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Hepatitis C (Expert Forum)
I'm new and have a couple questions
Answered by
Douglas Dieterich, MD - Internal Medicine, Gastroenterology
The Mount Sinai Medical Center
New York - NY
Questions posted in the Hepatitis C Forum are answered by medical professionals from The Mount Sinai Medical Center.
I'm new and have a couple questions
by granitekonig, Oct 19, 2008 01:39PM
I'm 32 and very fit but just found out I have hep c, genotype 3. I've done a ton of research and am scheduled to start treatment around November 19th. I know about the side effects and I read genotype 3 has 90% success rate.
My question is this: I understand a 2 log drop by week 4 is a good thing. My viral load is 2,660,000 right now. That was when I was drinking heavily. I quit drinking completely since I found out.
1. Will my viral load go down at least a little bit before I start treatment?
2. If I have a two log drop, then I'll be at 666,000 viral load aproximately by week 4 - does that decrease my chances of SVR by month 6 or is that not such a high load at the end of week 4?
3. I've read that less ribiron (sp) and peg. intervirion is needed for type 3's. Does anyone know if this lower dosage translates into significantly reduced side effects?
THANK YOU!
My question is this: I understand a 2 log drop by week 4 is a good thing. My viral load is 2,660,000 right now. That was when I was drinking heavily. I quit drinking completely since I found out.
1. Will my viral load go down at least a little bit before I start treatment?
2. If I have a two log drop, then I'll be at 666,000 viral load aproximately by week 4 - does that decrease my chances of SVR by month 6 or is that not such a high load at the end of week 4?
3. I've read that less ribiron (sp) and peg. intervirion is needed for type 3's. Does anyone know if this lower dosage translates into significantly reduced side effects?
THANK YOU!
Doctor's Answer
by Douglas Dieterich, MD, Dec 16, 2008 08:40PM
, Dec 16, 2008 08:40PM
Hi, you must be on treatment right now if you started november 19th and I hope you are doing good. To answer your 1st question, the viral load fluctuates a lot. The fact that you stopped drinking will certainly help your liver but I cant tell you that it influences the viral load. Question 2. What we want is at least a 2 log drop from baseline at week 12. If we dont achieve that, we recommend to stop treatment because your chances of response (SVR) are very low. 2 log means you divide the viral load 2 times by 10. So you remove 2 "0" out of 2,660,000. It gives you 26,000IUs. So we want your viral load to be below 26,000 at week 12 in order to achieve SVR. Question 3. The dosage of peginterferon is the same for all genotypes but a fixed dose of 800mg of ribavirin is recommended for the treatment of genotypes 2 and 3 infections. However we give weight-based ribavirin when we treat patients who are overweight. Yes, we expect less side effects with the lower dose. Mostly we expect less anemia (low red blood cells). Good questions! DTD
Member Comments (1)
by toxy, Nov 17, 2009 05:00AM
A related discussion, Question to Dr Dieterich was started.
