How long to wait to re-treat? Post TX PCR.

[jmjm530]

Feeling very positive finishing my 2nd week without Peg and my first without riba -- but being the pro-active soul I am, a couple of questions:

(1) Some of you like Calio, have jumped right back on the treatment bandwagon within days/weeks of relapse. Goofy, I believe has indicated he'd do the same thing in case of relapse.

Others, have indicated their doctors wanted them to rest/heal like 6-months or so before re-treating, as mine once suggested.

First, for all those who re-treated, how long did you treat and how long did you wait before re-treating, and what logic if any did your doctor give you?

And related, did any of your doctors discuss in detail the why's or why nots of re-treating sooner or later. I ask this second part because one way of looking at it is to hit it hard again before the virus has time to get strong. Another way, is to take a rest and let the immune system get strong before re-treating.

(2) So when exactly is the 4-week post-tx PCR/TMA?
When we count our treating weeks, we start with the Peg shot. So our treating week 4 PCR would be the day before our 5th shot. I'm assuming it works similar post treatment, except the difference is post tx we already start with drugs in our system. So do you start counting from the day of your last shot. Or, do you start counting from the day of your last riba?

Here's my example. Last shot Wed March 8th. Last Riba Wed March 15th. I therefore think my week 4 PCR/TMA should  be Tuesday April 4th. But counting from last riba would make it April 11th. Any input welcome.

Thanks.

-- Jim

[jmjm530]

NY: Jim you are done
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OK. OK. I'm going to Disneyland then. LOL.

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BTW I hope you're holding up with your little set back and if you think you're going to be so luck and be able to eat fudge pops for the rest of your life without losing weight, dream on. From what i underdtand many with inteferon-induced graves disease can be cured, so hopefully they'll be calling you "fatty" soon. LOL.  

Just remember, how hard you fight has to be weighed against how much is at risk. In my case, I'm around a stage 3. You have less damage if I remember correctly, so hopefully you will keep that in mind when making treatment decisions. I had absolutely no desire to treat at all until I heard I was stage 3 -- actually, they told me I was between stage 3 and 4, which was a mistake.

-- Jim

[Dale_Ray]

Jim: Quick note - my doctor told me when the treatment was over that 12 weeks post was the most accurate / optimum time to do a complete work up and see if the beast was back. I don't know if that is based on his personal experience or data. I am a 1A and that may be the factor as well. He said he had a very good feeling that we would nail it though and he is a pretty conservative fellow so that made me feel good. Dale

[GoofyDad]

Jim says:
<i>it's just my nature is to to keep fighting until the deed is totally done</i>

Shameless self promotion on a largely female msg board?
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Kalio, Sorry to keep dragging you into this... but here's a question for everyone. Why isn't it standard protocol to test at 1-2-3 weeks post tx, and restart tx immediately if virus is found. I mean, if we can restart in that timeframe without loosing preciously gained ground, why isn't everyone testing early?  
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Jim, One of those 4 links posted by cuteus last week had a breakdown of when relapse was detected. I looked back and could find it, but I remember a confusing sentence about mean relapse in 4 weeks. Did you happen to see it?

[jmjm530]

Don't remember the post but check my math here: If SVR can be 90% determined at week 4 -- and 99% determined at week 2 -- then mean must be less than 4 weeks and I figured around 2, which btw happens to be when my doc usually does his first post-tx PCR which I may just pass on since don't see the point unless I was going to re-treat right away which brings me to you other question to Kalio...

The question isn't so much whether or not you should do a 1-week, 1-week, 3-week, etc, post tx PCR but whether or not there's greater efficacy to treat right away after relaspe. Kalio's doctor seems to indicate there is. Mine thinks there's an advantage to wait a few months for the immune system to strengthen. What does your doctor say? Seems like different opnions on this.

Lastly, have you found your callendar yet? I need someone to check my math on when to do the 4-week post-tx PCR. You know callendar -- that bound thing, with boxes and such, with a different naked lady each month in an unmentionable pose :)

-- Jim

[jmjm530]

Meant "99% determined" at week 12, not week 2.

[jmjm530]

Stupid question. Have you had your PCR double-checked? A new study recently suggested there are more false positives and false negatives than one would think. I also read on Dr. Dieterich's web site, where he never makes a major treatment decision based on only one PCR. BTW thanks for the encouragment and understanding. You know the position I'm better than most -- maybe the best considering your recent scenario.  All the best luck moving forward in treatment, you certainly seem to have a very positive attitude plus lots of determination. You and NYGirl ought to bottle it up and the rest of us could inject some of it with our peg and riba.

-- Jim