What are my odds for SVR? Your opinion please !

Hy there again,

I finish my tx 2 weeks ago. 3 weeks from my last shot, and 2 weeks from my last riba.

My status is :

24 years old male, from Romania, was bx A2F3 (stage 3), don`t know what geno because in Romania they dont do the genotype.

Baseline PCR (before 1st shot): 200 000 ui
2 week PCR 159 ui
4 week PCR <15
12 week PCR  UND
22 week PCR  UND
36 week PCR   UND
48 week PCR   UND
64 week PCR   UND

Treated with pegasys 180    weekly for 65 weeks, and with 1200 ribavirin daily for 11 months, after that incresed riba to 1600 daily for 5 months.

My bloods 1 week POST tx :
ALT 50    (2 - 43)
GGT 57   (0 - 56)
AST 33    (2 - 40)

Bloods 2 weeks post tx :

ALT 32 ( the lab limit was 40)

I will do another PCR in 2 or 3 weeks I think .... or maibe in december.

What do you think ..... what are my SVR chances?

Please just tell me your opinions :)

Thanks a lot


PS : Please escuse my english .... :)

[Rockerforlife]

90 -100%

[Rockerforlife]

Seems like you were proberly a geno 1 or 4 as they usually dont treat 2 and 3 with some many weeksor,do they treat all geno types 65 wks
?

Elbert Hubbard
God will not look you over for medals, degrees, or diplomas, but for scars.

[WriteItDown]

Apparently almost all Hep C patients in Romania have genotype 1, so the treatment duration makes sense.

It sounds like you were almost undetectable by week 4, which makes your chances of SVR very good!  And your English is also very good, do not worry.

[Rockerforlife]

<15 is UD

[FlGuy]

That kind of strange that you would treat for 65 not knowing geno-type and have such a fast viral response.  Interesting approach, including the riba increase for the last 20 weeks or so.

[WriteItDown]

I'm going to guess that since the vast majority of Romanian HepC patients are genotype 1 (see link below), they probably employ a standard of longer treatment, though I don't know why it would be 65 weeks instead of 48, nor why they would increase the riba at the end.

http://www.ncbi.nlm.nih.gov/pubmed/19337633

[Rockerforlife]

Looks like the Romainians mean business whe it comes to fighting hepatitis.



Niccolo Machiavelli
"There are three different kinds of brains, the one understands things unassisted, the other understands things when shown by others, and the third understands neither alone nor with the explanations of others. The first kind is most excellent, the second kind also excellent, but the third useless"

[Bill1954]

Hi Andrei,

Like the others, I believe you have an excellent chance for SVR.

Low starting viral load (<400,000 IU/mL) as well as rapid viral response (UND by week 4) as an excellent indication of success; and in the E.U., a genotype 1 patient would only treat for 24 weeks given these circumstances.

You met all of the above criteria, yet treated far longer; this should bode well for you.

Your English is superior to many native speakers on this forum; you have nothing to be ashamed of :o).

Good luck and tell us the good news when it is time—

Bill

[Andrei24]

Thanks to you all.

Rockerforlife

It`s not  usual to treat 65 weeks in Romania. They treat all the pacients here for 48 weeks. They dont to the genotype here. They treat all the pacients like geno 1. But at the same time, if you are still detectable at week 12, they dont treat here for 72 weeks like in UK for exemple.
My tx was only 48 weeks, but I added an extra 17 weeks, not my doctor.

And you are right  Rockerforlife .... here it`s like a little bussines  whe it comes to fighting hepatitis. But, this is life :) Thanks God because I`m a responder, and i pray to God that I will stay UNDETECTABLE for the rest of my life.

Also .... I must to do my 4 weeks PCR after I took my last riba or after i did my last shot? Do you think that i must to wait 8 week and after that to do a PCR or it`s OK at 4 weeks post tx?


Thanks again to all :)

[Andrei24]

Thanks a lot  Bill1954

You are right .... i had had a low viral load, young age (24 years old), I`m not fat at all
(75 KG when I starded tx), i was almost a RVR
(i was not UND at week 4, but i was <15 ), and my only minus was the bx, who was stage 3.
Now .... I can just pray and waitm until the next PCR :)

[Trish77]

How many PCR's do you get after you're done treatment?  If you only get one post treatment between now and 24 weeks, I'd do one at 12 weeks post and at 24 weeks post.  The 12 week post PCR is an excellent indicator for your 24 week PCR - you'd be practically home free if you were still UND at 12 weeks.  It would make the waiting for the 24 week PCR alot easier.  That's my opinion.

Interesting question you ask - to do the PCR after last shot or after last riba.  Some people stop taking their riba the same day they do their last shot - others believe in taking their riba for a week after that last shot.  If it were me, I'd go from the last day of treatment period - therefore, from the last day you took any meds.  

Did you continue ribavirin after your last injection and for how long?

What made you decide to continue treatment, up your ribavirin and for that many weeks?  Just curious what your thinking on it was - although being Stage 3, maybe I can guess.

Your prognosis is pretty good - cleared by Week 4 is very good.  Doesn't sound like you had any dosage reductions during all of that either - did you?  If not, that only adds to your chances of success.

Btw...I worked with a fellow from Romania not so long ago.  Really nice guy, moved to Canada with his wife.  From Transylvania.  He's a good sport because we tease him about that and he takes it very well and then dishes it back to us too. :)

Good luck to you - hope you keep us posted with how you make out.

Trish

[Andrei24]

Thank Trish77 you your time and because you answered to my questions :)
Post tx, i receive 2 PCR`s . One at 12 weeks, and at 24 weeks. 2 free PCR`s :)

If I want to know my 4 weeks status, I must to pay for the PCR.

I continued my ribavirin after my last shot for another 10 days.

I added some extra weeks to my treatment because my bx was stage 3. I was on full dose of  pegasys and ribavirin all the tx. And I add 2 riba pills per day (1 600mg riba - day) for the last 5 months I think.

The only think that I can do now it`s pray to God to help me and to wait for my next PCR.


I promise that I will let you know when I will know any news :)

[Trish77]

In that case, I'd schedule your test in line with any time after 7 days from your last injection - if you're looking to be precise.  The last three days beyond that are gratuitous really.  Interferon lasts 7 days in the body, giving riba 7 days to do it's combo thing with the INF.  After that, it becomes monotherapy to continue the riba on it's own and not even quite monotherapy.  

No dosage reductions, RVR and you hammered it with 65 weeks of treatment.  I'd be very surprised if you are not SVR.  Here's hoping!

[Andrei24]

Trish77

Thanks you again

I think that i will do my next PCR from yesterday in 2 weeks. That will be 4 week post tx for me.
Now, I try to help my liver to recover. Eat well, low fats, healthy meals etc.

[Rockerforlife]

My last shot was on Friday, July 10-2009 and i did my last pills on that following Friday 17-2009 and this is when she drawed blood for testing  on the 17th.Then i got my 4 wk PCR results 4 wks later  (UD)


Frank Zappa
The mind is like a parachute - it works only when it is open.