New and ready for battle

[granitekonig]

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!

[nygirl7]

Geno 3 can be a very difficult strain to get rid of.  The doctors who use terms like "lucky geno's" really are not up to speed.  Just ask the G3s in here who have had to retreat,

Don't take anything for granted about this being some 90% cure rate.  Go for it full steam ahead and make sure you are completely aggressive about killing this virus off.

Get that UND at week 4 and then don't look back.  If you are still positive after 12 you are going to need to rethink your strategy so that you don't have to treat again....so make  sure you take ALL the meds right on time and do everything you can to get the UND - 4.

Good luck.

[granitekonig]

Thank you all for your responses, especially co-writer! That clears things up considerably.

[tahoeunicorn]

I too am a genotype 3a. My beginning VL was 19,900, very low for a VL. My GI told me I needed a to have at least a 2 log drop in my VL and UND by week 12, although they prefer UND by week 4. I actually had a 1 1/2 log drop by week 12. My treatment was stopped at week 12, due to my VL kept going up and down. Now I have been termed a Non-Responder.
You definitely need a BX done on your liver to know the extent of damage that has already been done to your liver... I'm just waiting on new TX to come out for non-responder / relapse patients..
Good Luck I hope things go well for you..

Lynn (tahoeunicorn)

[Trinity4]

If a geno 2 or 3 only had a 2 log drop by 12 wks, wouldn't treatment duration be extended to 48 wks?

[mar148]

I was genotype 3 also.  My initial viral load was 600,000, right before treatment shot up to 9 million.  No reason why, it is my understanding that for many it goes up and down of its own accord.  

I successfully achieved SVR after 24 weeks of treatment.  Your chances are very good and I wish you great success.

[CoWriter]

" I know about the side effects and I read genotype 3 has 90% success rate."

That's not true.  The success rate is about 82% for Genotypes 2/3 (most studies combine genotypes 2 and 3 together), but actually, Genotype 3 is not as easy to get rid of as Genotype 2.


"My question is this: I understand a 2 log drop by week 4 is a good thing."

You understood wrong.  Clearing the virus by week 4 is called "RVR" Rapid Virologic Response and it is associated with high treatment success.  

By week 12, you must be clear or at least have a 2 log drop for treatment to be continued.  If you don't get a 2 log drop, then treatment is considered ineffective and it is stopped.  


"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?"

Viral loads go up and down.  The number is only important during treatment to see whether the treatment is working.  


"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? "

LOL....that's funny.  You dropped the 2.  That's not a 2 log drop. A 2 log drop means you drop the last two zeros.  So if you start with a viral load of 2,660,000 a two log drop would be 26,600


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?

The Ribavirin capsules cause anemia.  For genotype 1 the dose of Riba is either 1000mg-1200mg daily.  For Genotype 2 and 3, the dose is 800mg daily, so obviously that's going to make a difference.

BTW, it's not true that you need a lower dose of Peg interferon.  If you use Pegasys, the dose is always 180 mcg no matter what genotype you have.  If you use PegIntron, the dose is weight-based for all genotypes.

One last thing.  It doesn't sound like you've had a liver biopsy done, which you probably should....because if you have cirrhosis, then treatment is 48 weeks instead of 24 weeks....and the only way of knowing if you have cirrhosis is by having a biopsy.

[Proactive]

Actually I'm not actually sure your stopping drinking would directly affect your viral load..Ideally it would be nice to have a new pcr blood draw prior to beginning the tx drugs--you might ask your doc about this..As it stands with a VL of 2,660,000, a 2 log drop would be 26,600 iu/ml.
I'm not sure of your situation, typically your doc will prescribe you the meds, then you will need a prior approval from your insurance co, then the drugs will be shipped to you on a monthly basis...all takes time..Unless of course somehow you are being supplied the drugs directly from your doc...and oh ya, you may also be asked to attended an educational workshop which teaches you how to inject the meds etc.
Anyhow, best of luck--save all copies of test results etc. and keep a positive attitude and physically active..
Pro

[granitekonig]

Hi Laura, did you have your appointment with a hep doctor yet? I was referred after my tests came back confirmed. My appointment is Nov. 19th. I'm hoping they give me the meds immediately. I want to start ASAP!! I really want to put this all behind me. I'm moving into a close friends place and I told them all about it and they are very supportive. My job is cake. So hopefully this 6 month treatment won't be bad. I'm evnious that you are only at 41,000!  =)

Joe

[LauraV2000]

Hey, I am in the same place you are. Genotype 3a, diagnosed a couple weeks ago. I am 30 years old and healthy. My virus load is lower though, I am at 41,000. I think that stopping drinking isn't going to drop the viral load (but your liver inflammation numbers may go down).  I am starting treatment early in December. I think we should hope to be clear of the virus after 4 weeks.

[HCA]

The statistics for decrease in viral load that you quote as benchmarks are for genotype 1.
At your age with genotype 3 you should hope to be undectectable at week four..
The dose of medication is usually the same but the treatment time is much shorter.
Stopping drinking will not necessarily reduce the viral load but it doesn't matter.

[desrt]

Dosage is the same for all genotypes. As a geno 3, hopefully you'll be undetected by week 4. Good luck.