Where can I find more info on Geno 3a's

[tahoeunicorn]

Jim, Researcher please help me.. I am trying to find out what is going on in regards to Geno 3a research. As you know I am a non-responder, everything that I am finding is in regards to Geno's 1 and 2. can yall help me find the right spot to look in. I going crazy trying to find out any new info on the 3a research.

Thanks for your help

Lynn (tahoeunicorn)

[jmjm530]

Eating too little can lower your metabolism and be counter productive to weight loss. So can eating the wrong kinds of foods, especially too many carbs and not enough protein. You might want to check this diet out:http://www.southbeachdiet.com

[tahoeunicorn]

thanks so much for everyone's input. I do test my sugar at least once a month, Mother got Type II at about my age. I have noticed every month my sugar is going up. Last month it was 104, tonight it was 144. I know that I need to loose some weight, but I hardly ever eat as it is, and then it is usually vegetables. I am gonna check out some of theses sites that I haven't been to before..

Thanks a lot for the Support Everyone

Lynn

[meki]

Interesting at this place http://www.hivandhepatitis.com/hep_c/hepc_news_liver_steatosis.html

litterally the

www dot  hivandhepatitis  ******* and / and hep_c and / hepc_news_liver_steatosis dot html

TAKE out the ands and spaces (there are no spaces)...

It's very interesting information - follows exactly what you were saying CS.

Meki

[fretboard]

You can Google pubmed or you can go to http://clinicaloptions.com/hepatitis.aspx
The clinicaloptions site you will have to register for, but that "ain't no thang".  That was some street slang I learned years ago.  lol  God Bless

[meki]

Interesting.

So - that may be why on TX I had absolutely INCREDIBLE urges for Chocolate anything.

And I am NOT a sweets eater.

Diabetes does run in my family.

But during TX - I wanted fudgecicles every 5 seconds. Or anything with massive amounts of sugar in it. Strange though --- as soon as I was about 1 year POST TX --- I haven't had much desire for sugars... Now it's just in my tea or coffee --- and I drink a soda a day.... But other than that --- no real sweet tooth... Maybe a bowl of ice cream once every 2 weeks.... And candy bars stay in the candy dish now --- and I don't mow on desserts regularly either. Hmmmmmm.

I'm wondering then - if the steatosis - combined with INF / RIBA  (cause I took both) causes the pancreas to under or over react?

Which in turn allows the virus to continue to run rampant?

Or allows it more freedom to grow or stay hidden?

Kinda like - let's say ---- uhmmmm... marijuana consumption keeps THC in the fat cells right? So maybe the virus can stay inside the fatty tissues for longer periods --- and maybe the pancreas keeps that locked in, as well.

Hmmmmmmmmmmmmm - interesting.

By the way -  year post TX - I went from being morbidly obese (doctor's standards) to just overweight by 20 lbs. from 215 prior to TX --- 180 after TX and now down to 165/160 one year and a half post...

Could it be that the steatosis (possibly created or more prevalent due to G3) controlled the pancreas ---- causing more obesity --- and now that I've maintained SVR --- the pancreas is starting to function more properly and the steatosis is repairing itself? Therefore I am capable of losing weight and no longer have intense cravings for sugars or massive carbs?

I'm just thinking out loud here... So - if it follows logical thought --- cool --- if it doesn't sorry --- I'm just jig saw piecing the puzzle together for my own personal full picture - because a lot of things happened to my body and mind in the last 2 years. Or maybe for even a little bit longer.

I'm also wondering if steatosis or now that you mention it --- IR --- can be an indicator of SX...

Hmmmmmmmmmmm.

Yeah -- me too --- Glad I didn't know CS - cause I'll tell you what --- I'm just very freaking lucky....

And even luckier to have youse guys to clue me in... LOL

Meki

[desrt]

This is simply measuring your blood sugar after you haven't eaten for a period of time. Easily and quickly done at a doctor's office or at home. Not sure how it is affected by tx. I didn't start having problems and keeping track of this until after tx.

[comeagain]

Such test has not been performed, is there any ideea to do the test when on tx or must it be done when of tx?

[desrt]

What is your fasting blood glucose?

[comeagain]

I´m a g3 relapser no steatosis although a BMI of 28, when doing my bx
2 months before current tx.

What test shall I ask for in order to know if I´m insulin recistant.

ca

[BelB64]

You said you now don't look at genotypes 2/3 as easy to treat and G1/4 as difficult. I understand your thought but isn't it a fact that G2/3 react to treatment MUCH better than G1/4?  The fact that if a G1 is RVR at week 4 the chance of SVR is the same as for G2/3 misses the point. The reality is G2/3 folks must RVR at week 4 much more than G1/4 thus the difference in SVR for genotypes. Even if Genotype 3 is tougher to treat than 2, it' still statiscally much "easier" to get to SVR than it is for those with Genotype 1/4.  The study mentioned many times in medhelp comments that shows nearly everyone who gets cirrhosis get it around age 65 has one VERY interesting stat that shows genotype, especially for young women is important in fibrosis progression. Their conclusion states that for women infected before age 37 with "non-genotype 1" will get cirrhosis on average at age 89!!  This MUST mean Genotype 1 for at least women is more virulent than Genotypes 2 and 3.

[CockSparrow]

is it the fact that G3s are PRONE to Steatosis --- and/or Fibrosis that having Steatosis "MAY" be the problem for the Non-Response?

I used to think that but know i am not so sure
Insulin Resistanse and Steatosis are related. So is it Steatosis or IR that is the problem.

So yes i do think Steatosis is one of the reasons that blunt IFN but probably because of Insulin Resistance if that makes sense.

BTW i am glad you didnt know about the lower response rates for G3 slow responders.
In your case you didnt need to extend and as you were having a hard time of Tx not extending was a good thing.

CS

[lolitriqui]

very strong!!!!! glad i read your comment
C.

[meki]

ALSO --- is it the fact that G3s are PRONE to Steatosis --- and/or Fibrosis that having Steatosis "MAY" be the problem for the Non-Response?

I dunno if that made sense --- but if it did --- do you think that the Steatosis might be the one thing that is causing the INF/Riba to NOT work?

Or perhaps does it allow the virus to survive inside the liver?

Just a thought.

[meki]

"Funny how quite a few of us don’t seem to be that easy to treat, "

Dude - you don't know how greatful I am for your information --- and for just you being around.

I'm also glad I didn't know ahead of time that my slow response was an indicator of possible treatment failure. I'm thankful that I SVR'd but I know --- I must have been on the cusp.

One of the things that I TOTALLY believe is that G3s seem to deteriorate much faster - as far as bodily damage --- at least if what I've "listened" to other G3s comment on --- is truth.

I think the steatosis might be part of the issue --- and may be why - as I've lost weight recently because of stress -- that I feel tremendously better.

So what you say makes a lot of sense (as usual --- LOL!)

Anyhow - check ya later.

Y'all G3s hang in there - something WILL change ---- I have good thoughts on this!

Meki

[CockSparrow]

Same thing. hyperinsulinemia and Insulin resistance is the same more or less

[CoWriter]

"Insulin Resistance and the Oxidative stress that the virus causes. "

and the hyperinsulinemia...that's what cancels the effect of interferon.

[CockSparrow]

Lynn
Not much out there on retreating us easy to treat types is there. Gets a bit annoying actually.
Funny how quite a few of us don’t seem to be that easy to treat,
Vx-950 is being trialed in Europe on G3 Tx naives. But don’t know how much us Nrs can take out of that.

I’ve changed the way I think towards the genotypes and no longer see G3/G2 as easy to treat and G1/G4 as being difficult.
The reason being is that G1 RVRs don’t seem that hard to Tx to me.
G3 non responders aint that easy either.

G3s can have both viral and metabolic steatosis. I would not be at all surprised if this also occurs in G1s as there is definitely something viral with G1 Steatosis.
Viral steatosis will be undone if Tx is successful. Metabolic steatosis requires exercise and diet to be undone. Both types slow down the viral kinetics and would have to make us less likely to RVR and more prone to relapse. Steatosis had a lower svr rate in the Accelerate study.

I now look at what the virus does to us that makes us hard to treat rather than focusing on genotype. This crosses genotypes. Its only the Genotype percentages that differ.

Then look at which negs you have and see whether you can undo them. Genotype comes into this.
As does your previous response. Retreating relapsers is a lot easier than for true NRs.
Relapsers can hit it harder early and extend, add Alinia and the chances of success would be pretty good.

NRs need to see if they can undo some of the reasons for the poor IFN response.
The two things I consider most important in this are
Insulin Resistance and the Oxidative stress that the virus causes.
Oxidative stress can damage the Interferon Signaling pathways. This is one of the reasons why I think G1s are difficult to treat. Its also why I am taking HRs list of supps.
They also help with Insulin Resistance, especially Resveratrol and to a lesser extent ALA.

In other word I think you can beet it with the current drugs.
The newer ones aint going to do much for true NRs anyway.

All the Best
CS

[tahoeunicorn]

Thank all of you so very much. I am trying to get the fight back in me, somedays it is here some days it's not. I've kind of tried to forget, but it's not getting any better only making me feel worse, so
Now is the time for me to try to get on the horse again.

Epiphiny-- do you what week you were UND? or did they just do the 4 week?
this sounds like something that my GI said is in the pipeline. Time for me to give his PA a call and find out what is going on or in pipeline now.


Thanks All
Lynn

[epiphiny]

Oh, I forgot to mention the result of the trial was very encouraging; there were virtually no SX and I was UND after 4 weeks of 1500mgRO5024048 BD/180 Peg/1200Riba.  As this was a Phase One trial it was test tolerability and safety therefore I am not sure that the UND result will be able to be used as research data which is why I'm mentioning it here.

I have heard, and this is anecdotal ONLY, all the people on the trial with me that had RO5024048 were all UND at week 4.  I have also read about other folk who were on the same trial in different parts of the world that also achieved UND at 4 weeks.  Of course it is still too early to know the long term results but at this point I am still UND at week 18.

All the best in your search :)

[epiphiny]

I'm a Geno 3a previous non-responder to peg/riba and like you have struggled to find information about our re treatment options.  To be honest, there aren't many studies out there about us as the majority of the industry still seem to think G3 is 'easy' to treat.  It's only recently that it's becoming obvious that some of us are in the difficult to treat group.

So, I was fortunate enough to get enrolled on PI trial for G3 non-responders in May/June this year.  The trial was for Roche/Pharmasset study drug RO5024048.  I took part in a Phase One trial and the results have thus far been very positive, which means they will be doing more trials on it that you might be able to get onto.  The FDA has put a fast track on this drug as our group is starting to be seen as an area that is lacking in re treatment options.

As to re treatment; as there is so little study info out there I have somewhat hi-jacked my current treatment (taking part in the trial means the company is supplying me with 24 weeks of peg/riba) and convinced my doctor to extend tx to 48 weeks.  I pointed out that I felt as there was so little to go on and that all the study results that point to only 24 weeks treatment were for Geno 3 treatment-naive folk that I should be treated as per Geno 1. Miraculously he agreed, and I live in NZ where the tendency is treat conservatively as per SOC!!

I gleaned most of my info from this website and wrote my doctor a very detailed letter quoting what info I could find.

The point I'm trying to make is that I believe if you are a Geno 3 non-responder then you need to put quite a bit of effort into getting the info and then getting your doc onside.  From what I can see from this site it seems to be somewhat easier to do that in the States as you have more choices and more doctors that are into tailoring treatment for the individual.

All the best and if I can help in anyway please let me know.

[jmjm530]

Fibrosis can progress more rapidly with geno 3's, as may have happened in your case. If you have fatty liver, getting down to your ideal BMI with a targeted diet and exercise may help slow the progression down.

As to re-treatment, I don't have anything geno 3 specific to add other than the first step is to have a well-qualified liver specialist (hepatologist) carefully evaluate your previous failed treatments. Perhaps there is something that can be fixed or altered moving forward. In any event, a prior tx history will give the doctor more of a road map to design a future treatment be it double-dosing, adding more ribavirin, asking you to lose weight, etc, etc.
Not sure if any exist or are in the immediate future, but ask about and keep an eye out for any PI trials for geno 3's.

[lolitriqui]

cocksparrow seems well read on the issue; you may want to wait a few years; there is medication in the pipeline; at columbia, i was told that the TX results are very encouraging; the sideeffects are  the issue at the moment; but as non responder, if you have time, i'd stay away from infergen if possible; i think you will have more options given time
good luck
C.

[Marcia2202]

I don't have it anymore. But he posted them somewhere on this site. And it should be in some of my old posts called something rather   genotype 3   or GT3  or G3. You can put it in the search field up there...

Marcia

[Marcia2202]

Pre tx I read a lot of studies. It was quite difficult to locate stuff, but  got some good links from CockSparrow. I will look if I have saved them somewhere on my mac. If I don't get back, it's because I can't find them.

You might look at CCO's site. There is some good info there, too. I get their newsletter.
www.clinicaloptions.com

Marcia