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Incivek triple drug treantment
Should I continue treatment? After 16 weeks of treatment (i completed 12 weeks of Incivek 4 weeks back). My Hep C is still detecable, but to low to measusre. My doctor states the "drug rep" want me to go 8 more weeks and retest, if no change to stop at that point. My doctor does admit that the odds of change now are low. I've had a problem with low blood platelets after starting treatment. At one point very low, to 1000. By cutting back on interferon to 135mcg, my platelet count stay at 1900 (doctor says still to low but liveable, if i don't get a head injury). As I understand it my platelet count was not up to normal before any treatment, just not at the current levels and this is caused by an enlarged spline holding the platlets beacuse of diffculty of blood to flow through my damaged liver. About me I'm geno 1, I was diagnosed with Hep C before the medical field knew that it was (they called none A or B) over 20 years ago, i did interferon treatment 6.5 years ago and was a none responder. Finally on my last in office visit with my doctor, the doctor spent the majority of time talking to my wife about things i will need to do to monitor my Hep C for the rest of my life and the odds of me ever getting a liver transplant. Do i continue treatment or not??
Thank you for responding. i'm stage 4. i'm not seeking a liver transplant, the doctor thinks if i don't get this under control later in life that where i will be. the treatment i did was interferon, the doctor stopped me at the half way point because my viral count was still to high (it had dropped alot, but stopped)
Thank you, for the wishes. i have decided to go 8 more week to know and try. i'm sure the wants this to work. i will be his only failure to date.
THANK YOU for responding. i'll try to answer your question as best i can. I don't think anyone can really advise me on what i should do, because of my limited understanding of whats going on. i decide to continue for 8 more weeks, if i don't at this point i would never know and i can do it. Some days the treatment, the results and/or the disease really get to my metal state. By none responder, i mean to say i did a treatment with interferon, but was stop by the doctor half way through because viral count was still to high (it did drop alot). My platelet count are the number they tell me (and i'm sure they are refering to platelet count. they are always commenting that my white blood cell are good, but with platelet this low bleeding and internal bleed could cause me problem. especially if on the brain.I've see more blood that normal, but nothing like they are concerned about). my liver is stage 4, but no liver disease yet. they doctor just believes that where i;m going. my doctor has mentioned a hepatologist, but positive they would stop my treatment and he believe he can keep me going for another 8 weeks. lastly i'm still very active, work 60+ hours a week, travel for my company alot and try to rest on the weekend. i'm not done yet!
Should I continue treatment?
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* There are many factor involved. We do not know enough about your condition to say for sure. Since you have cirrhosis I think personally it is always worth a try but you must realize the odds are probably not very good for success. As long as you have realistic expectations and the treatment doesn’t make matters worse I prefer that to having to have a liver transplant which is something you want to avoid if at all possible.
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After 16 weeks of treatment (i completed 12 weeks of Incivek 4 weeks back). My Hep C is still detecable, but to low to measusre.
My doctor states the "drug rep" want me to go 8 more weeks and retest, if no change to stop at that point.
My doctor does admit that the odds of change now are low. I've had a problem with low blood platelets after starting treatment. At one point very low, to 1000. By cutting back on interferon to 135mcg, my platelet count stay at 1900 (doctor says still to low but liveable, if i don't get a head injury).
--------------------------------------------------------------------------------------
* Please post your correct platelet count numbers. The numbers in your post are not platelet count numbers. Platelets are measured in “per microliter” by the way.
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As I understand it my platelet count was not up to normal before any treatment, just not at the current levels and this is caused by an enlarged spline holding the platlets beacuse of diffculty of blood to flow through my damaged liver.
----------------------------------------------------------------------------------
* Yes, you have stage 4 liver disease. Commonly referred to as cirrhosis of the liver. Persons with cirrhosis have much less odds of treating successfully than persons with less advanced liver disease.
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About me I'm geno 1, I was diagnosed with Hep C before the medical field knew that it was (they called none A or B) over 20 years ago, i did interferon treatment 6.5 years ago and was a none responder.
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* What type of non-responder were you?
Partial responders -
are persons whose HCV RNA level dropped by at least 2 log IU/mL at treatment week 12 but in whom HCV RNA was still detected at treatment week 24
Null responders -
are persons whose HCV RNA level did not decline by at least 2 log IU/mL at treatment week 12
Depending on which one you were makes a big difference between your odds of treatment success.
------------------------------------------------------------------------------------------
Finally on my last in office visit with my doctor, the doctor spent the majority of time talking to my wife about things i will need to do to monitor my Hep C for the rest of my life and the odds of me ever getting a liver transplant. Do i continue treatment or not??
--------------------------------------------------------------------------------------
* We have too little information to say that you have no chance of SVR but the odds appear extremely low based on what you have said. Are you being treated at a transplant center by a hepatologist? If not your should be. There are the only doctors qualified to treat a patient with chronic HCV who has developed cirrhosis. Depending on how advance your cirrhosis is you should be thinking of getting listed for a liver transplant at least as a backup option should you need it. Newer treatments will be available in a few years but no one can predict how rapidity your cirrhosis will progress. You need all the expertise at a transplant center to present you with the best options available to you now with your current condition. Time can be critical. If your cirrhosis decompensates (if you start having complications of cirrhosis) you will not be able to treat your hepatitis and will need a transplant.
* I hope this helps answer some of your questions and point out what the important issues are for you currently.
Hector
---------------------------------------------------------------------------------
* There are many factor involved. We do not know enough about your condition to say for sure. Since you have cirrhosis I think personally it is always worth a try but you must realize the odds are probably not very good for success. As long as you have realistic expectations and the treatment doesn’t make matters worse I prefer that to having to have a liver transplant which is something you want to avoid if at all possible.
--------------------------------------------------------------------------------------------------------
After 16 weeks of treatment (i completed 12 weeks of Incivek 4 weeks back). My Hep C is still detecable, but to low to measusre.
My doctor states the "drug rep" want me to go 8 more weeks and retest, if no change to stop at that point.
My doctor does admit that the odds of change now are low. I've had a problem with low blood platelets after starting treatment. At one point very low, to 1000. By cutting back on interferon to 135mcg, my platelet count stay at 1900 (doctor says still to low but liveable, if i don't get a head injury).
--------------------------------------------------------------------------------------
* Please post your correct platelet count numbers. The numbers in your post are not platelet count numbers. Platelets are measured in “per microliter” by the way.
--------------------------------------------------------------------------------------
As I understand it my platelet count was not up to normal before any treatment, just not at the current levels and this is caused by an enlarged spline holding the platlets beacuse of diffculty of blood to flow through my damaged liver.
----------------------------------------------------------------------------------
* Yes, you have stage 4 liver disease. Commonly referred to as cirrhosis of the liver. Persons with cirrhosis have much less odds of treating successfully than persons with less advanced liver disease.
--------------------------------------------------------------------------------------
About me I'm geno 1, I was diagnosed with Hep C before the medical field knew that it was (they called none A or B) over 20 years ago, i did interferon treatment 6.5 years ago and was a none responder.
---------------------------------------------------------------------------------
* What type of non-responder were you?
Partial responders -
are persons whose HCV RNA level dropped by at least 2 log IU/mL at treatment week 12 but in whom HCV RNA was still detected at treatment week 24
Null responders -
are persons whose HCV RNA level did not decline by at least 2 log IU/mL at treatment week 12
Depending on which one you were makes a big difference between your odds of treatment success.
------------------------------------------------------------------------------------------
Finally on my last in office visit with my doctor, the doctor spent the majority of time talking to my wife about things i will need to do to monitor my Hep C for the rest of my life and the odds of me ever getting a liver transplant. Do i continue treatment or not??
--------------------------------------------------------------------------------------
* We have too little information to say that you have no chance of SVR but the odds appear extremely low based on what you have said. Are you being treated at a transplant center by a hepatologist? If not your should be. There are the only doctors qualified to treat a patient with chronic HCV who has developed cirrhosis. Depending on how advance your cirrhosis is you should be thinking of getting listed for a liver transplant at least as a backup option should you need it. Newer treatments will be available in a few years but no one can predict how rapidity your cirrhosis will progress. You need all the expertise at a transplant center to present you with the best options available to you now with your current condition. Time can be critical. If your cirrhosis decompensates (if you start having complications of cirrhosis) you will not be able to treat your hepatitis and will need a transplant.
* I hope this helps answer some of your questions and point out what the important issues are for you currently.
Hector
I would not continue treating. I would go by what your doctor said about your chances of clearing the virus are low (to zero) at this stage. The drug rep is a complete stranger who has nothing but a vested interest in your progress.
______________________________
Now on to your future:
-I'm not sure about some of the decisions your doctor has made but in honesty I don't know much about treatment options in advanced liver disease...if that is what your condition is
-What is all this about a transplant list?
-What stage of fibrosis are you in?
-You say you treated one but you were a nonresponder? Were you ever UND with the Incivek (sorry but I was unclear on that)
I would restore my health and explore these areas. There may be more promise than you have been led to believe.
It would be great if you could post with this info.
______________________________
Now on to your future:
-I'm not sure about some of the decisions your doctor has made but in honesty I don't know much about treatment options in advanced liver disease...if that is what your condition is
-What is all this about a transplant list?
-What stage of fibrosis are you in?
-You say you treated one but you were a nonresponder? Were you ever UND with the Incivek (sorry but I was unclear on that)
I would restore my health and explore these areas. There may be more promise than you have been led to believe.
It would be great if you could post with this info.
There is no way I would continue treatment because a drug rep wanted me to !
I'd quit, and take good care of my liver, no alcohol and lots of coffee.
If you have ESLD, there are more dietary restrictions that can help aid you.
The good news is a new interferon -free treatment currently in trail that should be available in a few years.
Best of luck,
OH
I'd quit, and take good care of my liver, no alcohol and lots of coffee.
If you have ESLD, there are more dietary restrictions that can help aid you.
The good news is a new interferon -free treatment currently in trail that should be available in a few years.
Best of luck,
OH
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