48 vs 72 Week Treatment

Hy there to all !

First of all , just want to say HY to all the member from this comunity.

Such a great comunity you have here. This is my first post, but I readed this forum since 4-5 months ago.
Please escuse my english. I`m from Romania, and my name it`s Andrei. I`m a 24 years old male.
In 2006 I find out that i was infected with Hep C virus. In 2007 i did a biopsy, what show A2F3 stage. Not too good ....

Start tx with Pegasys 180 (once a week) and 1200 Ribavirin (daily) since July 2007. My PCR was :

Before 1 shot : 200.000ui
After 2 weeks: 129 ui
After 4 weeks: <15ui (but not quite UND)
After 12 weeks: UND (IUHUUUUUU)

Since May 2008, my RIBA is UP from 1200 to 1600.
I`m OK, just some weight lost, my HGB is 10.5 so not too bad.

And now I`m on week 58. And now it`s my wuestion : what do you think about doing the 72 week tx in my case?
My Doctor don`t agree with that, because she tols me that i was a quite rapid responder, but I want to give the best shot and to try to do all my best killing the virus.
Do you think that 60 week tx will be enought? Or I must to do the full 72? Just want to remember that my bx showed stage 3 .

Any advice will be mutch apreciated.

Thanks you a lot !

[mikesimon]

You didn't mention your genotype which is usually helpful to know. I will assume you're type 1 but at the stage you are now I doubt it really matters.
I would guess that you were detectable before week 12 - unless you tested between week 4 and week 12. You could have been undetectable at week 5 but almost surely before week 12.
I think you've gone long enough already. When you clear by week 12 the normal duration of treatment is 48 weeks. You're at week 58 now so you've done more than the standard of care prescribes. But, if you feel alright, can get the drugs and your doctor agrees you are probably not endangering yourself by going to week 72. I just don't think it's necessary Andrei. I think you have done enough treatment to give yourself the best chance of SVR already.
Good luck,
Mike

[nygirl7]

I had to do 72 but it was because I was not undetectible until sometime after week 12 but before week 24.  I am not sure if your test results above read that your 12 week test was UND? AT least you had a good sensitive test and at week 4 were detectible to 15. That is a great response at week 2 to 129!

If it is your 12 week test that was Und then you are free and clear to stop. There is never any guarantee with this disease either way no matter what you do.  I was afraid to stop at week 72 even!

Your hemo is not that high - amazing that you do not complain like so many of us have done when it gets down that low.

I'm sorry I'm so unclear about that you said Und After week 12 but don't say when - if you didn't have a 12 week test to ME it looks like you probably were UND sometime shortly after your 4 week test and I'd say you are safe as you are ever going to be in SVR if you stop as you did have good rapid results by my personal account.

Good luck in Romania!

[Andrei24]

Thank you a lot for your answer !

Unfortunately I don`t know what genotype I am . Unfurtunately they don`t do this test in Romania. I know .... it`s hard to believe, but ..... this it`s life. I supose that I am geno 1a or 1b because I was still detectable after 4 week (< 15 ui) but I`m not sure ....


nygirl7

:)) sorry !!! it`s was my mistake ! So ..... My 12 week PCR was UNDETECTABLE. I think I cleared the virus between week 4 and 12. Because my week 4 PCR was detectable but UNDER 15, and my 12 week PCR was UNDETECTABLE.
24 Week PCR UND as well , 36 and 48 week PCR UND as well.

Just dont know what to do .... to do another 14 weeks or to stop. If 12 more weeks will increases my SVR chances, I think I will do it. It`s not hard, but it`s not easy at all :)

Thanks you a lot for your advices !!

[HCA]

By all standards of accepted clinical practice you should stop now.
There is absolutely no evidence that over treating will increase your chance of SVR.

[Andrei24]

Thanks for your advice !

[nygirl7]

Yes  if your 12 week PCR was undetect then your doctor was right you've now done more than enough.

With the great response that you had I am sure you will be SVR.  In fact I already congratulated you in a PM and now just have to wait to say I was right like always! hahahha

Congrats Andrei it seems like you are DONE!

[mikesimon]

My statement: "I would guess that you were detectable before week 12" should have read:
"I would guess that you were UNDETECTABLE before week 12".

Just to clarify my position, if I were you I would stop, assuming all of your information is correct.

Good luck,
Mike