genotype 3a better with pegintron?

[Duke3d]

Went for my pre-treatmet visit with the hepatologist.

He said he was putting me on pegintron as it was better for 3A's.

I said well I would do whatever was better but have heard many say the side effects are worse.

He immedately says well you can do Pegasys if you want. I says well if the Pegintrom is better I can do it but he immediately says I can do the Peggasys.

I would have like to have some real info regarding his first statement but he gave no numbers, statistics or studies info.
Has anyone else heard  or read anything that says 3A's are better on Pegintron?

The he tell sme I will be on 800 of ribavirin. I express some concens that I will be underdosed, as I would take 1000 if he did weight based. Given that I have seen a lot of info that indicated weight based is better and that especailly for Genotype 3A's with high viral load and my age of 55. Especailly since I want to achieve RVR if possible so that I am looking at only 24 weeks. He immediately says well fine you can do the weight based if you want but given that you are a 3a and a stage 0/1 he says he is sure I will RVR and do well in any case.

I am glad he is so agreeable but a bit taken aback by his lack of usign weight based in the first place. Given that he is the cheif of hepatology at a major hospital. As to the Pegasys switch, I wished he had given me more info rther than just changing and not telling me what supported his first choise of the Pegintron.

Also I think he is a bit over confident on my results but hope he is right. I know they don't see a lot of 3A's here but am also sure given the size of the hospital that they have had others.

Ideas or opinions anyone?

Gai

[Marcia2202]

I do not think that there is any scientific back-up for his statement that Pegintron works better on G3, than Pegasys. I think his statement bullocks...

I would definitely go for weight based. Do not settle for anything less.

I did weight based and did not RVR and had to extend to 32 weeks. 4 weeks post EOT I still test UND.

There is nothing that makes it sure to RVR, even a geno 2...

[epiphiny]

I cannot answer the peg question you have but I can definitely say you MUST insist on weight based riba dosing.  

I am/was G3a and on my first treatment I was given the standard 800 riba.  I didn't RVR, and I never went UND in my 24 weeks of tx.

2nd time round I was weight dosed (1200) and treated for 48 weeks. I did RVR, have been UND since and I'm a week a way from getting my 4 week post tx VL test.

In the words of my current hepatologist, who is world renowned and involved in HCV studies and gives presentations at all the International Liver Conferences" MORE RIBA IS BETTER" so long as your hemoglobin can handle it.  And if your hb levels go too low then there are rescue drugs to help keep your hb in safe range.

After my first tx I was considered a null-responder however to this day I would dispute that and will always wonder whether I was really under-dosed.  

Falling hemoglobin levels are a good indicator of your body responding to the riba, and during my first tx my hb was always 'good'.  2nd time round they were always low.

For a long time G3 was considered "easy" to treat and a one size fits all approach was used.  Now doctors are finding that some 3a are in fact somwhere in between G1 & G4 for difficulty of treating and most of the older studies have always included the G3 SVR percentage rates with the G2.  Don't be fooled by those figures!

Later studies are disproving this for a variety of reasons and most doctors who keep up with current studies are tailoring treatment for the individual.

Please insist on weight based, ask him all the questions you have and if you still don't feel confident with this doc seek a second opinion.  It's your life and health and you really don't want to have to come back a second time as I did.

All the best to you.

Epi.

[comeagain]

Im a geno 3 dont know the letter.

Have the same biopsy as you grade 1 stage 0 had pegintron 100mcg and 800mg riba first tx was UND at week12 and EOT but relapsed.

My weight was 89 kilo almost 200lbs at start both treatments.

Have now done 48weeks with pegasys 180mcg and 1200mg riba this second treatment  will know in some weeks if I made it or not.

Its looking promissing though due to  alt tests made 4 weeks and 12 weeks post.

Im also the same age as you 55 years old

You can post question to our doc here at forum for a small fee.

His name is Dr Dieterish not only is he a well known specialist he has also treated twice him self and cleared.

ca