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Has anyone sought treatment of HCV Genotype 1 b?

I believe that I contracted Hep C in about 1987, because that is when my liver enzymes began to rise.  Is it possible that I contracted it many years before?  It appears that my virus count has increased 8 fold from 1998 to 2004 from 207,452 IU/ml to 1,660,000 IU/ml.  After two liver biopsies, the last one in 2004,  the mild fibrosis (scarring) had not progressed and my doctor did not advise treatment at this time.  At this rate in 6 1/2 years it will be 13,283,000 and in 6 1/2 more years it will be 106,265,000!  

From what I have read there is not really a good treatment for 1b?  

My WBC has been decreasing over the years from 1994 to 2005 from 6.0 to 4.5.

I have pretty much been leaving this in the hands of both my Internist and my Gastroentorologist, so I have not been doing much studying about it until now.

Any comments or advice is appreciated.

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Avatar universal
I did not know I was infected until this year (a few months ago).  I did NOT stay away from alcohol as I had no reason (except dignity and decency LOL) cause I didn't know I had this disease!

NOw I constantly wonder what stage I would have been had i known that I've had this disease for the past 20 years if I did not drink?!

But I can't let it bug me I can only stay sober now and take care of my liver like it is the precious commodity that it is.

I am 1a & 1b - double dutch combo ha!  Female 40 in week 3/48. Stage 2/3 - Grade 2.  Tx is doable but it sux with the sx...I want to get better and will do anything I have to at this point.

we're all in the same boat here Pirate.  It's not the Jolly Roger but then again it's so nice not to be alone and to realize NO I AM NOT A WHINER THIS REALLY DOES SUCK!

But we hang in, together.  Best of luck!

Debby
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Avatar universal
I was 46 (female) when I started tx....47 at end.  I didn't have a biopsy, just bloodwork.  My GI said it looked like I could have the start of fibrosis.  I think there is a bloodtest that gives them some of this info.  Would have done the biopsy if I had chosen not to tx.

I tx'd for 48 wks.  My PA suggested I tx 12 wks longer since I was a slow responder.  She moved and they transferred me to the NP who didn't believe in extending tx.  In the end, she gave me the option to extend or not but I chose not to at that point.

Don't know when I contracted HCV unless it was from a nail/manicure shop.  I had a couple of manicurists that really butchered my cuticles a few times......kept switching b/c I couldn't find one I liked.....finally quit having my nails done.  Anyway, found out I had it when I gave blood in 1993 but my dr didn't say anything about tx's or that I had an active virus.  That is, until I switched PCP's and he referred me to a GI.

I'm glad I chose to tx.  At least now I don't have it hanging over my head wondering all the time about new tx's and when/if I need to tx.

Good luck to you in making your decision.
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Avatar universal
OK, so when I hit something (probably not POST), I lost the message, I will repeat the first part because it answered your questions:

I am 58 years old, my alt and ast were in the 200's -high 300's for the 2-3 years before treatment.  I was stage 3 - grade 2, my general state of health was good (walking marathons, working, etc..), So, I had age, length of infection, liver damage against me.  But what I had for me was ATTITUDE.

(This is where it links to the first message, sorry about that!)
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Avatar universal
Sorry, I think i hit post without knowing it...

So, back to ATTITUDE.  In my mind, there was no doubt, I knew it was goingn to work.  I had set my FIRST goal for treatment as :  GIVING MY LIVER A BREAK, the ultimate goal was SVR.  At twelve weeks I knew that my liver was not attacked anymore and I had attained my first goal, then I just concentrated on SVR.

I welcomed the medication in my body, never thought of it as a poison, rather as a wonderful gift.  When I had sides, I saw them as a sign that there was "a fight going on inside" and that was a good thing.

6 months post treatment, if you are still undetectable, you are considered "cured", some doctors use that word, some don't, mine does.  It's a great word.

Also, looking back at last year, I realize that I learned a lot about myself and my strength, I found out who my real friends were, I know the difference between important stuff and not so important stuff, I don't stress about stupid things anymore, I treasure every moment.  So, there were lots of hidden gifts and hidden lessons in that year.

I used to stress about gaining five pounds and fantasize about being very thin.  Well, I lost 25 pounds on treatment and I was "model thin", never want that again, NEVER.  I welcomed the weight back, that was kind of a strange feeling.

Now, my hair is back, my energy is back, I am working out at the gym to get my muscles back.  I am in a constant state of gratefulness, after consciously (I knew about it, some people don't), living with a life-threatening disease, it is such a weight off my shoulders, I am able to think about growing old with my husband, never was able to think about that before.

I would do it again!  Good luck!
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Avatar universal
Former 1B. Tx'd for 48 wks ... still clear 1 yr post-tx.
Beg VL 596,000; 12 wk VL  370;  clear at 24 wks.  No alcohol til I was clear 6-mo post-tx.  I now have the occasional glass of wine.  I chose to tx for several reasons;  mainly that I didn't feel I had anything to lose by trying.  Also, my insurance at the time paid 100% of my tx;  today it would only pay 90%.

Hardest thing about tx for me was the fatigue and the first couple wks.  I still walked and rode my bike some but it was at a very, very, very slow pace.  Also, I was fortunate enough to not have to work so I think that helped me considerably.

Good luck making your decision.
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Avatar universal
Lynne,

Do you mind if I ask your age at treatment, the length of time you have carried the virus and what the Stage/Grade was when you began treatment?

Pirategold
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Avatar universal
Forgot to mention.  My GI had said that 1's start with a 50% chance.  If you have the 2-log drop in VL at 12 wks, chances increase to 60%; if undetectable at 24 wks, chances increase to 80%; and increase accordingly.  Unfortunately, some do relapse after tx but you have a very good chance of remaining clear if you complete tx and have cleared by 24 wks.

Again, good luck to you.
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Avatar universal
How long had you been infected and what was the Stage/Grade numbers?  Do you think age and general health and weight have anything to do with the progress of the disease or the success of the treatment?  I have noticed that when I lost weight the enzyme levels went down.

What do you plan to do next?

Pirategold
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Avatar universal
Good luck to you!  I have a lot of reading and study to do.  I don't even know what a tx shot is.  I sure hope in 3 months you find it is working.  I want to be around for a while longer too.  One thing I am a beliver in is God.  And what I have discovered is that life is more precious when it appears it is nearing the end. And I hope that you find yourself cleared in time.


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Avatar universal
That is great news!  Do you know if age, general health, weight and activity level are important for success?  How long do you have to be clear to know you have been cured?  Did you take any supplemental vitamins and nutrients and eat a special diet -- like no fat?  Did you ever drink alcohol?

What kind of ALT/AST levels and virus loads were you dealing with?  

I realize these are probably very elementary questions, but I'm trying to look to the future to see if I have some time to hope for new treatments and perhaps even improve my immune system to fight this virus right now.

Again, thanks!

Helpful - 0
92903 tn?1309904711
When I was choosing my day I was casually told by my team that moving one day in either direction would be OK. I actually have decided to advance by proably 12 hours (I selected a later start day so that if I needed to move I would be going earlier). I'm going to move in 2 hops of 6 hours each, more because I want to be sure the change is right for my QOL. I'm only going into shot number 4 (hey check me out - 1 box down!) so I'm not convinced the pattern I'm seeing is an established one.
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Avatar universal
CONGRATS, happy, happy for you, plus it sure gives me hope as I have the same results as you, I will start tx soon, hopefully...
Am going with pegintron/redipen as well, my age will go against me from what I understand, oh well, shall think POSITIVE

good luck in the future
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Avatar universal
I was a 1b treated for 48 wks and now 9 mos post tx, I'm still clear, my Dr. considers me cured. If you do decide to tx my only advice to you is to comply with tx 100%, doing so will give you the best odds of clearing the virus.
This is a very personal and difficult decision for you to make - very best of luck to you.
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Avatar universal
Thank you for responding and I really appreciate your advice.  I will take time to read more of the posts, I have learned so much already.  I have always kept copies of my medical records but never understood them except that the doctor indicated that I did not need to rush into treatment.  I'm 18 years from the initial Non-A/Non-B diagnosis and am Stage 1, Grade 2.  

Can I presume that most have stayed completely away from all alcohol?  I must admit that I did not.  Recently went an entire year 2004 with no alcohol, and have since had an occasional blass of beer or wine.  Sometimes I've had too much.  The year without was not a problem at all.

The nurse said that the viral load will continue to increase.

Again, I can't tell you how much I appreciate all of you taking time to respond.

Pirategold
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Avatar universal
How old were you for the first treatment and what Stage/Grade were you?  How long between each treatment attempt?  Do you consider yourself cured?  

Pirategold
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Avatar universal
As a 1b, stage 1 you have plenty of time to make a decision and watchful waiting is very appropriate. As part of your research, make sure you become familiar with the protease inhibitor trials, especially Vertex. Peg Inteferon and Ribavirin are very strong drugs and you only have to spend several hours reading posts here and elsewhere to understand a little about the side effects, some which may be permanent.

A lot of excitment about these new drugs and hopefully they will be available for standard tx in 2-3 years. Meanwhile, a repeat biopsy every 3-5 years and a yearly Fibrosure or Fibroscan test make sense. Currently there are only three Fibroscan machines in the U.S. (Florida, Boston, ____) but that will change soon as soon if and when the FDA approval trials are successful.

Your nurse is incorrect that your viral load will continue to increase. Viral loads go up and down over time and does not correlate with liver damage. Three years ago my viral load was 30,000,000 IU/ml. This past December it was 16,000 IU/ml. When I started tx in February it was 1,500,000 IU/ml.

Good luck with whatever you decide.

-- Jim
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Avatar universal
I am a 61 year old female, my June 2004 biopsy (one in 88, one in 99) indicated Stage 1/Grade 2.  My gastroenterolosit said of my June 2004 biopsy that "there has been no progression of the scarring (that is, fibrosis) which had been seen on your previous biopsy in 1999."  He recommended a repeat biopsy in 3 to five years.  He stressed "avoid all alcohol."  I was at that time six months into a "no alcohol for one year commitment" already so I just took that as good news, put it aside and sat back and waited to see what "those in control" would want to do next.  I was kind of happy that he was not going to recommend treatment -- treatment scared me because it meant the doctor thought it was serious.  He did say that there might be better treatments in the future and that I could wait.

The development of my Hep C began with my ALT liver enzymes elevating in September of 1986 and at one point they went up as high as 360, then continued to bounce around between 100 and 200 and the AST between 50 and 100.  The Hep C diagnosis came in 1993 and before and after that time, I would continue to indulge occasionally in wine and beer at dinner -- sometimes overdoing it.  Funny how denial works!  A comment by a nurse that in the scheme of things 360 isn't all that high, because it can go into the 10,000's -- that gave me false comfort.  

Then after the first biopsy in 1988, the result showed "mild inflamation of the portal triad" suggesting no big deal.  Oh my doctor did tell me to stay completely away from alcohol, and I would for a while but then I would slowly slip back to wine at dinner -- surely a glass at dinner can't be all that bad -- even though it was never just one glass.  At one point (after becoming so scared that I stopped all alcohol and didn't even eat well, lost some weight) in just one month the ALT score went from 300 down to 46!  Sooooo I took that as a sign that it wasn't anything serious and slowly slipped back into my bad habits of wine at dinner.  

The reason I began searching just now is that I have essentially been hiding my head in the sand, occasionally taking it out and getting scared and then putting it back in the sand.  

After the initial diagnosis, I became very fearful for our two daughters and my husband.  Had them all tested and we all got vaccinated for Hep A & B, because I had read that any double exposure lessens the chances for successful treatment.   I ran around writing names on toothbrushes, bought everyone their own clippers and told them to keep them safe in their own spaces (never worked!) and got back to living.

Recently our daughters 22 and 19 decided (with my encouragement) to start giving blood -- (that is actually how I discovered I was having problems) -- I got a letter one day in 1987 from the Blood Bank that there was a problem with my liver enzymes.  So, anyway, one of the questions she is asked is whether anyone in her living environment has Hep C?  She said that her mother does and they said that they used to not take blood from anyone living around someone with Hep C, but that they do now.  That gave me both comfort and brought the subject back to the surface again.  That is why I searched and found this website.  You are all so supportive of one another, I almost feel like this nasty disease has turned out to be a blessing in disguise!  One blessing is that alcohol use though never completely out of the picture was lessened from 1987 to the present.

Since I have been reading posts (as Jim suggested I do) I noticed some similarities in some of our experiences.

I started in 12/03 experiencing some pretty strange events.  At Christmas I was not feeling well at all and after checking my blood pressure it was going wild -- 300/ 130 or something like that!  As usual when I get scared, I came home in January and started walking -- but of course, I did not keep it up.  I promised I would lose weight but I did not.

Also in 12/03 I had a weird experience with my eyes, everyone I looked at had a droopy right side of their face!  It only lasted about 5 minutes and afterwards I experienced a piercing pain in my right temple.  Optomatrist says "occular migrane."

Also in 2003, starting mid-year, I began experiencing a bump on the edge of my tongue (usually after having anchovies).  Well, finally after this continued to occur month after month I became quite scared, brought it to the attention of my dentist, saw an oral surgeon, told my Internist and STOPPED eating anchovies!

December 2003, I pledged "no alcohol" for one year before my entire family and asked for their prayers and support.  What a wonderful family I have they are very suportive!

This year, July, I began experiencing an infection inside my nose.  I tried to treat it with Campho Phenique and Neosporin but after finally seeking help from the doctor, I used Rhinocort for one month -- one squirt morning and one squirt evening.  That resulted in my nose bleeding every day.  So I stopped using it at about day 20 and in two days an infection flared right up!  So, I used it again for a couple of days, infection cleared and have not used it again since.  I ended up with huge scabs inside my nostril that I believed were growths which I wanted OUT OF THERE SO I picked until now they are all gone.  

Since March of this year I have had consistent left temple pain.  Doctor said it is probably muscular, but I do not believe it is and I will go in to see him next week to discuss a number of things which I have learned here.

Sorry for the long-winded post, but I am actually feeling better about everything.  It is said that the Truth Will Set You Free, and I am starting to feel free for the first time in a long time.  

Pirategold
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Avatar universal
First treatment I was 51.
I was a liver transplant recipient. I was transplanted June 17th of 2000. I started tx in late July of 2000 so my liver was in good shape - no stage or grade.
After the first tx with 3x per week injections of regular interferon and 800 ribavirin (48 weeks) I waited 4 months before starting again. The 2nd tx was with Peg-Intron and 800 mg. ribavirin and lasted 52 weeks. I cleared but relapsed 2.5 weeks after stopping the drugs. I waited 1 month and started 3rd and final tx. 73 weeks of Pegasys and 1000 mg. ribavirin.
I consider myself cured but I know this is one tough virus. They've found it in some strange places upon autopsy ...CSF and brain...so I know nothing is for sure but hell, I'm lucky to be alive. I still get heptimax tests every few months. I stopped tx in June 2004 and have been okay so I figure I'm as cured as I'm gonna get. Mike
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Avatar universal
I was diagnosed last Nov. with HVC geno-type 1b.  Viral count 1,500,000 something.  I guess I didn't know enough about treatment or no treatment and was determined to start right away.  My first specialist in MI was so slow in communicating with me, making appts., starting the treatment (they just seemed too busy for another patient) that I went to the Mayo in MN in April and started the treatment a week later.

By the 4th week my viral count was down to 540 and by the 12th week it was 0.  I guess I'm just finding out through this forum that 1s are the hardest to cure...I feel so fortunate and so glad I went ahead with the treatment.  I have 24 weeks left.
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Avatar universal
I honestly don't know how to thank everyone here for their kindness and compassion -- is that what suffering does to most of us?  Seeing as I was diagnosed with Hep C 12 years ago, it was amazing that I asked such an elementary question and yet no one put me down.  You simply answered my question and encouraged me to spend some time reading the posts.

I did.  I was wide awake until 4:30 a.m. this morning reading as many posts as possible and cutting and pasting to a note page for future follow up.  (P.S. If you have trouble sleeping, buy one of those little black silk-type eye masks, it makes noon like midnight and sleep is so easy!)

You are wonderful, amazing people and when I awoke this morning, I woke with new hope, new energy, new faith in mankind and a sincere belief, that in my case, this whole Hep C thing was, in fact, a gift from God.  Strange as that sounds, I have gained from from the 19 years I have spend fretting over how I got it, and if I was going to infect my loved ones or anyone for that matter, it essentially removed most of alcohol from my life thereby ensuring that time spent with our children (now 19 and 22) was not marred by alcohol abuse (at least most of the time!).  

Again, my sincere thanks to all of you.  I have added all to my prayers and hope you will keep me in yours.

Pirategold
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Avatar universal
Hi!

I was first diagnosed with non-A non-B in 1976, then when they could test for it, it was confirmed that it was HepC. so, last year, having been infected for more than 30 years, Stage 3, grade 2, I did 48 weeks of Pegintron.  Finished in January 2005!  Have been clear since then, I was undetectable at week 12 - genotype 1B!!!  They had given me about 50% chances of success.  Treatment was not fun but do-able.  I am totally back to normal, no lingering side effects.  

If you have questions, please do not hesitate, I will be happy to share.
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92903 tn?1309904711
I would caution you to watch carefully. I've heard annecdotal support for the theory that progression is non-liner. My doc says he's seen lots of surprise jumps after long watchful waits. Others on this board share his sentiment.

There are a couple welcome tests you may want to look into. One is the Fibrosure blood test, and the second is, I think Fibroscan, an x-ray test in trials. These are both analogs to the liver biopsy. Since they're non-invasive, they are more practical for closer monitoring. I can't speak to their accuracy.

Those in the know (and that ain't me) can read more into standard blood panels than meets the eye. There's an online calculator somewhere, someone else will know more about that.    

Genotype is an obvious predictor to successful treatment (tx). That one's constant. Age, fibrosis stage, and duration of infection are also reported as predictors. Those obviously continue to mount against us.

Having said all that, if it were me, I'd go for watchful waiting. But I'd watch as closely as I could, and more so as time progressed.

Best of health to you.

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Avatar universal
I was 1b. I treated 3x and achieved SVR the third tx. My third treatment consisted of 180 mcg. Pegasys and 1000 mg. Ribavirin and it lasted 73 weeks. Some might say that's a long time but it worked for me. Mike
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Avatar universal
i am only 2 shots into this but i asked my doctor if i could change my shot nights from thurs to friday if i started not to feel good on friday & he said absolutely.  it would be perfectly alright to do so & would in no way jeopardize my treatment.  good luck!
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