Dear friends: 2 week PCR is UND :-)

Yeehhaaaaa
My friends, I'm so happy I could cry. My doc just called me and said that I'm UND after 2 weeks.
My blood panel is consistant with the 4 week PCR (no VL yet) (Hemo 14.9, platelets 120 X 10^3, low WCB).
Yesterday I was crying in the couch, sayin to myself I could not take this for more than 6 weeks (and now I say, bring me the IFN truck, I'm gonna do the whole thing ;-)
Now, wht do you think? Should I apply the commando approach get in get out at 18 wks? or should I go for the 24?

saludos y feliz a

[mikesimon]

Congratulations on the great news! Do what you feel is best for you. Mike

[pln]

Congratulations!!! Could you please tel me what geno type you were;) Thanks,Pam

[Better_Angels]

I don't know what you should do, but I wanted to ditto Mike's comment, congratulations! It's a wonderful feeling when the dark end of the tunnel starts to shed light.

Debbe

[chcnme]

Scuba,that's great!  I don't know what you should do, but I know you have reason to be sooo happy! That's great news!  I would have been crying too!  Best to you whatever you decide to do.

[FlGuy]

That's great news.  For now, keep your eye on 24 but get with your doc to decide if the short course is appropriate for you.  You'll do yourself a bigger favor later by 'shortenting' later rather than getting 18 in your mind now.

[APKhaos]

Nothing like getting that UND report, eh? You have plenty of reason to celebrate this, and it sure makes the rest of tx a lot easier to handle knowing that its working well.

The tx period is a tough call. Maybe an extra six weeks for insurance makes a lot of sense. Its a lot easier decision than geno 1 folks who are looking at extending from 48 weeks to 72 weeks.

Congrats again, man. Keep it up!

[scubadiver30]

Hi Pam:
I'm 2b with 2,800,000 VL baseline. I feel bad but happy at the same time.

Guys:
I feel that I shouldn't worry really right now about TX duration...but since we were talking about IFN/RIBA damage and stuff a few posts back. Now that I see it 24 ain't much...
I'm RVR and that's all that matters...I luv yous

Happy New year to all

[Lady E]

Congratulations!!!! That's great news!!
I would go for doing it right the first time. You wouldn't want to have to go thru this again, would ya?
Happy day to you!!
-E

[Alady1620]

This is great news!  Good for you!

[mikesimon]

Here is a site where you can read about this stuff.
http://clinicaloptions.com/Hepatitis/Conference%20Coverage/Boston%202006/Virtual%20Presentation%20Programs/HCV%20Treatment%20ER/shiffman.aspx

If you're not in the mood right to read right now I'll condense the genotype 2 SVR percentage for patients with a rapid response (undetectable at 4 weeks) for 16 week and 24 week duration.
For those RVR Type 2 patients who treated for 16 week SVR was 80%.
For those RVR Type 2 patients who treated for 24 week SVR was 91%.

As you can see there is a significant advantage to the 24 week duration for genotype 2 who respond rapidly. Whatever you decide I wish you good luck.
Mike

[aiuta]

Felicidades!  Que buen regalo de Navidad, de Dios!  En cuanto a tu decision de terminar antes, no te puedo dar consejos aparte de seguir el corazon y informarte de las estadisticas de otros en una situacion parecida.  Cuidate!  Evidentemente ya lo estas haciendo, y Dios lo esta haciendo tambien.  Un abrazo, Aiuta

[FL_Gal]

YAY!  That news does feel good, doesn't it?

Happy New Year!

[Myown]

WOW!!! that is so great!! so early,,,so happy for you!! hope its not been hard to handle for you,,but this news makes everything  easier i would imagine. continued success and svr!

[Pdilly]

My gosh how cool is that?   UND at 2 weeks.  Have a wonderful 2007...it looks like you are well on your way.

Pat

[ladybug52]

Congratulations! Makes it all worthwhile to get good news doesn't it? I'm so happy for you and envious that you got a pcr at 2 weeks. Way to go!!
I would just try to set your mind for 24 and then decide later if the side fx are worth the length of treatment. That's my plan. Actually my plan was to try to shorten tx based on my pcr's but after reading Mike Simons stats I guess I'll go for the long road.
Bug

[ladybug52]

Rev: I have a question: IS A RVR  a very good sign? Is it GREAT NEWS!!?

[scubadiver30]

Thanks for the presentation. I saw the whole thing and you're right. There is an SVR eleven point drop between 16 and 24 weeks.
But today I couldn get up to go to work. I think my hemo is dropping way too fast and my docs say procrit out of the question..
I wonder can I get something OTC like vitamin B12 or gammaglobulin to counteract anemia a little bit?. I'm afraid if I call the doc and tell him he might get me off TX...
I'm on my 6th week and still 18 to go...Did anybody experienced this fast anemia and recover without rescue drugs?

thanks a million

[jmjm530]

Hi Scuba,

Congratulations on being non-detectible at week 2! Great News!

Just want to comment a little on the study Mike Posted as several things stick out.

(1) The trial mentioned (Accelerate Trial) used fixed dose ribavirin -- 800 mg for all body weights. Previous trials using weight-based ribavirin suggested similar SVR rates for those geno 2 and geno 3's RVRs who shortened treatment from 24 to 16 weeks (Pegasys) and 24 weeks (Peg Intron).

(2) In the Accelerate trial, geno 3's actually did better than geno 2's with the shortened treatment although still not as good as the 24 week group.

(3) The most signifiant drop in SVR was between the RVR group and the group that did not RVR at 4 weeks, again suggesting the importance of at least a sensitive 4-week viral load test.

http://www.hivandhepatitis.com/2006icr/easl/docs/050206_b.html

--------
Where I come out is:

(1) The short course is still a viable option for those with little or no liver damage, both assuming RVR at week 4 via sensitive viral load test and treatment with weight based ribavirin -- and an especially viable option for those experiencing significant treatment related side effects.

(2) While I'm unaware of any direct studies -- weight based ribavirin appears the way to go for any geno 2 or 3's, regardless of treatment length.

-- Jim

[mikesimon]

I am a bit confused. You say you're undetectable at 2 weeks but then you say "My blood panel is consistant with the 4 week PCR (no VL yet) (Hemo 14.9, platelets 120 X 10^3, low WCB)". If your hemoglobin is 14.9 at 4 weeks I don't see the problem. My experience with Hb is that the rate of drop can affect the way we feel despite the fact that our Hb hasn't reached a level that would be considered anemic. So, if you dropped from 17 to 14.9 in just a few weeks that might account for the way you're feeling. I am also confused as to why your doctor would say that Procrit is out of the question - that's a rather rigid stance to take unless you have some condition that precludes the use of epoetin alfa. Regarding your ideas to counteract anemia I doubt they will provide any benefit to you. It is my experience that the only way to increase Hb while on treatment is by injecting Procrit or Epogen. I hope you start feeling better Scuba. Mike

[jmjm530]

My last post should have read in part:

1)...Previous trials using weight-based ribavirin suggested similar SVR rates for those geno 2 and geno 3's RVRs who shortened treatment from 24 to 16 weeks (Pegasys) and to 12 weeks (Peg Intron).

[scubadiver30]

Mike:
It took me 2 weeks to get my 2wk PCR result whan I had already done the 4 wk test (got the cbc the next day but not the VL yet) So I started at Hgb 16, was 14.9 at 2 weeks and 13 at 4 weeks. So I dropped 3 points in 4 weeks. I'll get my 4wk VL next friday (I hope it is still UND)...today I feel crappy :-( and I don't think Procrit or Neupogen are FDA approved for hepTX? You guys are really lucky that your docs & ins co's give it out like that and that you're state of the art sorta treating. I mean, we don't have heptimax, or Quest or nothing like that. Just the Roche Amplicor.
In Spain EPO is only used in supervised hospital settings and the doc at the beginning of TX said it was not part of the standard protocol. He told me not to worry, that I wouldn't fall below 10...I wonder if he could tell just by looking at my blood panels...

Jim:
You mean the Fellman study above didn't include 800 mg RIBA patients <65 kg? It is weird, cause the same website indicates fixed dosing for Genos 2/3 regardless of weight.
I weigh 90 kg and I had an elevated VL at TX start (almost 3 million). So this UND is either one of the following: The result is bogus (they didn't give me the sensitivity :-( it just says UND and tey just want me to keep TX...That's too Machiavellic to even think) or Dr Cecil is right when he says that Non-Americans respond better to Pegasys and that you guys do far better with Pegintron

[mikesimon]

I apologize for not realizing you were outside the USA. I don't know how your doctor can be certain your Hb won't get under 10 but I hope he is right. I wish you good luck with the side effects and, of course, your achieving SVR. Mike

[niceguy2007]

congrats my friend! do take b complex , n eat a tbsp of honey daily. pomegranates daily r also very good on tx.