Aa
Husbands rx
Is anyone taking Peginterferon injection and Ribavirin? My husband is 66 and is in his 10th week. I have never seen him like this he sleeps all of the time, itchy, burning bowel movements and complains of stomach pain. He normally works 10 to 12 hours a day. He is very fit. I am worried his white blood cell count is low 2.5 and his PLT is 103. He has no idea how he was infected. He went in for his yearly physical and we received a call telling us that he had Hep C he did not know he was tested for it. His Dr sent him to an infectious disease Dr and here we are. He wonders if he made the right decision to take the treatment. I was tested and I do not have the virus.
It's like waking up in a whole new world when you or someone you love is diagnosed. Everything is a little chaotic. I'm so sorry to hear that you are going through this. We've all been there and you can see by the responses that the treatment is do-able. There will be an end to it. Hopefully with NO virus!
Stay tuned in to the forum for support and guidance. It's great that he has you to care for him. Take care of you too!
xoxo Karen:)
Stay tuned in to the forum for support and guidance. It's great that he has you to care for him. Take care of you too!
xoxo Karen:)
"Many Hepas and knowlegable Gastros it seems feel that because geno type 3 having approx 75-80% chance of succesful therapy doing the combo INF/ Riba (without the worry of ressistance to one of the newer drugs used for geno type1) then a biopsy is often felt to be a mute point."
Very true, my doc said because Im a geno 3 I could do without a biopsy. I did have the FibroSure though.
Very true, my doc said because Im a geno 3 I could do without a biopsy. I did have the FibroSure though.
I am also a genotype 3 and did 28 weeks of treatment with an Infectious Disease Specialist. Many have experience in treating HCV while others do not. It sounds like yours does.
Here's an excerpt from "Hepatitis and Liver Disease" by: Dr. Melissa Palmer
"During the course of their two years of training in infectious diseases, some infectious disease specialist have little exposure to patients with viral hepatitis. On the other hand, some infectious disease specialists receive a great deal of exposure to patients with viral hepatitis during the course of there specialty training. Thus, the level of expertise among infectious disease specialist in diagnosing and treating viral hepatitis varies greatly."
My infectious disease doctor did not know how to treat HCV however he was very open to suggestions and I would print out info I pulled from this forum and that guided me through treatment. It sounds like your ID doc understands the protocol as he had a 4 week viral load check.
'They did his 4 week viral load check and we get the answer next week.'
That's good, please let us know the results.
I asked you about the stage of his liver and if he was undetectable at 4 weeks because it can help predict his treatment response. Lets say your husband had a high baseline viral load(>400,000), some level of fibrosis, did not RVR (undetectable at 4 weeks) and factor his age in as well, then his chances of having a sustained virological response would be significantly lower than that if we had positive features in his favor.
You said your husband wonders if he made the right decision to treat. Well, in my opinion the "right decision" is based on every individuals personal circumstances. I know very little about cirrhosis and whether waiting to treat would negatively effect that in the case your husbands liver is in bad shape. The above poster said whatever liver damage he has will "cease" if treatment is successful.
Its important to know as much as you can about HCV treatment so your husband can actively participate in his treatment and make informed decisions in the event something doesn't sound or feel right. Obviously your husband is almost half way through treatment so hes in it for the long haul, but I will post some info below so you understand a little more in regards to treatment response indicators. Every genotype is different.
"A recent study suggests that patients infected with genotype 3 who have cirrhosis are 10 times more likely to relapse following treatment with conventional or peginterferon plus RBV than those without cirrhosis [57], a finding consistent with the results from the trial by Hadziyannis et al. and described below. If data from cirrhotic patients infected with HCV genotype 1 are extrapolated to those with other genotypes, it is likely that longer treatment duration may be beneficial in reducing relapse in genotype 2 and 3 patients with cirrhosis. However, this remains to be established in prospective clinical studies."
Optimizing response by reducing relapse rates in patients with HCV genotypes 2 and 3
There is evidence that patients with HCV genotype 2 or 3 and higher baseline viral load have lower rates of SVR and higher relapse rates after 24 weeks of treatment than those with lower HCV RNA baseline levels [55], and that, in patients without RVR, the lowest rates of relapse are obtained with 48 weeks of treatment and a higher RBV dose [11]. Whether increasing treatment duration would help reduce relapse rates in patients with high baseline viral load requires further evaluation.
Although patients with genotypes 2 and 3 are generally considered to respond similarly to treatment, there is also some evidence to suggest that genotype 3 patients have lower SVR rates and subsequently higher relapse rates than genotype 2 patients [32]. An analysis of data from the WIN-R trial of peginterferon alfa-2b also demonstrated higher SVR rates and lower relapse rates in genotype 2 infected patients compared with genotype 3 (72%vs 63%, and 5%vs 10%, respectively) [56]. It is possible that genotype 3-infected patients would benefit from longer treatment duration and/or higher RBV dose compared with genotype 2-infected patients; however current data supporting this comes predominantly from retrospective analyses and requires evaluation in prospective clinical trials.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2759987/
Here's an excerpt from "Hepatitis and Liver Disease" by: Dr. Melissa Palmer
"During the course of their two years of training in infectious diseases, some infectious disease specialist have little exposure to patients with viral hepatitis. On the other hand, some infectious disease specialists receive a great deal of exposure to patients with viral hepatitis during the course of there specialty training. Thus, the level of expertise among infectious disease specialist in diagnosing and treating viral hepatitis varies greatly."
My infectious disease doctor did not know how to treat HCV however he was very open to suggestions and I would print out info I pulled from this forum and that guided me through treatment. It sounds like your ID doc understands the protocol as he had a 4 week viral load check.
'They did his 4 week viral load check and we get the answer next week.'
That's good, please let us know the results.
I asked you about the stage of his liver and if he was undetectable at 4 weeks because it can help predict his treatment response. Lets say your husband had a high baseline viral load(>400,000), some level of fibrosis, did not RVR (undetectable at 4 weeks) and factor his age in as well, then his chances of having a sustained virological response would be significantly lower than that if we had positive features in his favor.
You said your husband wonders if he made the right decision to treat. Well, in my opinion the "right decision" is based on every individuals personal circumstances. I know very little about cirrhosis and whether waiting to treat would negatively effect that in the case your husbands liver is in bad shape. The above poster said whatever liver damage he has will "cease" if treatment is successful.
Its important to know as much as you can about HCV treatment so your husband can actively participate in his treatment and make informed decisions in the event something doesn't sound or feel right. Obviously your husband is almost half way through treatment so hes in it for the long haul, but I will post some info below so you understand a little more in regards to treatment response indicators. Every genotype is different.
"A recent study suggests that patients infected with genotype 3 who have cirrhosis are 10 times more likely to relapse following treatment with conventional or peginterferon plus RBV than those without cirrhosis [57], a finding consistent with the results from the trial by Hadziyannis et al. and described below. If data from cirrhotic patients infected with HCV genotype 1 are extrapolated to those with other genotypes, it is likely that longer treatment duration may be beneficial in reducing relapse in genotype 2 and 3 patients with cirrhosis. However, this remains to be established in prospective clinical studies."
Optimizing response by reducing relapse rates in patients with HCV genotypes 2 and 3
There is evidence that patients with HCV genotype 2 or 3 and higher baseline viral load have lower rates of SVR and higher relapse rates after 24 weeks of treatment than those with lower HCV RNA baseline levels [55], and that, in patients without RVR, the lowest rates of relapse are obtained with 48 weeks of treatment and a higher RBV dose [11]. Whether increasing treatment duration would help reduce relapse rates in patients with high baseline viral load requires further evaluation.
Although patients with genotypes 2 and 3 are generally considered to respond similarly to treatment, there is also some evidence to suggest that genotype 3 patients have lower SVR rates and subsequently higher relapse rates than genotype 2 patients [32]. An analysis of data from the WIN-R trial of peginterferon alfa-2b also demonstrated higher SVR rates and lower relapse rates in genotype 2 infected patients compared with genotype 3 (72%vs 63%, and 5%vs 10%, respectively) [56]. It is possible that genotype 3-infected patients would benefit from longer treatment duration and/or higher RBV dose compared with genotype 2-infected patients; however current data supporting this comes predominantly from retrospective analyses and requires evaluation in prospective clinical trials.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2759987/
Yes ..a biopsy regarless of rare complications is an invasive procedure.
.
Many Hepas and knowlegable Gastros it seems feel that because geno type 3 having approx 75-80% chance of succesful therapy doing the combo INF/ Riba (without the worry of ressistance to one of the newer drugs used for geno type1) then a biopsy is often felt to be a mute point.
Good luck with your tx..
Will
.
Many Hepas and knowlegable Gastros it seems feel that because geno type 3 having approx 75-80% chance of succesful therapy doing the combo INF/ Riba (without the worry of ressistance to one of the newer drugs used for geno type1) then a biopsy is often felt to be a mute point.
Good luck with your tx..
Will
willbb,
thank you for this link
Being a 3a, 55 years old, infected with the virus, detected in '96.
I did not understand why my Hep C specialist went right to treatment with out biopsy. This info has helped my understand his decision.
Of course I did not achieve RVR, but at week twelve I was UND and have been ever since. But now were in to the 30 week of tx.
As far as sx, I am a poster child. And yet somehow everyday the goal out weights the cost.
Best wish's jlsen5, for me the only insight I may have, remain aware of what his body is saying, and address those issues has they appear.
thank you for this link
Being a 3a, 55 years old, infected with the virus, detected in '96.
I did not understand why my Hep C specialist went right to treatment with out biopsy. This info has helped my understand his decision.
Of course I did not achieve RVR, but at week twelve I was UND and have been ever since. But now were in to the 30 week of tx.
As far as sx, I am a poster child. And yet somehow everyday the goal out weights the cost.
Best wish's jlsen5, for me the only insight I may have, remain aware of what his body is saying, and address those issues has they appear.
The normal tx plan for Geno 3 is 24 weeks as your doctor has advised and the lack of having a biopsy is a mute point at this stage as whatever liver damage (fibrosis) he has will cease due to HCV if his therapy is succesful.
Many patients are treated by "infectios disease doctors " and as long as he has good experience and follows porper protocols ,that should not be a problem
Also "yes" Interferon" can often cause tiredness and flu like symptoms ,however side effects are variable in all individuals.
Something you may be intersested in on Geno type 3.
http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02715.x/full
best..
Will
Many patients are treated by "infectios disease doctors " and as long as he has good experience and follows porper protocols ,that should not be a problem
Also "yes" Interferon" can often cause tiredness and flu like symptoms ,however side effects are variable in all individuals.
Something you may be intersested in on Geno type 3.
http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02715.x/full
best..
Will
His genotype is 3 and his treatment plan is 24 weeks. He never had a liver biopsy. Our local gastroenterologist do not treat Hepatitis C they send you to the Infectious Disease Doctor. They did his 4 week viral load check and we get the answer next week. Is sleeping all of the time a side effect of the treatment?
Be sure he stays on his treatments and listens to his doctors to the tee. This is a very hard program but its his best chance. Best of luck John
Hi and welcome
"I am worried his white blood cell count is low 2.5"
Thats actually not that low at all and will possibly dip even lower as treatment goes on. While I treated mine got as low as 1.7
How long is your husband treating for? 24 or 48 weeks? What genotype does he have?
Infectious Disease doctors are ok but many on this forum have either Gastroenterologist or Hepatologist treating them.
Has your husband had a biopsy and if so what is the status of his liver?
There are many side effects of treatment as Im sure your aware of. I had all that you name minus the stomach pain. I did however have sever joint pain. It varies.
Has he had his 4 week viral load check and if so was he undetectable yet?
A little more info would be helpful.
"I am worried his white blood cell count is low 2.5"
Thats actually not that low at all and will possibly dip even lower as treatment goes on. While I treated mine got as low as 1.7
How long is your husband treating for? 24 or 48 weeks? What genotype does he have?
Infectious Disease doctors are ok but many on this forum have either Gastroenterologist or Hepatologist treating them.
Has your husband had a biopsy and if so what is the status of his liver?
There are many side effects of treatment as Im sure your aware of. I had all that you name minus the stomach pain. I did however have sever joint pain. It varies.
Has he had his 4 week viral load check and if so was he undetectable yet?
A little more info would be helpful.
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