Undecided about options

[EyesofBlue55]

Trying to question the scenarios available to me since I have the CC allele

1-If I do the standard soc and rvr at 4 weeks would I only have to do 24 weeks?Or  will I be doing 48 regardless?
I have a high VL so this would be a chance Id be taking,but I have read that high VL's were also associated with the CC gene.Maybe this is why my dr said he knew I was a CC? It was an educated guess but he was right.
I would like the best possible tx with shortest time.

I know Ive already talked about this but im just going crazy thinking bout all this  cindy
Thinking OUT OF THE BOX  as I always do !!!!

[Bali05]

"If I do the standard soc and rvr at 4 weeks would I only have to do 24 weeks?Or  will I be doing 48 regardless?"

from what I know
the rule for 24wk option with SOC for GT 1 is  low baseline VL + complete RVR.
http://www.natap.org/2009/AASLD/AASLD_71.htm

You have a high baseline VL , if you do just SOC even with RVR  it is 48wks.

With PI however you have a a great chance to do only 24wks.

Talk to your hepatologist and see what he recommends

[desrt]

There are already 24 week protocols in Europe for RVR g1s. This is why I suggested getting a 2 week PCR. Viral load is a weak predictor compared to the CC allele. If I were UND at 2 weeks and a CC allele, I would be sorely tempted to quit at 24, especially since CC is also connected with an increased incidence of psych sides. Unless you had several other negative predictors, i.e. cirrhosis, insulin resistance, etc., I would go with some type of response guided tx.
And I would also load up on Prozac (fluoxetine) beforehand if I ever needed to tx again.

[Bill1954]

Cindy, people have a tendency to repeat what they want to believe. If you only listened to this forum, it might be easy to conclude that if you waited a few months, you might only require 24 weeks treatment. I’m not sure this has been determined yet; and if it has, it’s yet to be disseminated.

I think it’s a good idea to go to other sources and confirm anything you read in here with published, peer reviewed data; or minimally to read professionally authored editorials.

One decent source of information is:

http://www.hivandhepatitis.com/hep_c.html

Use their search function and browse the articles. Another good source is:

http://www.clinicaloptions.com/Hepatitis.aspx

This requires (free) sign-up and is geared more towards the medical professional but has lots of good slide sets and articles.

I think HectorSF accurately outlined the situation above; I believe he’s spot on with that advice. This forum should inspire research, not be a source of definitive information.

Best of luck-

Bill

[HectorSF]

Hi Cindy.

As far as I know there are no studies to support 24 weeks of treatment. It is a theory that is untested at this time. IL28B geno-typing is still very new. So I believe any doctor would want you to do the standard 48 weeks. To do 24 weeks and then relapse seems like a risky proposition at this time.

RVR is still the true test for predicting SVR although C/C genotype patients have 2x the SVR rates then the other genotypes. This data is all based on standard treatment durations.

Things that can negatively affect likelihood of SVR include age >40 years, advanced degrees of liver fibrosis, male gender, increased body mass index, insulin resistance, race and hepatic steatosis.

General speaking patients with genotype C/C have about an 80% chance of SRV. Can't get much better then that. Of course if you have little liver damage you could what for studies to show that genotype C/C treating with either SOC and/or SOC+new PIs can reduce treatment time.

This is from my understanding of articles I have read in the American Journal of Gastroenterology. Others members may have different information/experience and I would be interested in learning more about this area also.

Hectorsf