Aa
Why do I have to finnish the full 48 weeks
I f on my last blood test there was no virus why do I have to finnish the full 48 weeks? I am geno type 1a
now I am having GI problems and Dr. wants me to have a MRI on my gastro track.
now I am having GI problems and Dr. wants me to have a MRI on my gastro track.
i just took my 48th shot.. yippie!!! i am 1b geno 48yrs old they didnt tell me til the other day that so many w/ this geno type dont make it. I knew that... i do research.. I have the best darn team of people @ my drs office. YES I KNOW HOW YOU FEEL!!! dont stop now.. you are at the end. i felt the same way. man when you take that last shot no- matter how bad you may feel from side effects you are gonna jump up and say YES I DID IT!!! good luck and may god give you the strenght to finish. lele
I'm so sorry to hear about all your troubles. Sorry to hear about your husband, too. It is terrible, especially when it all hits at once. It looks like you're surrounded by family with medical knowledge though, so I guess we shouldn't be too worried about you.
My prayers are with you and your husband. May the doctors be guided to find a way out of this soon and may you be given the strength to go through all this.
Hugs,
Marcia
My prayers are with you and your husband. May the doctors be guided to find a way out of this soon and may you be given the strength to go through all this.
Hugs,
Marcia
Sorry I have not writtenI had company. I was not going to quit was undected at 12 weeks. I was in the medical field for years I know this is the best chance and uncle is a Dr. sister is a RN so is my aunt they would not let me do so any way. The Gi problems I am having happens after the shot I feel like I am having a heart attack to 2 hours then get really sick I had it before the treatment but has become an every weekend thing GI Dr thinks it is Osi something disfunction so has to be fixed by surgery and can not fix while on treatment. So just have to deal with the pain. Just found out husband has a growth on leg up into liver stomach and hernia his surgeon dont have a clue. Now and not only do I have to take care of him and me but also keep working because I hold the insurance. Just alot going on.
Thank you also Marcia2202
Shelly
Thank you also Marcia2202
Shelly
I will write her a note, hope we didn't scare her away with too much information.
Marcia
Marcia
HOoooo NOoooo,
We lost another one to the illusions of Di tech. Darn, she could have gotten a better deal here, she’ll be back after she shops around.
jasper
We lost another one to the illusions of Di tech. Darn, she could have gotten a better deal here, she’ll be back after she shops around.
jasper
i am not very schooled on hep c yet but as i see it, your blood circulates to every cell in your body. your blood test may be clean but the virus may be hiding out in your organs, fat, etc. especially if you have been infected for years. the other posters obviously know alot more but i look at it in basic terms. why chance it returning and having to start all over again. as far as your GI problems, i would hope your doctor has the best advise for you - i have had a rough time so far with sx, but with my cirrhosis i have no option but to treat and hope it works - there may not be a 2nd chance for me - best of luck and keep checking these forums
Well you've heard the truth, there is no easy way out, but to complete the 48 weeks. Hopefully when you see your doctor he will figure out something that will help you with the sx's. God Bless
Lots of good well informed replies here.
The reason you have to go the distance is because when the interferon launches your T cells to destroy your infected cells the virus mutates to form what is called a wild type variant.Low levels of the mutant virus sit it out and begin to replicate freely when treatment ceases-this is what we call relapse.
Longer treatment causes more effective viral suppression.It is also the reason that a rapid response is best-denying the virus its best chance of forming a resistant strain.
Hope this helps.
The reason you have to go the distance is because when the interferon launches your T cells to destroy your infected cells the virus mutates to form what is called a wild type variant.Low levels of the mutant virus sit it out and begin to replicate freely when treatment ceases-this is what we call relapse.
Longer treatment causes more effective viral suppression.It is also the reason that a rapid response is best-denying the virus its best chance of forming a resistant strain.
Hope this helps.
I need you to do some motivation speaking to my sales team at work!!! Maybe you could tone it a down a notch though. HA
Trin
Trin
" do the odds increase for Geno 1 if you are UND by week 12 and stay in TX for the full 48 weeks?"...
There are no studies on this subject that I know of. The only studies I am aware of are for 48 vs. 72 weeks. If you drop more than 2 log by week 12 but are not undetectable, and then become undetectable by week 24 then you are a "slow responder" as someone above stated. You have better odds of SVR as a "slow responder" if you treat for 72 weeks. (20% vs 50% relapse rate)
All quotes from
"Understanding HCV Nonresponse and Identifying Candidates for Retreatment"
Source: New Management Strategies for HCV Nonresponders and Relapsers
By: Mitchell L. Shiffman, MD
http://clinicaloptions.com/Hepatitis/Treatment Updates/HCV Nonresponders/Module/Shiffman.aspx
"Three recent studies have now demonstrated that relapse can be significantly reduced in slow-to-respond genotype 1 patients—those who achieve undetectable HCV RNA after Week 12—by extending the duration of treatment from 48 to 72 weeks.[8-10,20] In each of these studies, the relapse rate was reduced from more than 50% to less than 20%. Two of these studies suggest that this benefit may be less or nonexistent in patients with higher HCV RNA levels at baseline and at Week 12.[8,9] However, these observations will need to be confirmed in future studies before these patients are not considered for treatment extension. Therefore, for now it appears that prolonging the duration of therapy will increase SVR rates in patients who are slow to respond and should be routinely practiced. "
8. Sanchez Tapias JM, Diago M, Escartìin P, et al. Peginterferon alfa2a plus ribavirin for 48 versus 72 weeks in patients with detectable hepatitis C virus RNA at week 4 of treatment. Gastroenterology. 2006;131:451 460.
9. Berg T, von Wagner M, Nasser S, et al. Extended treatment duration for hepatitis C virus type 1: comparing 48 versus 72 weeks of peginterferon alfa 2a plus ribavirin. Gastroenterology. 2006;130:1086 1097.
10. Sanchez-Tapias JM, Ferenci P, Diago M, et al. How can we identify HCV genotype 1 patients who may benefit from an extended treatment duration with peginterferon alfa-2a (40KD) plus RBV? Program and abstracts of the 42nd Annual Meeting of the European Association for the Study of the Liver; April 11-15, 2007; Barcelona, Spain. Abstract 641.
20. Ferenci P, Laferl H, Scherzer TM, et al. Customizing treatment with peginterferon alfa-2a (40KD) (Pegasys) plus ribavirin (Copegus) in patients with HCV genotype 1 or 4 infection: interim results of a prospective randomized trial. Program and abstracts of the 2006 Annual Meeting of the American Association for the Study of Liver Diseases; October 27-31, 2006; Boston, Massachusetts. Abstract 390
You ask about weight. A higher BMI does reduce the odds SVR but I believe it is not a major factor such as genotype, RVR, med compliance, fibrosis, etc.
As far as how to reduce Riba...
"Several studies have now demonstrated that mild reductions in the doses of either peginterferon alfa and/or ribavirin will not adversely affect the chance of achieving SVR, especially if this strategy is employed AFTER (my emphasis) the patient achieves undetectable HCV RNA.[15,24] By contrast, interrupting treatment for more than 7 days because of adverse events leads to breakthrough and relapse.[24] Therefore, it is the recommendation of this author to reduce ribavirin stepwise by 200 mg every 2-4 weeks until adverse events either resolve or are tolerable. Peginterferon alfa-2a can be reduced from 180 to 135 µg/week and peginterferon alfa-2b from 1.5 to 1.0 µg/kg/week. Neither peginterferon alfa nor ribavirin dosing should be interrupted unless the adverse event is particularly severe and there is a concern for patient safety. Whenever the doses of peginterferon alfa and ribavirin are modified or temporarily interrupted, HCV RNA testing should be performed again to ensure that breakthrough has not occurred."
15. Reddy KR, Shiffman ML, Morgan TR, et al. Impact of ribavirin dose reductions in hepatitis C virus genotype 1 patients completing peginterferon alfa 2a/ribavirin treatment. Clin Gastroenterol Hepatol. 2007;5:124 129.
24. Shiffman ML, Salvatore J, Hubbard S, et al. Treatment of chronic hepatitis C virus genotype 1 with peginterferon, ribavirin, and epoetin alpha. Hepatology. 2007;46:371-379.
Hope this helps.
Cheers!
Hector
There are no studies on this subject that I know of. The only studies I am aware of are for 48 vs. 72 weeks. If you drop more than 2 log by week 12 but are not undetectable, and then become undetectable by week 24 then you are a "slow responder" as someone above stated. You have better odds of SVR as a "slow responder" if you treat for 72 weeks. (20% vs 50% relapse rate)
All quotes from
"Understanding HCV Nonresponse and Identifying Candidates for Retreatment"
Source: New Management Strategies for HCV Nonresponders and Relapsers
By: Mitchell L. Shiffman, MD
http://clinicaloptions.com/Hepatitis/Treatment Updates/HCV Nonresponders/Module/Shiffman.aspx
"Three recent studies have now demonstrated that relapse can be significantly reduced in slow-to-respond genotype 1 patients—those who achieve undetectable HCV RNA after Week 12—by extending the duration of treatment from 48 to 72 weeks.[8-10,20] In each of these studies, the relapse rate was reduced from more than 50% to less than 20%. Two of these studies suggest that this benefit may be less or nonexistent in patients with higher HCV RNA levels at baseline and at Week 12.[8,9] However, these observations will need to be confirmed in future studies before these patients are not considered for treatment extension. Therefore, for now it appears that prolonging the duration of therapy will increase SVR rates in patients who are slow to respond and should be routinely practiced. "
8. Sanchez Tapias JM, Diago M, Escartìin P, et al. Peginterferon alfa2a plus ribavirin for 48 versus 72 weeks in patients with detectable hepatitis C virus RNA at week 4 of treatment. Gastroenterology. 2006;131:451 460.
9. Berg T, von Wagner M, Nasser S, et al. Extended treatment duration for hepatitis C virus type 1: comparing 48 versus 72 weeks of peginterferon alfa 2a plus ribavirin. Gastroenterology. 2006;130:1086 1097.
10. Sanchez-Tapias JM, Ferenci P, Diago M, et al. How can we identify HCV genotype 1 patients who may benefit from an extended treatment duration with peginterferon alfa-2a (40KD) plus RBV? Program and abstracts of the 42nd Annual Meeting of the European Association for the Study of the Liver; April 11-15, 2007; Barcelona, Spain. Abstract 641.
20. Ferenci P, Laferl H, Scherzer TM, et al. Customizing treatment with peginterferon alfa-2a (40KD) (Pegasys) plus ribavirin (Copegus) in patients with HCV genotype 1 or 4 infection: interim results of a prospective randomized trial. Program and abstracts of the 2006 Annual Meeting of the American Association for the Study of Liver Diseases; October 27-31, 2006; Boston, Massachusetts. Abstract 390
You ask about weight. A higher BMI does reduce the odds SVR but I believe it is not a major factor such as genotype, RVR, med compliance, fibrosis, etc.
As far as how to reduce Riba...
"Several studies have now demonstrated that mild reductions in the doses of either peginterferon alfa and/or ribavirin will not adversely affect the chance of achieving SVR, especially if this strategy is employed AFTER (my emphasis) the patient achieves undetectable HCV RNA.[15,24] By contrast, interrupting treatment for more than 7 days because of adverse events leads to breakthrough and relapse.[24] Therefore, it is the recommendation of this author to reduce ribavirin stepwise by 200 mg every 2-4 weeks until adverse events either resolve or are tolerable. Peginterferon alfa-2a can be reduced from 180 to 135 µg/week and peginterferon alfa-2b from 1.5 to 1.0 µg/kg/week. Neither peginterferon alfa nor ribavirin dosing should be interrupted unless the adverse event is particularly severe and there is a concern for patient safety. Whenever the doses of peginterferon alfa and ribavirin are modified or temporarily interrupted, HCV RNA testing should be performed again to ensure that breakthrough has not occurred."
15. Reddy KR, Shiffman ML, Morgan TR, et al. Impact of ribavirin dose reductions in hepatitis C virus genotype 1 patients completing peginterferon alfa 2a/ribavirin treatment. Clin Gastroenterol Hepatol. 2007;5:124 129.
24. Shiffman ML, Salvatore J, Hubbard S, et al. Treatment of chronic hepatitis C virus genotype 1 with peginterferon, ribavirin, and epoetin alpha. Hepatology. 2007;46:371-379.
Hope this helps.
Cheers!
Hector
Bottom line is you can’t quit! You want to know WHY! Because you started this process and you’ll damn well finish it, got it! I don’t care how you got it, but you got It’ and it’s in your blood, organs, intercellular fluids and it’s eating away at your liver and bile ducts very slowly and you’re not going to get rid of it if you don’t take care of it NOW! It will eventually scar your liver so bad that it will look like a cancerous lung of a 2 pack a day 50 year smoker but before then you will suffer a multitude of aliments hitting every organ in your body, maybe not so severe at first but in time the symptoms will start taking it’s toll on everything you do. Fatigue is the first symptom and maybe, just maybe the gallbladder is the first sign of a long line of aliments just beginning to manifest it self as it comes on slowly and then progresses with time until finally you go to the doctor to find out why you are so tired and then Bham! You are lucky in the fact that you had your gallbladder removed and the HCV was found early, so buck it up take the meds stay the course and keep moving forward because you don’t know who may need you somewhere down the road and when you least expect it, so that’s the truth of it, now take the shot, eat the riba and complain all you want because that’s the way it is uh huh, uh huh. Seriously tho, it is a personal challenge and you and you alone can overcome it by finishing treatment.
The GI problems is the Riba working.
Geterdone women, just geterdone.
The GI problems is the Riba working.
Geterdone women, just geterdone.
Hector, This may sound dumb but do the odds increase for Geno 1 if you are UND by week 12 and stay in TX for the full 48 weeks, And what to do you think of weight baseed riba? They started me 1000 mg. and last week lowered me to 800 mg. and now want to lower to 600mg. any advise?
Correction, you state in your comment:
If you don't go UND by week 12 - you are a non-responder
Actually, if you don't achieve a 2log/10 drop by wk 12 you would be considered a non-responder. If you achieve UND between wk 12-24 you are a slow responder and a candidate for possible extended treatment duration. If you are a non-responder continuing is virtually pointless.
If you don't go UND by week 12 - you are a non-responder
Actually, if you don't achieve a 2log/10 drop by wk 12 you would be considered a non-responder. If you achieve UND between wk 12-24 you are a slow responder and a candidate for possible extended treatment duration. If you are a non-responder continuing is virtually pointless.
The reason is for completing 48 weeks of treatment is the purpose of treatment is SVR. In order to achieve SVR a patient must...
1. drop virus load by at least 2 log.
2. have undetectable virus at the latest before work 24.
3. You have to keep the virus suppressed for a long enough duration so that the virus doesn't come back when treatment is discontinued. (Relapse).
Until you do ALL of these things you have no chance of SVR.
So for example if you become undetectable by week 4, then you will be suppressing the virus for 44 additional weeks during your 48 weeks of treatment.
Studies with many thousands of patients show that genotype 1's best chance of SVR is when treatment duration is 48 weeks. Any time less treating and the chances of SVR go down. Remember type 1's only have about a 40-50 percent chance of SVR to begin with so you want to give yourself the best odds possible.
Cheers!
Hector
1. drop virus load by at least 2 log.
2. have undetectable virus at the latest before work 24.
3. You have to keep the virus suppressed for a long enough duration so that the virus doesn't come back when treatment is discontinued. (Relapse).
Until you do ALL of these things you have no chance of SVR.
So for example if you become undetectable by week 4, then you will be suppressing the virus for 44 additional weeks during your 48 weeks of treatment.
Studies with many thousands of patients show that genotype 1's best chance of SVR is when treatment duration is 48 weeks. Any time less treating and the chances of SVR go down. Remember type 1's only have about a 40-50 percent chance of SVR to begin with so you want to give yourself the best odds possible.
Cheers!
Hector
I am 1A and I was undetectable at 3 months and it was hitting me really hard but my GI said the best chance to keep it from returning or failing treatment was to complete 48 weeks. I decided then I would give it all I had because I did not want to start over and let it defeat me.
sadd
sadd
Usually this is a one shot deal. Take it as long as you should by the doc. I took it for a year and been symptom free since 2001. It doesnt work for a lot of people and if your one of the lucky ones, keep taking it. It would be bad and a waste of time if in two months after stopping your symptoms came back and you have to start over again. You either go into remission or you have it for life. Its worth a year of your life. I had it for 15 years before I started having problem. Of course I still worry about it comming back. Is a pain in the butt but stick it out. Keep positive.
Brent
Brent
How long have you been on treatment now. The result you got week 12, is it from blood taken week 12 or you received the result week 12 from blood taken earlier? Either way, you need to treat for 48 weeks.
I cannot comment on your attacks mimicking gall bladder attacks, as I have no knowledge about it.
marcia
I cannot comment on your attacks mimicking gall bladder attacks, as I have no knowledge about it.
marcia
I have had 6 blood test but only heard results from 2 the first at 2 weeks was still there then didnt hear anything till week 12 that is when they said it was undected. The Gi problems I have had since I had my galbladder out last year when they found the HCV virus, Since I started treatment I have what seems to be glablader attacks even though I no longer have one always after the shots it acks up.
Thanks all
Thanks all
Even though the virus is not detectable in your blood anymore, it hides in the cells in the body. You see, the hep c virus is a very sneaky one. So doing the treatment for 48 weeks for genotype 1 is to kill the virus wherever it is hiding, even though you cannot see it in the blood anymore.
Good luck with your treatment and hang in there!
Marcia
Good luck with your treatment and hang in there!
Marcia
Ralph,
The reason to do the full 48 weeks is that you will maximize your chances of a sustained viral response, assuming of course, that you were UND by week 12.
I'm in week 45 of 48 right now. Do I want to quit? You bet. But I'm staying in till the end because I don't want to ever have to do this again.
Hope you can understand the logic.
The reason to do the full 48 weeks is that you will maximize your chances of a sustained viral response, assuming of course, that you were UND by week 12.
I'm in week 45 of 48 right now. Do I want to quit? You bet. But I'm staying in till the end because I don't want to ever have to do this again.
Hope you can understand the logic.
The probably of a relapse will increase greatly if you stop early. How quickly did you become undetectable?
OK - first - it's standard protocol...
How long ago did you go Undetectable?
How far into the 48 weeks are you?
If you didn't go UND in the first 4 weeks --- then your chances of SVR decrease.
If you don't go UND by week 12 - you are a non-responder.
Many folks who went UND in the first 4 weeks and did not complete the 48 weeks of therapy - returned to a positive Viral load.
The virus is not just in the blood --- it remains in the liver and other organs.
Although the blood tests cannot detect it - it often is waiting to come back stronger if it is not "killed" completely - or enough to where it cannot replicate.
The SOC --- 24 weeks for 2 and 3 genos --- and 48 -72 for 1 genos has been put into place because of studies and results of many years of testing.
The virus seems to be more resistant for geno 1s
I don't know what kind of GI problems you might be having --- or how long you've been on the Chemo... But --- if you want to beat this thing - being on the chemo longer gives you a much better chance.
BUT --- with that said ---- the chemo TX is VERY hard... Hard on your body - and mind.
You are the one who has to make the final decision.
How long ago did you go Undetectable?
How far into the 48 weeks are you?
If you didn't go UND in the first 4 weeks --- then your chances of SVR decrease.
If you don't go UND by week 12 - you are a non-responder.
Many folks who went UND in the first 4 weeks and did not complete the 48 weeks of therapy - returned to a positive Viral load.
The virus is not just in the blood --- it remains in the liver and other organs.
Although the blood tests cannot detect it - it often is waiting to come back stronger if it is not "killed" completely - or enough to where it cannot replicate.
The SOC --- 24 weeks for 2 and 3 genos --- and 48 -72 for 1 genos has been put into place because of studies and results of many years of testing.
The virus seems to be more resistant for geno 1s
I don't know what kind of GI problems you might be having --- or how long you've been on the Chemo... But --- if you want to beat this thing - being on the chemo longer gives you a much better chance.
BUT --- with that said ---- the chemo TX is VERY hard... Hard on your body - and mind.
You are the one who has to make the final decision.
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