Aa
Relapsers......
I am confused either to continue hubby s treatment or not......Want to know how many genocide 3 are here who relapsed after 6 months of treatment........This disease has become so much common in our country recently and hubby is the 5th person in our whole family with hcv.......My aunt and cousin sister both relapsed after 6 months of treatment so I am not as much in the favor of treatment,,,,,,,,,,,How many genocide 3 relapsers are here......
So sorry to hear about your husband and family members relapsing.I was a genotype 3.I did a treatment on SOC last year for 24 weeks and was one of the fortunate ones who got a SVR.I did PEGASYS® (peginterferon alfa-2a) and COPAGUS (ribavirin USP).I was fortunate enough to have no dose reduction and be compliant to my medication
100%.
100%.
I am also a genotype 3a and am currently I'm on my 21st week of treatment. I understand your concern about being a G3 and having a high relapse rate. I took a peek at your profile and see that you and your hubby live in Pakistan....I think that explains a lot. Until recently G3's were always associated and grouped with G2's. Many studies were done jointly and the statistics reflected accordingly. I have been reading....and reading.....and reading some more about genotype 3. As I read, I come across more and more articles about high relapse rates for genotype 3s in Pakistan. Ive spent the last 45minutes trying to find a study I read that talks about G3's developing a resistance over there....that's not seen in Western countries which explains the high relapse rate. I will look for it and hopefully come across it so I can share it with you.
What kind of treatment did your aunt and cousin who relapsed so? Did they do the standard interferon with Ribaviron or the Pegylated? the reason i ask is because it is my understanding that the Pegylated form of Interferon wasn't readily available over there in the past. The SVR rates are much higher with the pegylated interferon than the standard old school stuff. Here is a study that may interest you:
RESPONSE RATES TO STANDARD INTERFERON TREATMENT IN
HCV GENOTYPE 3A
Saleem Qureshi, Uzma Batool, Musarrat Iqbal, Omarah Qureshi, Rao Kaleem, Hina Aziz,
Muhammad Azhar
Department of Medicine, KRL General Hospital, Islamabad, Pakistan
"It is estimated that there are approximately 10 million people infected with HCV in Pakistan with an average prevalence rate of 6%.3 Multiple studies
confirm that type 3 is the prominent genotype in Pakistan with the prevalence of between 75–90%.4 Treatment of Hepatitis C virus has shown response rates of up to 80% in the easy to treat group as observed in western5–13 and local studies14–16. However, we observed
recently that the SVR appears to be lower in contrast to previously published data. Recent international studies using Pegylated Interferon also suggest that previous response rates were due to falsely assuming similar response rates in geno 2 and 3, with lower rates for geno
3. We know from studies in other infectious diseases that both bacterial and viral resistance factors and mutagencity causes shift in response rates."
CONCLUSIONS
"The sustained viral response is lower in this study as compared to international and national data. The emergence of resistance, its clinical consequences, monitoring drug efficacy and finally managing
resistance needs to be tackled on emergent basis. Refining our approach to management of patient with Hepatitis C genotype 3 has become imperative and attention to predictors of response and then tailoring
duration of therapy, on the basis of responses at 4 or 12 weeks as is now being done for the more resistant genotypes, may lead to better outcomes.
http://www.ayubmed.edu.pk/JAMC/PAST/21-4/Saleem.pdf
___________________________________________________________
Here's another one you may like:
Treatment of Genotype 3a Relapsers of Chronic Hepatitis C and its duration
"In Pakistan, a rather rosy picture of CHC has been painted in the past as far as the prevalent genotype is concerned. We are thought to be ‘blessed’ with genotype 3 and doubly blessed since genotype 1, the ‘black sheep’ of the family is least prevalent here. Since the response rates to treatment are so good with genotype 3, a liver biopsy is not deemed necessary before initiating treatment. Regarding re-treatment in relapsers of this genotype, a 24-week course was considered sufficient in the past. All such concepts are rapidly changing as an increasing number of relapsers and non-responders carrying genotype 3a emerge. Researchers in one local study involving a single centre detected 58 non responders of genotype 3a in 2005 alone8. All had received a twenty-four week treatment course of conventional interferon and ribavirin. Genotype 3a relapsers are now increasing because of important reasons. Our first such patient (genotype was confirmed when the facility became available) received conventional interferon monotherapy in 1991-92 at Holy Family Hospital Rawalpindi, the first time it was used there. The product was not locally available then. He responded but relapsed in 1997. By this time ribavirin had also come into use, which he received in combination with conventional interferon. He has not relapsed since. However there are many such patients who have. They too were subjected to similar modes of treatment including conventional interferon monotherapy which is associated with a high relapse rate. Pegylated interferon, associated with a better SVR was approved for use by FDA in 2001 but remains outside the range of the common CHC sufferer due to its prohibitive cost. These factors have contributed to a steadily increasing pool of genotype 3a relapsers which is now coming to notice."
http://journalrmc.com/Journals/JRMC%202008%20Vol%201-2/JRMC_Jan_2008-V-111-No-1/2-Treatment%20of%20Genotype%203a%20Relapsers%20of%20Chronic%20Hepatitis%20C%20and%20its%20duration.pdf
___________________________________________________________
Hope some of this info helped.
What kind of treatment did your aunt and cousin who relapsed so? Did they do the standard interferon with Ribaviron or the Pegylated? the reason i ask is because it is my understanding that the Pegylated form of Interferon wasn't readily available over there in the past. The SVR rates are much higher with the pegylated interferon than the standard old school stuff. Here is a study that may interest you:
RESPONSE RATES TO STANDARD INTERFERON TREATMENT IN
HCV GENOTYPE 3A
Saleem Qureshi, Uzma Batool, Musarrat Iqbal, Omarah Qureshi, Rao Kaleem, Hina Aziz,
Muhammad Azhar
Department of Medicine, KRL General Hospital, Islamabad, Pakistan
"It is estimated that there are approximately 10 million people infected with HCV in Pakistan with an average prevalence rate of 6%.3 Multiple studies
confirm that type 3 is the prominent genotype in Pakistan with the prevalence of between 75–90%.4 Treatment of Hepatitis C virus has shown response rates of up to 80% in the easy to treat group as observed in western5–13 and local studies14–16. However, we observed
recently that the SVR appears to be lower in contrast to previously published data. Recent international studies using Pegylated Interferon also suggest that previous response rates were due to falsely assuming similar response rates in geno 2 and 3, with lower rates for geno
3. We know from studies in other infectious diseases that both bacterial and viral resistance factors and mutagencity causes shift in response rates."
CONCLUSIONS
"The sustained viral response is lower in this study as compared to international and national data. The emergence of resistance, its clinical consequences, monitoring drug efficacy and finally managing
resistance needs to be tackled on emergent basis. Refining our approach to management of patient with Hepatitis C genotype 3 has become imperative and attention to predictors of response and then tailoring
duration of therapy, on the basis of responses at 4 or 12 weeks as is now being done for the more resistant genotypes, may lead to better outcomes.
http://www.ayubmed.edu.pk/JAMC/PAST/21-4/Saleem.pdf
___________________________________________________________
Here's another one you may like:
Treatment of Genotype 3a Relapsers of Chronic Hepatitis C and its duration
"In Pakistan, a rather rosy picture of CHC has been painted in the past as far as the prevalent genotype is concerned. We are thought to be ‘blessed’ with genotype 3 and doubly blessed since genotype 1, the ‘black sheep’ of the family is least prevalent here. Since the response rates to treatment are so good with genotype 3, a liver biopsy is not deemed necessary before initiating treatment. Regarding re-treatment in relapsers of this genotype, a 24-week course was considered sufficient in the past. All such concepts are rapidly changing as an increasing number of relapsers and non-responders carrying genotype 3a emerge. Researchers in one local study involving a single centre detected 58 non responders of genotype 3a in 2005 alone8. All had received a twenty-four week treatment course of conventional interferon and ribavirin. Genotype 3a relapsers are now increasing because of important reasons. Our first such patient (genotype was confirmed when the facility became available) received conventional interferon monotherapy in 1991-92 at Holy Family Hospital Rawalpindi, the first time it was used there. The product was not locally available then. He responded but relapsed in 1997. By this time ribavirin had also come into use, which he received in combination with conventional interferon. He has not relapsed since. However there are many such patients who have. They too were subjected to similar modes of treatment including conventional interferon monotherapy which is associated with a high relapse rate. Pegylated interferon, associated with a better SVR was approved for use by FDA in 2001 but remains outside the range of the common CHC sufferer due to its prohibitive cost. These factors have contributed to a steadily increasing pool of genotype 3a relapsers which is now coming to notice."
http://journalrmc.com/Journals/JRMC%202008%20Vol%201-2/JRMC_Jan_2008-V-111-No-1/2-Treatment%20of%20Genotype%203a%20Relapsers%20of%20Chronic%20Hepatitis%20C%20and%20its%20duration.pdf
___________________________________________________________
Hope some of this info helped.
The success rates for genotype 2 & 3 are failry good.
What type of interferon are you able to get? I think some countries still use the non-pegylated interferon. The pegylated interferon gives one a much more constant stream of interferon and it better.
How much ribavirin is prescribed? The standard for genotype 2 used to be 800mg a day, no matter what weight a person is. However in the US it is much more common now to get weight-based ribavirin. This has proven to be more effective than 800mg.
" weight-based dose of ribavirin, which started at 800 mg/day for patients weighing under 65 kg, and increased by 200 mg/day for up to each additional 20 kg of weight up to a maxiumum dose of 1400 mg."
"A sustained viral response was achieved by significantly more patients who received a weight-based dose (44.2 percent) than fixed dose (40.5 percent) ribavirin," the authors report. "Overall, response rates decreased as weight increased when a fixed dose was used but remained unaltered with a weight-based dose." Discontinuation rates and reported adverse events did not differ significantly between the two treatment schemes, and relapse rates were lower for patients who had received weight-based dosing. The researchers also found that 48 weeks of treatment offered no additional benefit compared to 24 weeks for patients with genotypes 2 or 3..
What type of interferon are you able to get? I think some countries still use the non-pegylated interferon. The pegylated interferon gives one a much more constant stream of interferon and it better.
How much ribavirin is prescribed? The standard for genotype 2 used to be 800mg a day, no matter what weight a person is. However in the US it is much more common now to get weight-based ribavirin. This has proven to be more effective than 800mg.
" weight-based dose of ribavirin, which started at 800 mg/day for patients weighing under 65 kg, and increased by 200 mg/day for up to each additional 20 kg of weight up to a maxiumum dose of 1400 mg."
"A sustained viral response was achieved by significantly more patients who received a weight-based dose (44.2 percent) than fixed dose (40.5 percent) ribavirin," the authors report. "Overall, response rates decreased as weight increased when a fixed dose was used but remained unaltered with a weight-based dose." Discontinuation rates and reported adverse events did not differ significantly between the two treatment schemes, and relapse rates were lower for patients who had received weight-based dosing. The researchers also found that 48 weeks of treatment offered no additional benefit compared to 24 weeks for patients with genotypes 2 or 3..
Im Genotype 3a i did 6 mos tx with pegasys & riba, und at 5 wks, und at 12 wks post tx but replapsed at 6 mos post tx....
Will wait til non interferon is available to treat again...
Will wait til non interferon is available to treat again...
Hi i am type 2 and if im right type 2 and 3 are the easy to treat type i went undetectable at week 4 and am on week 18 and still undetectable
Just want to ask what kind of meds is he on and how much ?
i am on 180 peg and 800 mg of riba 400 mg in the am and 400 mg in the pm
i am in no way an expert on this virus but we can compare notes there are plenty of people on here that do know much more then me
i dont think stopping his treatment is a good thing but again im no expert someone will come along to give you much more knowledgeable advice
Just want to ask what kind of meds is he on and how much ?
i am on 180 peg and 800 mg of riba 400 mg in the am and 400 mg in the pm
i am in no way an expert on this virus but we can compare notes there are plenty of people on here that do know much more then me
i dont think stopping his treatment is a good thing but again im no expert someone will come along to give you much more knowledgeable advice
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