Probably a naive question...

[sunshines76]

Are there any cases when therapy for 1b type was stopped after 24 weeks of treatment (and patient became UND by week 4) and SVR was still achieved?

[newleaf09]

Thanks Bill, guess we have the reference bases pretty well covered.

[Bill1954]

Oops, just now seing Newleaf's post :)...

[Bill1954]

Here are a couple of links to discussion of abbreviated, 24 week therapy for a subgroup of GT-1 patients using the current standard of care interferon/ribavirin treatment:

http://www.hivandhepatitis.com/hep_c/news/2008/101408_b.html

http://www.hivandhepatitis.com/2009icr/aasld/docs/111709_a.html

Bill

[newleaf09]

I don't think low VL and non-cirrhotic are criteria for stopping, they just tend to be factors that influence UD by 4 weeks of TX.  Interestingly, a recent study done on genetics of patients with the genetic polymorphism, CC, that caused strong response to interferon, found a lot of early responders (with exceptional odds for SVR) with the CC to have high viral loads.

Here are some links to popular accounts of studies on 24 week TX for early responders:
http://www.natap.org/2005/AASLD/aasld_55.htm
http://www.natap.org/2007/HCV/021207_01.htm
http://www.natap.org/2006/HCV/042106_02.htm

[WriteItDown]

My husband (Geno 1b) just finished up a clinical trial, SOC + new protease inhibitor.  He was RVR and stopped at 24 weeks.  In 6 months we will know if he is SVR, but I have heard the odds are good, maybe 95%.  With the new drugs there is definitely hope to treat Geno 1's in 24 weeks.  On these new protocols if you attain RVR you can likely stop with little more chance of relapse than if you did 48... but of course the drugs are still in the trial stages, so no one can say for certain yet.

A large part of the reason he chose to do the trial was to have the chance to treat in only 24 weeks.  It will be a happy day when all Geno 1's have this shot.

[chemister]

I thinks that will happened me, answer at 12 weeks :)

Start virus load 2700000 IU/mL
Week 1: 6300 IU/mL
Week 3 and 4 = UND

Non cirrhotic, responder, RVR

[Bill1954]

I think the European Union has adopted a 24 week Tx for genotype 1 patients that are:

Non cirrhotic
Low baseline viral load (<400,000)
RVR (RNA serum negative at 4 weeks of Tx)

Not only do they suggest stopping at 24 weeks, I believe they insist on it. There are a number of credible studies that demonstrate that under these circumstances, further treatment doesn’t appreciably increase SVR odds. You can search for studies if you like; or let me know, and I’ll try to dig something up for you and your doc.

Best of luck—

Bill