After The Loving

[Poobah_Johnny]

Many of you may know that treatment recently failed me.
My current concern is what will happen to my liver now?
Will the VL continue to rise or will it decline or level off?
Same questions regarding the enzymes.
(Please, I'm mostly interested in the VL aspect from this posting,
I would like to save 'progressing into liver disease' for a later time, thanks).

[merryBe]

I agree with Goffy dad here, your alts are an indicator of cell death and more research is showing that cell death is realated to total metabolic process and cell death and not in a symbiotic ratio to VL.
Ergo the thing to concentrate on is ways to reduce inflammation which is the real culprit.
to that end concentrate on the natural anti-inflammatories and eating a liver friendly diet as HR suggests (small meals, low fat, moderate protein, etc) and try to keep your iron down as well.
Many people have a spike in alts, VL etc during relaspe, that will seetle down as your own INF comes back on board, but do all you can to take care of the organ, just as you would were it your heart, kidneys or whatever.
mb

[GoofyDad]

utter rubbish
alt going up does not equal vl going up, this is complete nonsense!!!!!!!!!!!!!!!!!!!!!!

There is some merit here. Before having PCR available, I believe LFTs were used to monitor viral response on tx. Start tx and see LFTs drop, that's an indicator of a viral response to the meds. It's a crude yardstick - but better than nothing.  

[mj6000]

I'm worried about you. I left you a post on the Suicidal thread you posted and a personal message. I get the sense you are stronger than you think!

[Poobah_Johnny]

OMG. I wish I could.

I have no control over anything anymore, and now I'm losing control of my emotions.

[nygirl7]

PS hopefully you don't really even need to worry about being one of the 24% because you won't have to worry about it and can just go on with life.  Sometimes a lot of us who treated and cleared still feel that way some days.

Go out and ejoy the almost spring weather and breathe in life. :)

[nygirl7]

Johnny,

Isn't the possibility of knowing that you don't even need to treat right now enough to give you courage to get that biopsy? You know most hep patients will die of something else before hep which is so slowly progressing in most cases.

Seriously, live your life to the fullest and the healthiest you can.  Worrying about LFTs and VLs isn't going to help in any way. I know that is impossible to forget about but if you could screw up the courage well you might find it's not really a current concern and then you could easily wait till the new drugs someday hopefully come out!

You have to know by now none of us would lie to you about it and it is scary but not painful in any way and it would totally be in your best interest all the way around to relax and enjoy your life!

[Poobah_Johnny]

Crap MJ...

Coinfection only has a 24% SVR success rate, highly increased progression to liver disease, plus a dramatically greater chance of relapse after treatment.

I didn't find any information regarding the new PI's and coinfection.
I'm depressed again.

[Poobah_Johnny]

That would be absolutely SWELL!

[Willy50]

"I have a feeling that they both will have a trial for TX naives."
-------------------------------
should have read for *past TX  failures*.

Willy

[Willy50]

Looks like Boceprevir also has one;
http://clinicaltrials.gov/ct2/show/NCT00959699?term=boceprevir%2C+HIV&rank=1

I have a feeling that they both will have a trial for TX naives.  Keep your eyes peeled for them or for other compounds.  Pay attention to what facilities are doing the trials and see if they align with your location.

best,
Willy

[Willy50]

Sure, I understand that.  The deal is that virtually all such type trials start w/ naives, BUT not always.  That means that you can start scouring for others, such as Boceprevir.  I would also mention that Shering did not follow the same pattern as Vertex; they tested Boceprevir from the get go on TX failures; so never assume.

You might also look over the medical facilities who do such trials and consider checking them out if you are actively seeking a trial.  Sometimes it's good to wait however ans see how things shake out.  A word of warning; many of these start to fill up even before the trials get listed.  Waiting for an opening is not always advised.  The process can be a little like getting pre-approved financially for buying a house. That way, when something opens you are ready to go, and the people who run the trials already have you in mind as a possible participant.

best,
Willy

[Poobah_Johnny]

Thanks Willy, this Trial has an exclusion for Previous Treatment.

I have scoured every Trial I could find in the NYC area and I'm am excluded from all of them for one reason or another.

If anyone finds an NYC Trial accepting HIV+ Previously Treated participants, please let me know.

[Willy50]

There is currently a Telaprevir co-infection trial that is recruiting.  I didn't look it over closely enough to see if they were only accepting TX naives, but they may also do one for TX failures.

http://clinicaltrials.gov/ct2/show/NCT00983853?term=HIV%2C+Telaprevir&rank=1

Regardless, I wanted you to know that this trial was on and there could be others coming (such as with Boceprevir)

Generally speaking, with HCV monoinfection, if one responds to treatment one has a very good chance at SVR with SOC when a PI is added.

best,
Willy

[jusjames]

its a deal ! Trinity...sign me up

[Poobah_Johnny]

Hobo - Seriously, thank you - God bless you, man!

[Poobah_Johnny]

James / Trinity - LMFAO!

Trish - Thank you, it's a lot to grasp especially because I'm well educated on dealing with the HIV Virus which is obviously different that dealing with the HCV Virus.

[Trinity4]

Yes, I'll throw and a juicer and some snake oil no-charge to you.

[jusjames]

will you do a deal with some snake oil as well?

[Trinity4]

Correct James, utter nonsense.  James, you want to buy an ozonator?

[jusjames]

utter rubbish
alt going up does not equal vl going up, this is complete nonsense!!!!!!!!!!!!!!!!!!!!!!

[hobo2]

Hello Johnny, You're concern with tracking your viral loads, so I'll give ya some input into this, based on my own experiences with having to overcome my stage4 HCV myself,
[since the doc's figured I was too high of a risk to take the interferon treatments and would be a gonner in less than 6 mos.]  thus had to become my own doc. so to speak...
   Anyway, as you probably already know, the viral load test is more expensive and your lab has to mail your blood vial off to have the RNA test done.  
  Your doctor can track your hep. progression with an "in-house" lab in the hospital by doing the normal liver panel blood work-up, that shows your ALT and AST liver functions.  The AST pretains to your liver, but can also be effected by a number of other factors too, that are not liver related...It's the ALT that reflects your liver enzymes primary..so that's the one that will tell you if your Viral Loads are starting to climb or staying down.
  As for your viral loads continuing to climb?  Sorry..they'll take off slowly and then start accelerating after awhile, the virus can mutate a number of times, that's why it's so hard to wipe it out, even with tx. but it can be done!  
  Wishing you a speedy recovery my friend!
  

[Trish77]

I think VL is more of an indicator and matters more when monitoring HIV than it does with HCV, where viral load matters little.  With HCV, either you have viral load or you don't and the amount is of little consequence - VL doesn't even correlate to liver damage.  It doesn't tell you affect much until you're doing treatment.  Liver enzymes are an indicator but not always accurate and not the best measure to go on.  If your liver damage is advanced, your liver enzymes may even drop into normal ranges as cell death decreases simply due to less cells available to die off. Taken in conjunction with a biopsy, they can paint a broader picture for you and would be part of the monitoring process as you go along. The article Bill suggested is a good one and I would agree that biopsy is your best monitoring tool.  

Have you had a biopsy?  Good luck with recovery from treatment, both mentally and physically.

Trish

[Poobah_Johnny]

Bill, MJ - Nice links thanks, it will take me a while to go through them.
MJ - The HIV/HCV site adds so many more issues to our situation.
James - I could think of a few other holidays I'd rather take!

[jusjames]

during tx your liver would of had a nice holiday , remember that !