Interferon tx for HBV vs. genotype

[NashPred]

As a reminder, I have both Hep C & B. I was planning on tx Hep C for 24 weeks and then managing the HBV with an antiviral after that.

Dr. now thinks I should continue on Interferon tx for 48 weeks total (an additional 24 weeks) for HBV because I had such a great initial response to it (UND at 4 weeks) and because of my HBV genotype being “type A”

They said I had a 40% chance of getting rid of HBV with all things considered in my case with IFN. I don’t know where they got this figure from, but if anyone has any insight I would appreciate it.

I know that genotype A can be the easiest to tx, but my main concerns were autoimmune problems developing from the IFN and the way the drug makes me feel. They said that at 24 weeks when I am able to stop taking the Ribavirin for Hep C that my symptoms would improve because the symptoms are more related to the Ribavirin than the IFN.

I could handle an additional 24 weeks of IFN if I truly have a 40% chance of clearing HBV and the symptoms subside after stopping the Riba. I’m just having a hard time figuring out if it is worth it and where they got this figure from. I’m also ready to start feeling better and want my old self back.

Anyone ever heard of a HBV genotype A clearing from IFN mono therapy? Especially when VL was UND after only 4 weeks of tx? Would my chances really go up with 48 weeks of IFN tx versus only 24?

Thoughts anyone?

Anyone currently on or have taken IFN mono therapy? How does the IFN alone make you feel? What was/is your genotype and result?

[zellyf]

26...I'm positively jealous!

So happy for you!

[cajim]

Yeah, your treatment is showing optimal result.

Best.

[NashPred]

Just a quick update…..I got my lab results from last week back this morning.

VL still UND. (Thank you PEG IFN)

HBsAg still reactive (no big surprise…just had it checked out of curiosity)

ALT is now down to 26. This is probably the lowest it has been in over 20 years (guessing)

ALT was in the 90’s at start of PEG IFN tx back in April.

[cajim]

>>>Wish I knew if the additional 24 weeks would make any difference.

There were one or two studies that did say prolonged IFN treatment strengthened/improved the good results.

Best.

[NashPred]

Being able to post charts and graphs would be a nice feature to have on these forums sometimes.

So far, it looks like my chances are about the best anyone could hope for with current tx options and all things considered in my case.

The post from April says:

>>>>> Patients who are treated with peginterferon alfa-2a receive therapy for a fixed duration of 1 year, but it is possible that a shorter duration of therapy may achieve the same outcomes.<<<

Wish I knew if the additional 24 weeks would make any difference. I guess that’s what I’ll have to decide when the time comes. I may just take it a week at the time and see how I feel or just split the difference and tx for 36 weeks. Either way I’ll keep you posted as to my progress.

14 shots down and who knows how many more to go.?

Thanks again for all your help.

[cajim]

>>>it was stated that speedy VL suppresion within 24 weeks is the optimal treatment result.

Apr 19, 2008 05:13PM, Notes on "Treatment of the HBV-Infected Patient: When to Start, When to Stop, and When to Change Therapy," Keeffe, E.B.  March 5, 2008.

Sadly, their tables are easier to see but there is no way to post graphs in threads, so you have to get their message through words.

>>>it was stated that genotypes A and B respond better to IFN than C and D

Jun 14, 2008 01:32PM, Notes on “Should Treatment of Hepatitis B Depend on HBV Genotypes? – A Hypothesis Generated from an Explorative Analysis of Published Evidence,” Wiegand, Jet al., AASLD 2006, #1009.

Best.