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575840 tn?1217542605

non-responder

I'm a 57 yr old black male with genotype 1b. I've been taking peg-intron and ribaviron and just got my week 24 labs back. Since my viral load is still detectable at 1217, my doctor advised that I discontinue treatment. He did not seem to be too concerned but I am! Here is my background: Based on my past lifstyle, I would guess that I contracted this virus approx. 30 yrs ago. My liver biopsy report states the following:
    periportal inflammation 2(mild)
    lobular inlammation 2 (mild with focal necrosis)
    fat (some)
    fibrosis 2 (periportal fibrosis)
I know that now that I have stopped taking meds my viral load will go back up. I guess I'm concerned about the progression of the disease. Am I worried too much?
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Avatar universal
Sorry to hear you were not UND by 24 wks.  The protocol is to discontinue tx if not UND by 24 wks.  Judging by your vl, if you were to continue with tx, your chances of reaching SVR are less than 2%.  There are some studies that indicate continuing until you reach UND and then treating 48 wks from that point but tx is too hard on the body and I would not want to do that with such a small percentange of reaching SVR on current SOC.
Your liver damage is moderate -  stage 2 is in the middle.  You have time to wait for better meds in the next 2 years.  Liver damage progress differently with everyone -  Having had the disease for around 30 years and 57 yrs old, I'd say you've progressed at a fairly slow rate.  
Perhaps you could get into a clinical trial if you are concerned with the progression of liver disease.  Keep in mind, vl is not an indication of how fast the disease will progress.
Good Luck
Trinity
Helpful - 0
Avatar universal
HCA
I don't think you need be too concerned.You are indeed a non-respoonder but there is good news although you have moderate/severe fibrosis.
The first of the new generation inhibitor drugs will hit the market probably late 2010.These promise dramatically improved treatment regimes.
If you live healithily,don't drink and keep your weight down you have an excellent chance of getting cured.I think you have enough time in hand and should not get stressed.
Helpful - 0
Avatar universal
I am not sure the data for SVR rates (which historically is accumulated in studies which treat low numbers of black people) is reliable in black people. There are a lot of differences in response to interferon, SVR rates, etc. It may be that you are a candidate for the 72wk therapy, or 48wks post-UND regimen?

Two names keep coming up when I research this issue (I am biracial but have many lab and physical characteristics common in black people): Lennox Jeffers in Florida and Andrew Muir at UNC.

Given that Telapravir etc are just around the corner, it may be that you'ld be better off quitting for now; I agree with the other commenters that your disease seems to have progressed slowly, and correcting the correctable factors - alcohol, smoking, weight, iron overload, exercise etc may improve your chances next go-round...

Best of luck!

Helpful - 0
Avatar universal
I agree with your doctor. Check out the Telaprevir trials/results with emphasis of course on hard-to-treat population data such as with Afro Americans. Telaprevir should be on the market within a few years but you could qualify for earlier trials. Personally, as a stage 2, I'd probably just wait until it hits the market as more data will then be available.
Helpful - 0
244899 tn?1313624639
My viral load started at 4.1m and I did not repsond to interferon, after 6 months we stopped treatment and started on daily infergen shots with 1000mg of riba. I just found out today I am down to 109 within 16 weeks. So just because interferon didnt work doesnt mean infergen wont. The side effects are abount the same fatigue, body aches all the usual, but its all worth it when they tell you your cleared.
Good luck
joe
Helpful - 0
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