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Why Treat Now!
Hi friends. If anyone is unsure regarding the benefits of treating your Hep C, take a few minutes and read this post SVR study.
You will never question that thought again!
......Kim
http://www.medscape.com/viewarticle/782532?src=nl_topic
You will never question that thought again!
......Kim
http://www.medscape.com/viewarticle/782532?src=nl_topic
You're welcome! You bring us such interesting articles and information. I love it! Thank you! Pat
Sorry I guess I thought the results would express reason for the study so others could read
I hear ya, Susan
When all the phlebotomists know you by name and you know how often the floors gets waxed, you know you're spending far more time and emotional energy than would make any person happy
Enjoy your respite. Your time for SVR will come
~ Linda
When all the phlebotomists know you by name and you know how often the floors gets waxed, you know you're spending far more time and emotional energy than would make any person happy
Enjoy your respite. Your time for SVR will come
~ Linda
Susan. Don't want this to come across in a negative way but you are the exception, not the rule. As my old boyfriend used to tell me, "You are a freak of nature" since I battled so many ailments and came out on top.
The important message had nothing to do with worrying about relapse, but everything to do with what happens down the road if you don't treat! I can't say it enough, Get Treated!!!!!
This virus has so many manifestations of other illness and possible death.
Yes, my words and I do believe it. Do whatever you have to beat this.
Enough said!
.....Kim
The important message had nothing to do with worrying about relapse, but everything to do with what happens down the road if you don't treat! I can't say it enough, Get Treated!!!!!
This virus has so many manifestations of other illness and possible death.
Yes, my words and I do believe it. Do whatever you have to beat this.
Enough said!
.....Kim
I understand the general concept and thought process, but I think it does not apply to every person and every case. As everybody knows, I have treated, ALOT 12 times actually. And I have very little damage. There really is no need for someone like me to be rushing into another treatment, w/o carefully weighing whether or not I would benefit more from waiting.., as treatments are getting better and better in the research arena and treatments lengthy of time are getter shorter. I am tired of having to spend all my time and emotional energy in doctor's offices and since I'm not doing that bad, I am perferctly happy to take a break on this and step back for awhile. I get the school of thought for someone who has a lot of damage or who has never done any treatments..., but that doesn't apply to me.
This is one of the most comprehensive, professional, up to date list of recommendations and reasons to treat including priority. Please go to link to read
"Successful hepatitis C treatment results in sustained virologic response (SVR), which is tantamount to virologic cure, and as such, is expected to benefit nearly all chronically infected persons. Evidence clearly supports treatment in all HCV infected persons, except those with limited life expectancy (less than 12 months) due to non-liver-related comorbid conditions (See sections on HIV/HCV coinfection, cirrhosis, liver transplantation, and renal impairment). Urgent initiation of treatment is recommended for some patients, such as those with advanced fibrosis or compensated cirrhosis (see Table 1)."
AASLD/IDSA/IAS–USA. Recommendations for testing, managing, and treating hepatitis C.
http://www.hcvguidelines.org/full-report/when-and-whom-initiate-hcv-therapy
Accessed February 20, 2015
This website is constantly being updated. Please remember to always refresh your page. Follow recommendations to cite including date link accessed.
"Successful hepatitis C treatment results in sustained virologic response (SVR), which is tantamount to virologic cure, and as such, is expected to benefit nearly all chronically infected persons. Evidence clearly supports treatment in all HCV infected persons, except those with limited life expectancy (less than 12 months) due to non-liver-related comorbid conditions (See sections on HIV/HCV coinfection, cirrhosis, liver transplantation, and renal impairment). Urgent initiation of treatment is recommended for some patients, such as those with advanced fibrosis or compensated cirrhosis (see Table 1)."
AASLD/IDSA/IAS–USA. Recommendations for testing, managing, and treating hepatitis C.
http://www.hcvguidelines.org/full-report/when-and-whom-initiate-hcv-therapy
Accessed February 20, 2015
This website is constantly being updated. Please remember to always refresh your page. Follow recommendations to cite including date link accessed.
The following Re exerpted from that article. The exerpts were taken from the Subsections "Patients", "Figure2.", and Summary and are not complete sections of any ot those.
I believe this shows:
1: All subjects were in treatment from 1984 through 2003.
2: Study was don in, or soon after, 2007.
3: Treatment was not nearly as effeciatious back then.
4. SVR DID definitely imporve liver life and, at the very least stopped, the
progression of liver disease.
5. Non-success could lead to liver worsening, and, ultimately, possibly, HCC.
I could find no listing of authors' names, but the information under the subheading below shows the patient group and the organization conducting the study.
Hope this helps instead of muddying the waters. Pat
============================ =========================
Patients
All patients who achieved a 6-month post-treatment SVR in clinical research protocols conducted by the Liver Diseases Branch, NIDDK between 1984 and 2003 were included in this analysis. Of the 262 patients enrolled, 103 achieved an SVR. Thereafter, many patients were followed on a regular basis. Starting in 2007, patients who had not returned in the previous 2 years were asked to return for a medical evaluation, blood tests, abdominal ultrasound and ultrasound transient elastography. The initial protocols included studies of interferon alfa-2b alone for 6 or 12 months, escalating doses of interferon alfa-2b for 12 months, and the combination of standard interferon alfa-2b or peginterferon alfa-2a with ribavirin for 6–12 months. All patients gave written informed consent for the initial trials as well as for long-term follow-up and transient elastography in a protocol, which was approved by the NIDDK Institutional Review Board and registered in ClinicalTrials.gov (#NCT00001971). All authors had access to the study data and had reviewed and approved the final manuscript.
***************************
The initial 5 of 10 patients treated with antiviral therapy in 1986 at the NIH for chronic HCV achieved an SVR and had both biochemical and histological evidence of improvement in the year following treatment. These five patients have now been followed up for more than 20 years and remain HCV RNA-negative and have normal or near-normal serum enzyme levels. Liver biopsies on these patients 10 years after initial therapy showed resolution of the disease activity and regression of fibrosis in some. After this initial study, patients at the NIH were enrolled in various therapeutic trials for chronic hepatitis C. As of 2003, a total of 103 patients had achieved an SVR, all in response to interferon-based therapy. The duration of subsequent follow-up in these 103 patients varied from a few months to as long as 23 years. In this cohort, three patients relapsed, and the remaining 100 patients had markedly improved liver tests at the time of follow-up evaluation and none had clinical evidence of advanced cirrhosis, hepatic decompensation or end-stage liver disease. These findings indicate that an SVR from interferon-based therapies for chronic HCV is usually durable and associated with improvement in biomarkers of disease, a favourable long-term prognosis and lack of evidence of progression of liver disease.
Similar findings after SVR in chronic HCV have been published in other cohorts. However, the current analysis extends this experience to more than 20 years after therapy. Importantly, while patients who achieved an SVR did not develop progressive liver disease, at least one case of HCC still occurred. In this cohort, one patient who had cirrhosis before treatment developed HCC despite having had an SVR 12 years previously. The occurrence of HCC after SVR has been reported in several cohorts, although the rate of liver cancer appears to be far less than occurs among untreated patients with advanced fibrosis or cirrhosis due to chronic hepatitis C. Such findings suggest that patients with an SVR should continue to have regular surveillance for HCC if they had histological evidence of cirrhosis before treatment.
A shortcoming of this study is the lack of a control group of patients with chronic hepatitis C who were not treated or a comparison group of patients who were treated but did not achieve an SVR. However, it was not feasible or considered ethical to randomise patients to therapy vs. no therapy and follow them for an indefinite period. In early controlled trials of interferon for hepatitis C, some patients were not treated for the initial 1–2 years after randomisation. However, the controls from those studies were subsequently offered therapy on an open-label basis and some achieved an SVR and are a part of this analysis. Since 1992 and the approval of interferon as therapy of hepatitis C, all large 'controlled' trials of treatment have compared one interferon-based regimen to another and patients were not given placebo or randomised to no therapy.
*************************
In summary, with continued follow-up of patients with chronic hepatitis C for up to 23 years after achieving sustained clearance of HCV RNA, progressive liver disease was not seen. Among patients who had advanced fibrosis and cirrhosis before being treated, evidence from platelet counts and transient elastography suggested the persistence of some degree of hepatic fibrosis and a low but continued risk for HCC.
I believe this shows:
1: All subjects were in treatment from 1984 through 2003.
2: Study was don in, or soon after, 2007.
3: Treatment was not nearly as effeciatious back then.
4. SVR DID definitely imporve liver life and, at the very least stopped, the
progression of liver disease.
5. Non-success could lead to liver worsening, and, ultimately, possibly, HCC.
I could find no listing of authors' names, but the information under the subheading below shows the patient group and the organization conducting the study.
Hope this helps instead of muddying the waters. Pat
============================ =========================
Patients
All patients who achieved a 6-month post-treatment SVR in clinical research protocols conducted by the Liver Diseases Branch, NIDDK between 1984 and 2003 were included in this analysis. Of the 262 patients enrolled, 103 achieved an SVR. Thereafter, many patients were followed on a regular basis. Starting in 2007, patients who had not returned in the previous 2 years were asked to return for a medical evaluation, blood tests, abdominal ultrasound and ultrasound transient elastography. The initial protocols included studies of interferon alfa-2b alone for 6 or 12 months, escalating doses of interferon alfa-2b for 12 months, and the combination of standard interferon alfa-2b or peginterferon alfa-2a with ribavirin for 6–12 months. All patients gave written informed consent for the initial trials as well as for long-term follow-up and transient elastography in a protocol, which was approved by the NIDDK Institutional Review Board and registered in ClinicalTrials.gov (#NCT00001971). All authors had access to the study data and had reviewed and approved the final manuscript.
***************************
The initial 5 of 10 patients treated with antiviral therapy in 1986 at the NIH for chronic HCV achieved an SVR and had both biochemical and histological evidence of improvement in the year following treatment. These five patients have now been followed up for more than 20 years and remain HCV RNA-negative and have normal or near-normal serum enzyme levels. Liver biopsies on these patients 10 years after initial therapy showed resolution of the disease activity and regression of fibrosis in some. After this initial study, patients at the NIH were enrolled in various therapeutic trials for chronic hepatitis C. As of 2003, a total of 103 patients had achieved an SVR, all in response to interferon-based therapy. The duration of subsequent follow-up in these 103 patients varied from a few months to as long as 23 years. In this cohort, three patients relapsed, and the remaining 100 patients had markedly improved liver tests at the time of follow-up evaluation and none had clinical evidence of advanced cirrhosis, hepatic decompensation or end-stage liver disease. These findings indicate that an SVR from interferon-based therapies for chronic HCV is usually durable and associated with improvement in biomarkers of disease, a favourable long-term prognosis and lack of evidence of progression of liver disease.
Similar findings after SVR in chronic HCV have been published in other cohorts. However, the current analysis extends this experience to more than 20 years after therapy. Importantly, while patients who achieved an SVR did not develop progressive liver disease, at least one case of HCC still occurred. In this cohort, one patient who had cirrhosis before treatment developed HCC despite having had an SVR 12 years previously. The occurrence of HCC after SVR has been reported in several cohorts, although the rate of liver cancer appears to be far less than occurs among untreated patients with advanced fibrosis or cirrhosis due to chronic hepatitis C. Such findings suggest that patients with an SVR should continue to have regular surveillance for HCC if they had histological evidence of cirrhosis before treatment.
A shortcoming of this study is the lack of a control group of patients with chronic hepatitis C who were not treated or a comparison group of patients who were treated but did not achieve an SVR. However, it was not feasible or considered ethical to randomise patients to therapy vs. no therapy and follow them for an indefinite period. In early controlled trials of interferon for hepatitis C, some patients were not treated for the initial 1–2 years after randomisation. However, the controls from those studies were subsequently offered therapy on an open-label basis and some achieved an SVR and are a part of this analysis. Since 1992 and the approval of interferon as therapy of hepatitis C, all large 'controlled' trials of treatment have compared one interferon-based regimen to another and patients were not given placebo or randomised to no therapy.
*************************
In summary, with continued follow-up of patients with chronic hepatitis C for up to 23 years after achieving sustained clearance of HCV RNA, progressive liver disease was not seen. Among patients who had advanced fibrosis and cirrhosis before being treated, evidence from platelet counts and transient elastography suggested the persistence of some degree of hepatic fibrosis and a low but continued risk for HCC.
Yes, you have to sign up to read it but it sounds like rather dated information based on out-dated tx methods?
The three relapses appeared to be one at around 6 months. The other two were over 6 years later. The word "appeared" is the question. There are
262 studied between 1984-2003. Around 6 months appears as an actual relaps. The other two came up having the an identical strains as before treatment and "appeared" over 6 years later. You know people don't disclose information concerning hepatitis C infection for many reasons.
Out of these 262 people I'm sure there is a good possibility infection was by drug use. Many of these studies are done through the VA. People protecting careers and covering up personal relaps into abuse. Could be someone they have a long time relationship with who has hepatitis C. I'm not referring to a sexual relationship. After the years I spent studying and reading about hepatitis C.....I doubt that what "appears" to be a relaps - nothing more than a re-infection. Out of 262 only two returned to their past through old friends with Hepatitis C is more convincing than relaps.
262 studied between 1984-2003. Around 6 months appears as an actual relaps. The other two came up having the an identical strains as before treatment and "appeared" over 6 years later. You know people don't disclose information concerning hepatitis C infection for many reasons.
Out of these 262 people I'm sure there is a good possibility infection was by drug use. Many of these studies are done through the VA. People protecting careers and covering up personal relaps into abuse. Could be someone they have a long time relationship with who has hepatitis C. I'm not referring to a sexual relationship. After the years I spent studying and reading about hepatitis C.....I doubt that what "appears" to be a relaps - nothing more than a re-infection. Out of 262 only two returned to their past through old friends with Hepatitis C is more convincing than relaps.
Good article, I tried to access with Kim's and Lynn's url, I still had to log in, simple to create an account. I copied the results. Scary thing to me, that they determined that 3 people relapsed vs being reinfected.
Results
Among 262 patients treated in five clinical research protocols between 1984 and 2003, 103 had an SVR and comprised the analysis cohort for this study. These patients were followed up for a median time of 7.5 years (6 months to 23 years) after SVR and 89 were seen and evaluated after 2007. The duration of follow-up after SVR was less than 5 years in 27 patients, 5–10 years in 58 patients, and greater than 10 years in 12 patients. Of this cohort, three patients were found to be HCV RNA positive at the time of follow-up and were considered late relapsers. The estimated time to relapse was 0.67, 6.3 and 6.5 years after stopping therapy. Thus, the relapse free rate was 96% at an average of 7.6 years after therapy (Figure 1). The three HCV RNA positive patients appeared to have suffered a relapse rather than re-infection, as the recurrent virus was almost identical to the pre-treatment sequence strains (Supplemental Table S1, published online).[34] None had ongoing risk factors for hepatitis C or a clear predisposition for relapse (i.e. corticosteroids, chemotherapy or immunosuppression).
Results
Among 262 patients treated in five clinical research protocols between 1984 and 2003, 103 had an SVR and comprised the analysis cohort for this study. These patients were followed up for a median time of 7.5 years (6 months to 23 years) after SVR and 89 were seen and evaluated after 2007. The duration of follow-up after SVR was less than 5 years in 27 patients, 5–10 years in 58 patients, and greater than 10 years in 12 patients. Of this cohort, three patients were found to be HCV RNA positive at the time of follow-up and were considered late relapsers. The estimated time to relapse was 0.67, 6.3 and 6.5 years after stopping therapy. Thus, the relapse free rate was 96% at an average of 7.6 years after therapy (Figure 1). The three HCV RNA positive patients appeared to have suffered a relapse rather than re-infection, as the recurrent virus was almost identical to the pre-treatment sequence strains (Supplemental Table S1, published online).[34] None had ongoing risk factors for hepatitis C or a clear predisposition for relapse (i.e. corticosteroids, chemotherapy or immunosuppression).
Did you try the link I posted that was a few characters less that the original one livelife777 posted?
http://www.medscape.com/viewarticle/782532
I think the discussion is why we should not wait for treatment not about being made to wait.
Why treating now is a good idea for those who are hesitant to start.
Best to all
Lynn
http://www.medscape.com/viewarticle/782532
I think the discussion is why we should not wait for treatment not about being made to wait.
Why treating now is a good idea for those who are hesitant to start.
Best to all
Lynn
Couldn't read it. Wants me to sign in. No one should have to wait for treatment.
You both found it. Perfect! Wasn't sure how to post a link so thanks Lynn for the clarification.
Trigger, glad you were also able to pull it up.
Lynn's link is the same one I was trying to convey. If interested on a good read follow this one as a sign up may not be necessary.
Thanks friends
......Kim
Trigger, glad you were also able to pull it up.
Lynn's link is the same one I was trying to convey. If interested on a good read follow this one as a sign up may not be necessary.
Thanks friends
......Kim
think I got it without the sign up
http://www.medscape.com/viewarticle/782532
Long-term Outcome of Chronic Hepatitis C After Sustained Virological Response to Interferon-based Therapy
http://www.medscape.com/viewarticle/782532
Long-term Outcome of Chronic Hepatitis C After Sustained Virological Response to Interferon-based Therapy
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