Infergen (consensus interferon)

[justtry]

I am on hep C treatment (pegasys and Ribo) 6 months, but my 5 months viral load still not as law as it should be. My doc told me if my 6 months blood test viral still higher then 1000 she recommended me to
change peginterferon on infergen (consensus interf).
Is anybody had an experience with this drug (side effects, results,..)How long will I continue (hepC 1B)
Thank you

[hondapatches]

I only had the high high fever that first shot. I started on a Friday so I would have Sat and Sun to recover. You have to take a shot everyday. I took 2 ribos in the morning and 2 at night along with my shots. If you already stay home and take care of your children you will be fine. I worked from Aug. untill Feb. I wanted to keep working but my principal was freakin out cause I looked really bad I felt really bad by that time. But I took a leave anyway. My situation is different. My hunsband is not happy he has to help me with my bills. So finnancilly (spell ck)  I am a bit screwed. But life goes on...Like I said if you already stay home, you'll be ok. You'll just have to rest some. It's really hard I know I have a teenager and a husband who is just running me around, I really haven't rested like I should have, everybody is so selfish around here.
Live, Love, Laugh
Honda

[CockSparrow]

How long do you think it might be reasonable to wait (if I stop
treatment) before to start new tx with infergen?
---------------------------------------------------

Till you Hgb and neuts return to normal levels, would be the minimum wait.
Infergen will be a lot harsher than what you have been on.
But if you can tolerate it, probably a lot more effective as well.

All the Best
CS

[justtry]

  Dear Honda,

Thank you so much for sharing your experience. It seems might help to me too
because I was very close to reach good result on regular txt ( still hope may be
I will be UND, next week my 6 months result will come). But with all those side
effects ( I have 19months old son and 4.5 years old and no relative in the USA, only my husband) I am scared. Did you have such a terrible night just 1-st shot? What was
your fiver after that (only night time or during the day)?

[hondapatches]

5 years ago I did interferon and ribo for a year, then I did 6 months of peg interferon I was a non responder to both of the medications. I came across the infergen on the internet I asked my docter and he said this isn't going to work for you because you were a non responder. I told him well we can try it you never know. And he agreed. I have been through hell but I am HCV free, thanks to will power and the love of God.
This last year Aug 2007 I began infergen. for 10 months I have been undectible.
But this stuff will knock your socks off, I had no sides what so ever, worked the whole time, and I teach first grade. But with the infergen whoa..........it is a really rough ride.
The first night I took it I thought ok just another night like with the treatment........Whoa.......... it has nearly killed me since day one. I had 103 or 104 fever it was something else, teeth chattering. Got up couldn't walk, tried to call my girlfriend,
she didn't know what to do. Finally I got to the stairs and called my husband to come down. I could hardly tell him what was going on. He got wash rags with ice and put it on my head then took a wash rag and washed me down. Finally after about 2 hrs I could talk and was feeling better But my God I will never forget that night. It was the 1 and only high fever, Then it just went to low grade fever everynight. But I have come up undectable every time. Did a lot of praying and prayed with all the Christian leaders for healing.
My hair did fall out, looks really bad these days, but if you do the infergen be strong, Between the meds and God you can do it. It seems to really get at the virus.
Live, Love, Laugh
HondaPatches

[justtry]

Hi CS,
"NYGirls idea of stopping and then retreating this time with Infergen makes a lot of sense to me."
How long do you think it might be reasonable to wait (if I stop
treatment) before to start new tx with infergen?

thank you

[CockSparrow]

Baseline 6,000,000
Week4 360,000
Log Drop 1.22
This was a reasonable response

Week 4 VL 360,000
Weeks 20 VL 80,000
Log drop 0.65

You have become Resistant to Pegasys and have been for quite awhile
You would need a 2.56 log drop to be 1000 at week 24.
To be UND this would be a 5.56 Log drop

Neither of these are likely to happen.
I have no idea why your Doc wants to wait. You shave swapped before now.
My guess is the 1000 is 600 IU with PCR variabilty factored in.

Now for the bad news
You will need to do what magnum advised against. Overdose on Infergen.
Monitor for 4 weeks and check VL. If it turns response around then continue.
But really the most likely outcome is relapse.
You would also need to do at least 48 weeks from when you become UND.
Playing catch up with this virus doesn’t work that well.

NYGirls idea of stopping and then retreating this time with Infergen makes a lot of sense to me.

All the Best
CS

[Magnum]

In the Search Med Help at the top right of the page, type Magnum Infergen. It should take you to posts I posted

Magnum

[justtry]

Dear Magnum,
Thank you for comment. Whould you mind to post a link on your previous comment
that you mentioned, I couldn't find it.
Did you have any discomfort or side effects on regular peginterferon alfa-2a and Riba?

I don't know yet that would be my dose on alfacon -1(infergen), but I did not had any
unusuall felling from peginterferon and riba.My 4 -years old son seems like doing well on regular txt too.

[HectorSF]

It seems to me justtry is experiecing a "Partial Virologic Response".

"Partial Virologic Response"

These patients elicited an initial response to interferon-based therapy and exhibited a 2 log10 IU/mL or greater decline in HCV RNA during the first 12 weeks of treatment. If these patients are treated with higher doses of interferon or peginterferon alfa, they can potentially achieve a greater decline in HCV RNA, perhaps achieving undetectable values and, in some cases, SVR (Capsule Summary).[32] Unfortunately, most retreatment studies have not characterized the previous virologic response pattern, and the relative percentage of null and partial responders is commonly unknown. However, in 2 studies, the previous response pattern was well characterized. In the first study, a population of patients with previous nonresponse to standard interferon were retreated with a higher dose of standard interferon and ribavirin. Only 13% of patients achieved an SVR. However, all of these responders had also achieved a partial response during their initial course of therapy; no previous null responders achieved SVR.[33] In the second study, patients with a previous nonresponse to standard interferon and ribavirin were retreated with peginterferon alfa and ribavirin.[34] Overall, 28% of patients in this study achieved an SVR. However, 75% of these patients had a partial virologic response during the initial course of treatment. In an interim report of another study, the REPEAT trial, patients with nonresponse to peginterferon alfa-2b and ribavirin were retreated with either standard-dose (180 µg/week) or high-dose (360 µg/week) peginterferon alfa-2a (Capsule Summary).[35] After 12 weeks of treatment, the percentage of patients who achieved undetectable HCV RNA was 17% greater with the higher dose of peginterferon alfa-2a compared with the standard dose. Final SVR results will be required to see if the advantage of high-dose peginterferon alfa treatment remains.

Based on these observations, it has been hypothesized that some patients with a partial treatment response can achieve undetectable HCV RNA if switched to a more intensive interferon regimen. The time at which to intensify the interferon regimen can be anywhere between 12 and 24 weeks. However, the patient must be able to tolerate the higher dose of peginterferon alfa and be motivated to continue with treatment. The major limitation to this strategy is firstly the accessibility of higher dose of peginterferon alfa to many patients, as it is unlikely to be approved by many insurance companies without more concrete data supporting this approach and, secondly, the increase in the discontinuation rates because of tolerability issues. In patients treated with a more intensive interferon regimen, HCV RNA should continue to be monitored at monthly intervals. If the patient does not achieve undetectable HCV RNA within 12 weeks of dose intensification, treatment should be discontinued. By contrast, if the patient does achieve undetectable HCV RNA, this treatment should be continued for an additional 48 weeks. This is the typical duration of extended treatment in patients with slow virologic response.

32. Gross J, Johnson S, Kwo P, Afdhal N, Flamm S, Therneau T. Double-dose peginterferon alfa-2b with weight-based ribavirin improves response for interferon/ribavirin non-responders with hepatitis C: final results of “RENEW.” Program and abstracts of the 56th Annual Meeting of the American Association for the Study of Liver Diseases; November 11-15, 2005; San Francisco, California. Abstract 60. (Capsule Summary)
33. Shiffman ML, Hofmann CM, Gabbay J, et al. Treatment of chronic hepatitis C in patients who failed interferon monotherapy: effects of higher doses of interferon and ribavirin combination therapy. Am J Gastroenterol. 2000;95:2928-2935.
34. Jacobson IM, Gonzalez SA, Ahmed F, et al. A randomized trial of pegylated interferon alpha 2b plus ribavirin in the retreatment of chronic hepatitis C. Am J Gastroenterol. 2005;100:2453 2462.

Cheers!
Hector

[justtry]

Hi nygirl7,
thank you for the detailed explanation.
My hep.C genotype is 1, so treatment is 1 full year. My first 4 weeks VL was
very good (from 6,000,000 to 360,000), after that very strange.
I guss infergen is stronger than peginterferon.
As I said in 1st message, if my VL 6months will be hight my doc will try ALFACON-1,
if it will be UND- same standard treatment(pegasus and RIBO).
I did not have any side effects from txt, so I am not sure that did you meen by  
"regrouping and then starting again once you've built up your strength."

[justtry]

Hi CS,
Thank you for the response.
My VL befor treatment was 6,000,000
after 4 weeks 360,000
now - 80,000
6 months - I will know next week
I am gen. 1 hepC, so txt 1 year
I did not have any side effects from my txt. Do you think I might have
from INFERGEN?
thank you again

[Magnum]

Not to alarm you, but search for the word Infergen on this board and find my near death experience on this drug. In my case, because I had failed three prior treatments, the doctor was determined to once and for all get rid of this virus. He recommended overdosing. Instead of the typical 15mcg daily, I was injecting 24mcg daily. It nearly killed me. My bilirubin reading was through the roof and I became jaundiced. DO NOT let your doctor overdose you on this powerful drug.

On the upside, before he told me to stop immediately, it was the ONLY drug that was working in my four treatment attempts. My doctor said that because of the bad side effects, he will not retreat me with Ingergen. Please remember, I'm talking about OVERDOSING. Your doctor should keep a very close eye on you even with typical dosing. At least once a month bloodwork is highly recommenced in my opinion. Who knows, this may be the "miracle" drug that does the job for you...

Good luck,

Magnum

[nygirl7]

I've never heard of them switching interferons so late in the game.

Honestly, you would probably be better off stopping - regrouping and then starting again once you've built up your strength. If you haven't already gotten to UNDETECTIBLE viral load at six months the chances are VERY slim that you will.  Iv'e NEVER EVER heard of a doctor refer to it as "under 1000".  Tests these day go all the way down to 2 - yes TWO.  The more accurate the test the better your chances. Having a viral load of 1000 or so it not good.  You are still positive. when you are positive it doesn't matter if you have two or 2million.............it will still come back.

Personally I had gone all the way down to 411 at week FOUR. But at week 12 I still had a viral load of 419 (same thing). I needed to EXTEND treatment to 72 weeks because of that. I am SVR now.

Your doctor seems to have some very strange protocols that honestly don't make very much sense to me.  It might be worth getting a good second opinion.

Even though I'd read all the studies and knew what was going on...I still made an appointment with the doctor who was the lead investigator of one of the big studies I was using to determine what to do.  That second opinion most likely was one of the smartest things I've ever done because he did encourage me to go to 72 weeks.

you should google the Berg Study and see what it has to say. The closer you are to undetecible by week FOUR the better your chances are. The farther away you get the worse.

Good luck.  Learn all you can so you can begin to make your own educated opinions...that is the key to beating this disease.

[CockSparrow]

Your chances without making a change would be fairly slim. Not zero maybe but not that good if you were only doing 48 weeks.
Switching to infergen is worth a try but the sides can be severe.

What was your VL at week 12 and what is it now?

All the Best
CS