GOT MY 12 WEEKS RESULTS TODAY

I GOT MY 12 WEEK RESULTS TODAY AND MY VIRAL LOAD IS DOWN TO 1020. I STARTED AT 4.1M, WITHIN 4 WEEKS, IT DROPPED TO 57,000. MY DOC SAYS WE WILL CHECK IT AGAIN IN 4 WEEKS AND HOPE TO BE TOTALLY CLEAR BY 24 WEEKS. DOES THAT SOUND RIGHT? IF I AM CLEARED SHE SAID I WOULD PROBABLY HAVE TO TREAT FOR 72 WEEKS. I AM ON DAILY INFERGEN AFTER FAILING TWICE ON INTERFERON. I ALSO NOTICE THAT SINCE MY VIRAL LOAD HAS GONE DOWN SO FAR THE SIDE EFFECTS ARE MUCH LESS, ALSO THE WHITES OF MY EYES USED TO BE YELLOW AND THEY HAVE CLEARED UP TO BRIGHT WHITE.

[HCA]

Yes-if you test clear between week 12 and 24 then you should expect to treat for a total of 72 weeks.
The yellow eyes is normally excess bilirubin.If this has normalised during treatment it suggests an improvement in liver function which is of course good news.If you were jaundiced it may mean that your liver is damaged .We would need more details of your liver function tests to make an informed comment on this.
Good luck!

[HectorSF]

Yes that all sounds correct. If you don't become UND by week 12 odds of SVR increase if you treat for 72 weeks. Note that you must clear by week 24 to have a chance of SVR.

All the following quotes from Mitchell Shiffman M.D. papers:

"Three recent studies have now demonstrated that relapse can be significantly reduced in slow-to-respond genotype 1 patients—those who achieve undetectable HCV RNA after Week 12—by extending the duration of treatment from 48 to 72 weeks.[8-10,20] In each of these studies, the relapse rate was reduced from more than 50% to less than 20%. Two of these studies suggest that this benefit may be less or nonexistent in patients with higher HCV RNA levels at baseline and at Week 12.[8,9] However, these observations will need to be confirmed in future studies before these patients are not considered for treatment extension. Therefore, for now it appears that prolonging the duration of therapy will increase SVR rates in patients who are slow to respond and should be routinely practiced."

8. Sanchez Tapias JM, Diago M, Escartìin P, et al. Peginterferon alfa2a plus ribavirin for 48 versus 72 weeks in patients with detectable hepatitis C virus RNA at week 4 of treatment. Gastroenterology. 2006;131:451 460.

9. Berg T, von Wagner M, Nasser S, et al. Extended treatment duration for hepatitis C virus type 1: comparing 48 versus 72 weeks of peginterferon alfa 2a plus ribavirin. Gastroenterology. 2006;130:1086 1097.

10. Sanchez-Tapias JM, Ferenci P, Diago M, et al. How can we identify HCV genotype 1 patients who may benefit from an extended treatment duration with peginterferon alfa-2a (40KD) plus RBV? Program and abstracts of the 42nd Annual Meeting of the European Association for the Study of the Liver; April 11-15, 2007; Barcelona, Spain. Abstract 641.

20. Ferenci P, Laferl H, Scherzer TM, et al. Customizing treatment with peginterferon alfa-2a (40KD) (Pegasys) plus ribavirin (Copegus) in patients with HCV genotype 1 or 4 infection: interim results of a prospective randomized trial. Program and abstracts of the 2006 Annual Meeting of the American Association for the Study of Liver Diseases; October 27-31, 2006; Boston, Massachusetts. Abstract 390

15% of genotype 1 patients achieve undetectable HCV RNA between Week 12 and 24 of treatment and have been referred to as “slow to respond.” Virtually no patients will achieve undetectable HCV RNA levels after Week 24 if they have not done so already by that time point, regardless of genotype. Therefore, if a patient has not achieved undetectable HCV RNA by Week 24, treatment should be stopped."

Best of luck!
Hector

[Trinity4]

You've had a 3.6 log drop in 12 wks.  Looking very good.  Hope you clear by 24 wks.  I'm waiting on the results of my 12 wk PCR and I'll take a 2 lg drop but UND would be the bomb.  At 6 wks I only had a 1.1 log drop and you had 1.68 so you're doing well.  Good Luck.
Trin