Is it best to treat while in accute stage or wait till chronic?

[cursed180]

im confused because i have been told its better to treat in acute phase and read that also and then i read elsewhere that it can be harder to get rid of in acute stage.

[Anne1717]

Well, maybe the joke will be on me - it usually is!!  By the end of December I will know if I am SVR.

I had done a lot of research before I went to the doctor so knew that it was prudent to treat early.  Also, since they are not used to seeing acutes, I was only one of three they had seen in 10 years and this is a big hospital, it took some convincing them that I had Red Cross documentation.  UGH

[katla]

I actually have a pretty good idea when I was infected and diagnosis was confirmed less than a year later. My doctor thought I should wait for the PI's to come out, and then thought there was no rush. I subsequently changed doctors who thinks I should wait for a trial. I wish I had treated immediately but I knew a lot less then than now and it wasn't up to me. (just venting...)

[Anne1717]

Hi - I was lucky, I regularly give blood so the Red Cross picked it up. I only had two possible exposures - a tetanus shot which is supposedly safe pooled blood product, and a hemangioma removal.  

I had symptoms but never would have associated them with HCV nor would I have suspected exposure to the virus and they were not severe enough to require a doctor's visit.

I did have  two opinions and both were of the thought that you treat early, within a year of exposure, and you treat aggressively with the peg/Riba for 24 weeks.  Some docs will say 16 weeks but why fool around with it?

So I guess to answer the question about how you know you are acute, I would say it's luck or you know you were exposed - ie., nurses who know they had an incident.

It makes sense to go for it before it becomes chronic and well established. And while fool around with it when it is much easier to get rid and a higher cure rate of in the acute stage?  That they do know.  Please see earlier post.
.  

[katla]

Anne1717 wrote:
"It i not clear how long you are acute,  some studies say 6 mos but it could be as long as 2 years."

Is there any way of knowing if one's in the acute phase? And if so how?

[willbb]

Agree with lynda on this one James.. we don"t hear to much about acutes  as there are not many here.. however Anne 1717 is one who just finished up..and the thinking is if you can treat while still in this phase(up to 6 months or so from exposure) with just Peg/Riba ..then the success rates is approx.90% fot just 24 weeks.possibly because of usually very low VL.
Will

[lynda607]

James, I don't follow your logic on waiting until 2012 and treating with triple therapy.  The odds of SVR are as high if not higher with SOC only in the acute stage plus the treatment duration is usually shorter.  There is no added value to adding the additional antiviral compound when the patient is acute.

[James10500]

If you're G1 wait until 2012 and do 3x .....imho

[cursed180]

i will try not to let this worry me but its hard,its not in my nature not to worry,i have depression,have had it for years, plus i have had a alot of bad luck in my life and i tend to think the worst case senario at times.if my LFTs had of been normal then i would not be worried because only time they was above normal was when i had hep c

[cursed180]

hi will i have had pcr and still waiting for results but i had LFTs and they are elevated and i have some other symptoms so i guess im just panicking,im a worry wart but i just want to be prepared for the day i get my result so i know exactly what to do.it will be type 1a or 1b not sure what he has but its 1 and the risk is low so im told but i dont care i still want to learn reguardless.i have many friends and some family with hep c and it doesnt hurt to be prepared hey :)

[cursed180]

i did not say lynda was wrong and i didnt say it was just her oppinion.i think lynda seems very switched on and knows exactly what she is on about but what is the harm in getting oppinions and experiences from others?i do not want to offend anyone,sorry!

[cursed180]

thanks again lynda,i didnt say you was wrong omg please dont think im not taking in your advice,i appreciate every single comment whether fact or experience etc and i am now definitely going to treat in acute stage with soc(because new drugs are not approved here yet and wont be till 2012) i was only confused from some thing i read last night,i should have saved it so i could tell you what it was but it said basically the opposite but it was from few years back and it wasnt a doctor etc so they might not know the correct info,plus read some accute people on this forum from years ago and they didnt clear but i know that doesnt mean everyone will be the same.
i just like to know ahead of time and be prepared incase i do have it and its looking like i do but who knows my LFTs might have just gone up on their own and my symptoms but be unrelated.

[lynda607]

I believe you said you had a PCR done and are awaiting the results. It may take up to 3-6 months for antibodies to be detected but HCV RNA is detected by PCR within 2-3 weeks after exposure.  You're not sure you are infected so all this may be a moot point.

Try not to worry - nothing you can do until you know your status.

Treating in the acute stage definitely increases the odds of eradicating the virus with all genotypes.  If you are infected, you could wait and see if your immune system eradicates the virus but it would be prudent to have frequent PCR's to see if the viral load is decreasing as well as ALT & AST before the six month period is up.  In the acute stage, liver enzymes are generally very high.

[willbb]

You say you think you have been re- infected? Do you know this for a fact .? Have you had a Pcr done ..and if so what were the results and Genotype?
Will

[hrsepwrguy]

lynda607 post is fact based, not opinion,.

[cursed180]

thanks for reassuring me anne,its hard when you read different oppinions and articles etc,confusing.

[cursed180]

yes i know but i like to know peoples personal experiences anddifferent oppinions.

[hrsepwrguy]

lynda607 has already given you thi s data

[Anne1717]

Hi - If you are acute, the popular thought is to wait the 16 or so weeks to see if you clear the virus on your own and if not, then start treating within 6 mos - 12 mos of contracting the virus.  It i not clear how long you are acute,  some studies say 6 mos but it could be as long as 2 years.  The just don't know since there isn't much data to use.

My doctors, both from major clinics believe it is best to treat in the acute stage since they DO know that the cure rate is higher with a shortened treatment time.  It used to be the would just throw  interferon at you with about a 80 % cure rate but my Doctor felt treating aggressively for 6 mos was best and hopefully he is correct.  I was UND at 2 weeks and won't know about the rest for another month.

It is your decision of course.  But from everything I have read, my doc's advice and my own personal experience, I would go for it while the VL is low and your liver is presumably in good shape.

IMHO only

Best,  Anne