SVR rates?

[snook_man]

Yep, you know at week 26 this is definately on the mind..BY the way, week 24 was clear and all my labs are stable..actually improved alot.

My questions is for the researchers..Come on, unleash the knowledge..

OK, when a clinical is conducted, and SVR % are factored, do they only factor in those who completed tx, or all who started? I guess what I'm asking is whether or not everyone that enlisted off the bat is factored into rates, or just those that made it through their 24 or 48 weeks of tx..And there has never been a break down of controlled groups, or a break down where just low viral load and early responders where studied was there? My doc says I only have a 50% shot, but my other doc swears that with all the factors of my personal case, that my chance of SVR is greatly higher and he feels comfortable more around 75-80%..The only real comparison I have seen in seperate groups was on the Dr Cecil site. I believe it was posted or conducted by the FDA, and takes alot of things into account, age, VL, EVR, fibrosis staging, etc..  

I'm thinking about extending tx, but DR is against it.. She says that I cleared early, and posess all the right factors of SVR.. But I wanna do this once, no habits for me or repeat business...

[miked]

Scott, thanks for the information (although it reads like stereo instructions).  Also I wanted to congratulate you on reversing your to Stage 2. That gives some breathing room

I've not seen much on the topic of viral breakthrough during tx.  Has anyone else experienced this and/or have information?

Mike

[miked]

Rev,  you stated above "I have not seen too many viral breakthoughs, couple but not many."

I think I'm one of these because my VL went up arounf week 32.  What information do you have on this topic?

When I found that my VL was going up I put a post here but nobody really commented.

Thanks.

[miked]

The fact that you have a negative PCR @ 26 weeks means your chances are very good.  Although I can't remember the exact number, the percentage is high (like 70+%).

I experienced a 2+log drop at 12 weeks and continued to slowly drop my VL until week 32 when it rose slightly, which stopped my tx.  

Continue on and do the 72 weeks.  Google for "HCV 72 weeks, Spain, Germany"....there are some very impressive SVR
percentages for geno1's on 72 weeks of tx.  If your doc won't do it then find one who will. Contact Dr. Ben Cecil who most likely will do the 72 weeks.

Even though my VL didn't become undetectable, as long as it continued to drop I was determined to stay the course and become the exception to the rule.  Without an undetectable PCR my percentage for success was significantly lower than yours.  

Just do it.  Good luck.

[cuteus]

i'm with layla on this one, you were almost cirrhotic right? go for longer if so.

[Califia]

Hmm....although I just petitioned for a relatively small extension of tx so that I would have a full 36 weeks undetected,  my stats were just too good to convince my doctor that I needed to go the full 72-week route.   In fact, that was the opinion of two reputable hepatologists, one of whom is associated with an important research practice.  

I imagine that age is a huge factor in your favor, both in terms of minimal side effects and better odds for total clearance.   Having said that, however, what are your liver enzymes doing?  Did they ever normalize?   Because that is kind of a wild card, not too well understood, and not a concrete marker of anything yet universally agreed upon--but it IS a sign of incomplete response.  

The old fahrts on this list who are twice your age are much harder cases to treat.   (Speaking personally again.)   So I would tend to think you're in good shape as long as you indulge in fullout clean living after you come off tx.   It's a tough question, this, but of course we want to avoid unnecessary toxicity if we can help it.  After all, what if another six months of interferon turned you into a raving Democrat?

[Imagine]

I can't really offer an oppinion one way or another. The decision is much easier for me because I have been advised upfront that for me in my case 72 wks would be best. I can prepare(as much as one can) myself for that. I do think the condition of the liver is an important factor as well as geno type. I'm trying not to focus on svr rates %'s I have not been the "lucky type" so I will do the time and hope for the best. The decision must be harder if you have not prepared for it from the beginning.

[honey1616]

Hey Snook,,,Glad to see you back and congratulations! Sounds like you have a very good chance of staying clear so keep on doing whatever your doing to get through this whole ordeal!

[snook_man]

You all see this article posted today? This goes against most of the others, but just goes to show how HCV is a hit or miss!!

http://www.hivandhepatitis.com/2005icr/easl/docs/042005_hcva.html

[snook_man]

Man, that is why this place has always drawn me back, the perspectives!!!! Funny how everybody has a little different approach and outlook of the same situation..

Okay, for me at start I was 27 years old, 6ft. 175lbs, geno 1a, Vl 4000, and stage 2/3.. Moderate fibrosis, and foci suspicious for bridging, but no apparent bridging present.No health problems other than HCV, and poster child for treatment..
I shown clear at week 12, and still clear at week 24. I have taken NO other drugs with my tx, and have had very minimal sx's.
What I have seen on the web, is age is a major factor.. and that my almost nonexistant VL is a MAJOR factor.. But I also see the moderate fibrosis as a contradiction.. That is why I opted for the pegysus though, as I wanted meds to be processed by the effected organ. My Dr works under guidance from the Schiff liver institute, and will not grant me extended tx. She says that my situation does not warrant it, but might allow me maintanace after completion sort of like Rev took.

Califia, my dear... A democrat, never... These meds are having major mental effects in my judgement, but not that bad.. LOL!!
I go to my Doc on Friday for my results and a visit.. We will discuss options and what she plans for me. Haven't seen results so I do not know ALT levels yet but remember that last labs where 60, borderline.. Steady decline from start, but not within norm. So yes, I am definately factoring that in.. That is my numero uno concern, as YOU know..

What I'm thinking is persuading my Doc for atleast an extra month or two.. I wanna get off this stuff, don't get me wrong...but I sure as hell do not want to tx again. Mental effects get alot more interesting after week 24, I have found.. The fog has definately rolled in!!

Thanks for all the input!

[snook_man]

Wait a dang minute!! I just heard that while I was gone you got a 3 month post PCR and are still clear!!!
Let me just say, CONGRATS!!!! CONGRATS, CONGRATS, CONGRATS, CONGRATS!!!!!
I got my dancing shoes laced, you ready?

[doll face]

So glad to see the your computer is up and working again. I can't comment on the studies, just give you my two cents on the extended tx for us 1As. I was on pegintron combo for 48 weeks and relapsed after 2 months. Recently I just finshed up my second time on tx (72 weeks of pegasys), and my 5 month post came back - Negative. I truly believe that the extended time is what did the trick. I asked my hepatologist and he agrees that the extended time is what I needed. I would definately consider it if I were you, especially seeing as your sides are minimal.  It's a ***** having to do tx twice. Good luck

[layla]

Hey, good to hear form you and congrats on the undetectable. The studies include everyone who starts in the study so I can see why you doc thinks your chances would be higher than the average. After reading this I also began to think of my SVR chances as higher. My reasoning was my good fitness, age, being female, low labs, good weight,not taking any other meds, no other illnesses etc. As I went along in tx I also factored in being 100% compliant on tx. I do think all these thing count for something and my doc does too. Still I was not clear at 3 months. I was under 600 but still detectable on the more sensative test. I opted to do 48 months from clearing though most docs recommend 36 months, my doc is quite agressive. I did 18 months. Personally I think tx should be (for G1s) 48 from clearing and if I had any single factor that would make my SVR chances less such as weight, high VL, even being male I would even make sure I did 72 weeks. Now that is just me. I know this is not the thoughts of everyone but I am just sharing mine. My nature tend to be on of " well lets just fix it now and get it done with". I just can't fathom doing tx over or maybe it is because I can and can't stand that thought. It's a personal choice for each of us and a hard decision. LL