Non-responder

I'm going to start treatment in 2 days. When do I know I am a nonresponder if that happens. Cause I'm 1a and need to know at what time do you know if the treatment is not gonna work. Or do you do the whole 48 weeks and then is it that you know or can at 6 month you know if you are a non-responder?

[Diane12855]

I'm a 1a too and personally I think it is VERY important to start treatment with the belief that it IS going to work. We may have the worse chance of achieving SVR, but a positive state of mind will help improve that a lot.

My starting viral load was over 6 mill., they checked my viral load after 2 weeks... it was down to 120,000 then 2 weeks later it was down to 2,000... which tells me it is going to work... most likely. They say you need to at least have a 2 log drop by the 12th week, or it is a good chance you won't get undetectable. For each log, you take one of the zeros off of the end of the number. Do you know what your viral load is?

Please don't hesitate to ask whatever you need to know here. I'm 11 weeks into tx and this site has helped me more than I can say.

Welcome to our group!

Diane

[Magnum]

I know I've said this before but ask your doctor if you can wait for the Protease Inhibitors to be released next year, which will give you yet a better chance to clear. I'm 1a non-responder as well and I'm waiting... good luck...

Magnum

[Bill1954]

The E.U. provides for truncated 24 week HCV treatment for certain genotype 1 patients. Along with other criteria they require:

No HIV coinfection
No cirrhosis
Rapid Viral Response (undetectable for virus at the four week treatment juncture)
Low baseline viral load (<400,000 IU/mL)

The U.S. hasn’t adopted these measures yet to my knowledge. Was this offered to you in the Dominican Republic? If you are a previous non-responder to IFN therapy, I don’t believe the above would apply to you.

--Bill

[nygirl7]

I dont think this person IS a non-responder they want to know how to tell when they would BE a non-responder.

Technically you are looking to have a two log (take the last two numbers off of the end of your viral load for example if it is 568,000 you would need to be 5,680) by week 12 but preferably you want to be UND by week 12. If you are not UND by week 12 you will need to continue to week 72 or decide to start over and wait for the PIs.

If you do not hit the two log drop you are a slow responder.  If you don't come near to it you are a non-responder.

The only way you could reasonably expect to do 24 weeks is if you are negative completely at week 2. If you are UND at week 4 you have a good chance of success if you continue to week 48.

That is the basics.

And no you cannot get into telepravir or bocepravir without a trial they have not been approved byt he FDA.

[nygirl7]

Sorry missed the EU part of all of the threads somehow but as Bill said above..........my mistake.  :)

[nygirl7]

jex and i meant dominican republic so much for reading/typing fast at the end of the day I have enough trouble when it's not 5pm.

[nygirl7]

due to the fact your viral load start is over 8mil I think it takes you out of the equation but as your doctor - he is the final rule.  Of course I could have remembered that part wrong too...it's been one of those days sorry about that!

[Bill1954]

From a Roche-funded study using Pegasys in 2005:

http://www.natap.org/2005/AASLD/aasld_55.htm

“The recommended treatment for patients with hepatitis C virus (HCV) genotype 1 infection is the combination of a pegylated interferon plus ribavirin 1000 or 1200 mg/day for 48 weeks.[1,2] The ability to identify genotype 1 patients that might respond to a reduced length of treatment would limit the burden of therapy in this common but more difficult-to-treat patient population. Recent data from an uncontrolled study suggest that HCV genotype 1 patients with a low baseline viral load who have undetectable HCV RNA after 4 weeks of treatment with the combination of a pegylated interferon plus ribavirin may require just 24 weeks of treatment to achieve a sustained virological response (SVR).[3]”

--Bill

[yoyoma123]

Thanks guys, you are alot of help. Just wanted to know about the non responder, just curiosity. Also about the 4 weeks UND is just curiosity as well. Everything is very new. About telaprevir I know that in US is not approved yet but I'm in the DOminican Republic things run differently here, just asking.

[pcds]

I have had the 2 log drop at 10 weeks, but my doctor says there is less then 5%chance of having a SVR if not at UND at week 12.  I'll let you all know.  In my mind I can see the *undetected* on the lab result.
Judy

[WriteItDown]

I agree with pcds, if you are not undetectable at 12 weeks you are unlikely to attain SVR and certainly not in 24 weeks.

[nygirl7]

if you extend to 72 weeks it looks to me like it goes back up to a bit higher than 50% again - just looking at our "72 week extender club" thread - which is hardly scientific.

WheN I was not UND at week 12 I had to really read the studies and figure out what to do.  I have been SVR for over three years now and am very glad I extended (as a stage 3 I had no choice).

If telepravir is not available in the USA where it is being developed it won't be available in the Dominican Republic.  I'm sorry about that.  If you can wait a year and see IF it is available then perhaps that would be the way to go. But remember there are no guarantees.  It is all a gamble either way.