell, NewYork-Presbyterian/Weill Cornell and The Rockefeller University.

The 207 patients enrolled in the clinical trial, known as POSITRON, either did not respond to interferon, could not tolerate it or were unwilling to use it, despite the fact that there were no other treatment options available to them.

"This new treatment represents a paradigm shift in the way that hepatitis C is going to be treated," says Dr. Jacobson. "We are achieving the same or higher cure rates in many patients with sofosbuvir, compared to interferon, and we are doing it in half the time with a drug that has a remarkable safety profile."

Dr. Jacobson estimates that up to half of patients with hepatitis C infection either can't use interferon or don't want to use it. "Sofosbuvir is an extremely promising treatment for this population. It is widely hoped that combinations of potent antiviral drugs will eventually replace the use of interferon, in general, for most hepatitis C patients."

The drug sofosbuvir works by interfering with the ability of the hepatitis C virus to replicate. The drug also confers a high barrier to developing the complication of drug resistance. The U.S. Food and Drug Administration (FDA) has not yet approved sofosbuvir. However, results of the four clinical trials published in the NEJM were used to support the regulatory filing submitted to the FDA by the drug's developer, Gilead Sciences, Inc.


If you don't have insurance you can sign up with your state's health exchange which will be managed by the Federal government because state government decided not to set up their own exchange starting October 1st. The health insurance that will become active starting Jan. 1, 2014.

"The North Carolina health insurance exchange will be operated through a federally-run health insurance exchange, called the Health Insurance Marketplace. According to healthcare.gov, starting in October 2013 North Carolina residents will be able to access information about all the plans available through the Exchange. The SHOP Exchange will also be available to small businesses with 100 or fewer employers. Coverage from the Exchange starts in January 2014.

According to an estimate by healthcare.gov, 1,346,601 or 17% of North Carolina’s non-elderly residents are uninsured, of whom 1,252,882 (93%) may qualify for either tax credits to purchase coverage in the Marketplace or for Medicaid if North Carolina participates in the Medicaid expansion."

Good luck.
Hector
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Avatar universal
Hi I was Geno3 I did Rib and peg for 24 weeks in Jan.2012 thro June29 2012 My first blood work was 4 weeks into treatment it was Und. I stayed UND throughout. My Dr did not do a liver Biopsy but my viral load at beginning of treatment was low and I was told very low compared to some. Best I remember it  was around 52,000. I had some hair loss and some minor side's but no pain and no flue symptoms. Just mostly fatigue and I did  not want food it tasted real bad. I lost 32 lbs. during treatment but I am back to normal now. I  got SVR  and Thank God I pray it never return . I had to pay for my treatment and I sure hope you get help. with the meds they are so exp.
God Bless
bbj
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5979406 tn?1378064701
Nuhepper and Shyrl,

I went one vist to a gastro who refused tx unless I got a colonoscopy and other exams so I refused and got the referring clinic to get me a referral to Duke Med. Ctr. I guess I will be going up late Sept or Oct. and it would be grand if I could get into a trial. On their site (specific for gastro and liver) they give the idea that entering trials is commonplace.

I surely hope I can do that as I have no ins. and also the interferon and ribavirin is harsh.

I am busy reading the arts. recommended above and haven't a question yet this evening but I soon will.
I thank you for reading and it is wonderful the way we can all band together on this. I honesty would have remained in the dark pit of despair I was in the days between diagnosis and finding this community. I am very lucky in that.
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5720485 tn?1373563055
I learned a lot about Genotype 3 when I joined, in this thread:

http://www.medhelp.org/posts/Hepatitis-C/HCV-RNA-below-15-IU-ml-/show/1971985#post_9262485


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5720485 tn?1373563055
Welcome Lilli,  I'm a G3.  Just passed halfway of 24 weeks.
Shyrl
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Avatar universal
Hi,

Welcome to this forum.  I am a Genom 3a too!  There are a few of us here.  Pooh gave you some good links to start with and there are some very helpful people here with G3.  Some have succeeded to SVR, but they still visit and try to help us people that are taking the treatment to find answers and info and to be supportive.  

If you input Gen 3 into the search box at the top of the page you can go through some of the previous blogs and begin to get some familiarity with the experiences that others have had.

Do you know when or if you will begin treatment?  Even that decision can be a dilemma because if your liver is not damaged very much, you may want to hold off for a while because they are working on cures that are far less harsh than the only one cure for G3's right now.  

Do you have any specific questions at this time?

nuhepper



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5979406 tn?1378064701
Thanks, pooh! Will do.
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1815939 tn?1377991799
There are several people on the forum who have Genotype 3. I am sure some of them will respond to your post soon. In the meantime, here are some links to some articles about Genotype 3.

http://depts.washington.edu/hepstudy/hepC/mgmt/gt23/discussion.html

and another:

http://hepatitiscnewdrugs.blogspot.com/2012/01/treatment-of-patients-with-genotype-3.html

And here is a link to several articles about Genotype 3. Just look at the titles and click on the articles you would like to read.

http://www.hepatitiscnewdrugresearch.com/genotype-3hcv-treatment.html

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