More Genotype Questions (again!)

[hep62pj]

sorry but I keep coming back to this, I guess because I dont know what genotype i am - 3 tests all say untypeable/atypical/ unknown...so maybe I am either a brand new type (woohoo, right?!) or a mutant (!!!) haha

But this is my question, I am stage 2/grade 2, have probably had this for over 20 years, it seems to me that even though genotypes 2 & 3 respond much better to tx, does the virus progress more agressively in these individuals?  I have seen many a stage/grade 3 & 4's post here that they are genotype 2 & 3...I am just wondering, I am really concerned about progression since I failed tx (virimadine & peg phase III trial)...

[cuteus]

why do people always think NYC when someone mentions NY? It is like nothing else exists in the whole state! NYC does not = NYS.
wow! what a shock!
(having fun poking fun)

[dammitjanet]

Well, you have to admit tha NYGirl just Sounds like a city girl.  Besides, NYC, Brooklyn, LonggIsland -- it's all the same to us hicks out here in the other 49!  :)

[NYgirl]

you are the best do you know that?  you should move to NY so you can do treatments with me hee hee!  ;)

[v eggie dip]

I'm reading a book now that may have some of those answers, if so I will forward on to you and Susan...Best of luck to you both ..

Beth

[NYgirl]

I dont know but somebody may hopefully have some sort of idea.

It's bad enough to get one thing but to have to have them both is just the way my life works...

I ain't givin' up though!  :)  Will fight this thing till it's over.

I wish I knew Veggie...I wish I knew.

[v eggie dip]

wow, I didn't know that you could get more than one strain, that sucks big time eh...Too bad you didn't have one 1 and a 2 instead of both 1's...I wonder if that means the virus attacks the liver harder than with one strain...Has anyone reached SVR with 2 strains?  Sorry to be asking so many questions but I had no idea there could be more than one strain in a person...

Beth

[v eggie dip]

I don't think I would survive in NY, I am a country girl that needs clean air, although I do like NYC, used to go there at Xmas time to see the Radio City Music Hall do the Nutcracker and we would stay in a fancy hotel and go shopping, it was tons of fun, but there's no AIR there lol...

[susan400]

It means that I have 2 different strains.  The National Genetics lab (a very reliable lab) determined both genotypes.

Susan

[NYgirl]

It means I have both 1a & 1b.  Don't ask me how or why or anything.  All I do know is it's not easy to get SVR with it I guess.  but I'm still going to keep trying cause some others have!

I really don't understand how I can have two. I mean was I infected two different times or did the person who gave this to me?  I sure dont understand any of it - at all.

[v eggie dip]

1a/1b..does that mean you have 2 different strains, or they didn't know which one it is?

Beth

[NYgirl]

I am 1a / 1b too.  Guess we just have to work a little harder huh?  :)

[hep62pj]

I treated for 6 months as a type 1, I was on a trial for virimadine, it was a 48 week trial but I was dropped because not enough response...still trying to get some kind of results from the drug company, it was a double blind study and they do not share v/l results with the hospital.  I had minimal side effects so I am hoping to tx again soon...

[NYgirl]

What a bummer huh?  Well we are strong women and can kick the butt of both of these strains.  I'm of the never give up mind right now (but after one shot it's not that hard to say).

My mom learned how to do the shot just in case I try to give up she can sneak in and get me in the middle of the night LOL. She's a freak but I love her!

I wonder how it works that we got both.

[NYgirl]

I don't live IN NYC I live in the country in one of the suburbs about an hour outside NYC.  It's clean air and fishing and camping and bbq'ing and all of that where I am. Lovely place to live cause you can go to the city whenever you want but not have to live there. (Which who can even afford!)

I couldn't live IN the city...but outside the city is more country than you can imagine.

See...you need to come here to the USA for tx I tell ya!  ;)

[susan400]

I am a mixed genotype.  I was typed as a 1A and a 1B.  My doctor thinks that this may be why I've had such a hard time obtaining a viral clearance.  

Susan

[LvdByGod]

jm, that first link is just a link to a "google search page" with many articles and web pages. is that the one you intended to give me? could you perhaps tell me which article has it in it that 1b's progress faster than other genotypes.

the first article on the list only shows that 1bs account for the majority of those with hepatitus "not" that they progress faster to "cirhosis" than other genotypes. so i would love to have the exact article that shows 1bs progress faster than other genotypes to end stage liver disease. like i said i have only read of 3s progressing faster primarily due to the fatty liver issue.

ps. i'm not saying that this is definately not true about 1bs, or that you did not read this somewhere, just that "I" don't see it anywhere and have never heard of that before. that's why i'm interested in the article to educate myself if it is true.

ok jm?

i just read your following post and it is saying the exact thing that i was talking about, that the reason for so many 1b's getting the disease in more advanced stages is because it is hardest to cure and 1s are more common, so there would obviously be more folks going on to cirhosis from that group, because there are more of them.

hey, don't worry about it jm, i just kinda freaked out when i heard that cause i never heard it before. i'm just in "riba brain" right now...i also agree it has no bearing on whether or not we do treatment. we all need to kick this dragon in the butt!!!

thanks again for the great links!

sandi

[jmjm530]

Maybe this excerpt puts the genotype/fibrosis progression thing into perspective. References are provided for those that want to pursue more. Whatever the differences, I don't see them signifcant in any treatment decision.

"It is unclear whether viral factors, such as virulence of the infecting viral genotype, viral load and quasispecies diversity, impact on the development of HCV-related cirrhosis. Infection with HCV genotype 1, particularly subtype 1b, has been reported to increase the rate of progression to HCV-related cirrhosis.[70-74] Rather than a direct effect attributable to HCV genotype, it may be that genotype prevalence is changing, other genotypes are becoming more common and patients with genotype 1b have simply been infected for longer.[75,76] Studies that have considered other factors related to disease progression have typically failed to find any association between HCV genotype and cirrhosis.[16,27,31,36,5"

Full link: http://www.medscape.com/viewarticle/460551_4

[jmjm530]

LOL. You crack me up.

[LvdByGod]

yep jm i agree...your a good sport here...i kinda was just messin with ya! :O) i know i'm bad!

[jmjm530]

I think we're pretty much on the same page.

As the link in the last link states, "Infection with HCV genotype 1, particularly subtype 1b, has been reported to increase the rate of progression to HCV-related cirrhosis.[70-74]."

It then goes on to say, "that may be that genotype prevalence is changing, other genotypes are becoming more common and patients with genotype 1b have simply been infected for longer."

The second statement is uses the word "may be" so nothing is in stone here.

Sorry for the open google link but I couldn't remember where I read the articles and figured if you were that interested you could wade through them. :)

In any event, in the hep c scheme of things, nothing to get excited about or make any treatment decisions on, except of course, for treatment length.

-- Jim

[NYgirl]

It wasn't near as bad as I thought it would be. I took the shot at 4:30 (was so easy I thought I'd never be able to do it!) and I passed out dead at 8:00pm.  I mean like unconcious. Slept for 17 1/2 hours and woke up just exhausted...but no fever, no nauseau (I was freezing if I got out of the blankets but no shaking chills or anything).

Spent the whole weekend under the blankets and came in to work today.  WISH I stayed home but figure I probably will need the days later on.

All in all it went ok - much better than I ever dreamed!

I just pray that it keeps going on like this. Although I'll probably get fat instead of lose weight because everybody was bringing over all my favorite treats all weekend - candy, cookies, pasta....

:)

When will I lose my appetite please? hahahahahaha.

Thanks for asking...you are the best. I love this place.

[FlGuy]

So, how did your initiation go this weekend? Hope you are functional.  If the sides were not bad - great.  If they were - they'll probably get better over the next few weeks.  Either way, it's positive and you are killing those buggers already.  Good luck, hang in there and it's time for another glass of water.

[jmjm530]

Maybe our posts crossed, but I previously posted a link to several articles that suggest geno 1's may progress faster than other genotypes. The link again: http://tinyurl.com/ddts3

I wasn't trying to worry anyone just answering Hep62's question. In fact, I  added the part about hep c being "slow moving disease" not for you, but to put the whole thing in context for others who may be new here. Point again being that even though one genotype may move faster, they all move very slowly.

-- Jim

[LvdByGod]

This was said in 2002 about viral load and fibrosis progression, by the american association of liver diseases.

http://www3.interscience.wiley.com/cgi-bin/abstract/106597949/ABSTRACT
  
"The rate at which fibrosis progresses varies markedly between patients. The major factors known to be associated with fibrosis progression are older age at infection, male gender, and excessive alcohol consumption. Viral load and genotype do not seem to influence significantly the progression rate. Progression of fibrosis is more rapid in immunocompromised patients. Hepatic steatosis, obesity, and diabetes may also contribute to more rapid progression of fibrosis."


jm, when i said "progresses faster" i meant "faster than the other geno types". i'm well aware that in general hep c is concidered a slow moving disease. i just havent read that 1s move "faster" than other genotypes as you stated. the only thing on that, that i have found is on genotype 3s, as stated above.

i would hate to lead anyone with type 1 to worry cause there is just nothing written that i can find that says they move quicker than the other types.thank you for the articles jimbo.