reg HCV viral load.

[naidu9999]

sir,

my son 20 years old got hcv  type 3, and IL28B is CT, taking treatment with peginterferon 135 weekly, with ribavirin 200 twice daily. the viral load before to 1st dose is 92,00,000 and after first dose it came down to 1,74,000. now 4th dose was given. it has to be tested before to 5th dose. is it good response after dose. pls send me any links on decrease of viral load inbetween doses. kind regards

kumar

[hrsepwrguy]

Please disregard my last post, I misunderstood the thread.

[hrsepwrguy]

Dosing schedules for pegasys and pegintron are different, pegintron is weight based and pegasys is not, it appears that you are taking pegasys

2.1 PegIntron Combination Therapy Adults  
The recommended dose of PegIntron is 1.5 mcg/kg/week. The volume of PegIntron to be injected depends on the strength of PegIntron and patient’s body weight (see Table 1).

To see table 1 follow the link and go to prescribing info

http://www.pegintron.com/peg/pegintron/consumer/index.jsp

PEGASYS/COPEGUS Combination Therapy:
The recommended dose of PEGASYS when used in combination with ribavirin for chronic hepatitis C is 180 mcg (1 mL vial, 0.5 mL prefilled syringe or 0.5 mL disposable autoinjector) once weekly. The recommended dose of COPEGUS and duration for PEGASYS/COPEGUS therapy is based on viral genotype (see Table 1).

To see table 1 follow the link and go to prescribing info

http://www.pegasys.com/patient/index.html#

[Shyrlgame]

I am genotype 3,  my dosages are higher than your son's.
Here are my details so far;
Weight at start:  150 lbs. or 68 kg
Interferon dose:  180 ug weekly
RIBA dose:  1400 mg per day
Reduced to 1200 mg at wk 3
Weight at wk 4: 140lbs or 64 kg

I am responding to treatment undetected at wk 10.
In my "opinion" your son's  dose appears low to me.

[desrt]

Even if your son is of low weight (which the 135 mcg IFN would suggest) he still should be taking at least 400 mg ribavirin twice a day.
If taking a standard dose of IFN and riba, undetected at 4 weeks would give him an excellent chance of sustained response. Even if detectible at 4 weeks, he would still have a good chance if undetected at 12 weeks.

[ActingBrandNew]

"I need to confirm the SOC for Genotype 3 meanwhile I hope someone leaps in and posts the treatment duration if not UND at week for. "
____________________________________________________________
"The 24-week course is especially recommended in the presence of steatosis (often associated with Genotype 3 infection), fibrosis stage two or more, high BMI and high viral load. In patients who do not achieve a rapid viral response (RVR) with combination therapy, an extended course up to 48 weeks should be considered."

http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02715.x/full

[ActingBrandNew]

Your son is the same HCV and IL28B genotype as me.

If Im understanding correctly, your son's baseline viral load was 9.2 million. After the first week (first dose), his viral load was 174 thousand and you are currently waiting on his 4 week viral load results?

It sounds like your son is responding well to the medication if his VL dropped that much in the first week. Hopefully your son will be undetectable at week 4 which will classify him as an RVR and with him being a gentoype 3, IL28B CT his chances of an SVR are pretty good versus if hes does not have an RVR his chances of SVR will be lower.
_______________________________________________________
Treatment of patients with genotype 3 chronic hepatitis C- current and future therapies

"In patients who received 24 weeks of antiviral treatment, the probability of achieving an SVR in those who did not achieve an RVR, was higher in those with the CC allele (74%) than with the CT (59%) or TT alleles (29%). Mangia et al. [21] reported that IL28B influenced treatment outcome in patients who did not achieve an RVR, with SVR rates of 29%, 67% and 87% in patients carrying the TT, CT or CC alleles at rs12979860 respectively. "

http://hepatitiscresearchandnewsupdates.blogspot.ca/2012/01/treatment-of-patients-with-genotype-3.html#.UdcYTG0gvFK  
_________________________________________________________

In terms of his medication, it sounds as if hes on a very low dose. What is his weight?

[Idyllic]

Could you write more about your son's stage of fibrosis and how much he weighs.


Is your son on weight based Ribavarin? If there are no mitigating reasons for the dose of meds your son is taking Ribavarin twice daily seem kind of low. Ditto with the Peg to a lesser extent.

It is important you clarify the ending the viral load numbers. It sounds like his response could be more robust if his meds were different doses but it would help if you confirm if he is on weight based Peg or what the situation is.
___________________________

I can't tell where the comma is on your son's ending VL. Is it 174,000 or 1,740,000?

Starting VL 92,000,000 or Logs  7.96
Ending VL 174,000 or         Logs 5.24

2.72 log drop
_______________________________-
If his ending VL is 1,740,000 (6.24 log) it would only be a 1.72 log drop.

_______________________________


I need to confirm the SOC for Genotype 3 meanwhile I hope someone leaps in and posts the treatment duration if not UND at week for.

It is looking like your son has had a 2 log drop which I believe he would need by week 12 but you really need to clarify the items mentioned in order to receive the right response.


Here is a viral load drop calculator
http://www.hcvsociety.org/files/HCVLogDropCalc.htm