confused about duration of tx as i dont know my genotype

[alijee]

as you all know that i dont know my genotype and im on week 11. i have heard that if a person is once undetected the gynotype is possible to know. i have given blood for 10 week pcr and if im undetected, then what about my tx length??? Today im going to new doc and will tell you the whole story what he will tell me. If unfortunately im g1 it will be relapse after 24 week tx and if im g3  and treated for 48 weeks i will face 24over tx. much confused. help plz

[jmjm530]

Yes, you should have had a biopsy, been tested for genotype and had both a week 4 and a week 12 test. No argument here.

That said, a lot of this is in the past and cannot be changed. And even with the less than ideal decisions made by your doctor, your case is far from dire and hopefully you will not let it get you down too much as it appears it is.

Truth is that you have close to a 90% chance of being an easy to treat genotype meaning even without all these tests/procedures your odds of being cured are much better than most of us genotype 1's here. That is the perspective you should hold and not try and look back and ruminate.

My opinion is to try and get a viral load test as soon as possible and if undetectable treat for 24 weeks total or whatever protocol they use for your non-pegalayted formulation. But even if they refuse to test your viral load at week 12, you still have around an 80% chance of being cured. And btw, genotype 2's and 3's are often treated in similar way in this country as well. No biopsies and on occasion no week 12 test, at least as reported here. It's not the right way but often done because some doc's feel that geno 2's and 3's are most probably going to get cured anyway. And in the vast majority of the cases they will be right. So stay postitive!!!

-- Jim

[nygirl7]

Unfortunately if you cannot find out the geno and were not UND at week 4 I would assume to do the 48 weeks in order to make sure you do clear this virus.

Even for Pakistan this seems very odd to me as knowing the geno seems to be the first and most important part of the equation.

I would definitely ask and double check this situation with the doctor and see if they can rectify it.

What a nightmare of a situation!

I wish you the best.

[R Glass]

Are you 100% sure your Dr. doesn’t know your gynotype? It seems strange to me that a Dr. would start tx without know the gynotype. Maybe things are done different in Pakistan. Hopefully the Dr. you are going to see, will give you all the information you need. Good Luck, R Glass

[jmjm530]

:)

[Bill1954]

Oops! Oh well, definitely AND defiantly :o).

[Bill1954]

HI Jim;

The table I linked supports the data you gave Alijee as well; I would defiantly play the odds if I were him myself, given his current situation.

Bill

[Bill1954]

You are quite welcome, my friend :o).

[jmjm530]

Haven't looked at Bill's links but I posted a link in one of your other threads that suggested something like there was only a 12% chance you were a genotype 1. It's really an odds game anyway but a little more so in your case since they didn't run a genotype test. Try and get the test run now and see if they find something. If not, and given your side effects so far, I'd strongly consider going with the odds and treating as if you were a non-genotype 1.

-- Jim

[alijee]

Thank you very much for every thing.

[Bill1954]

I have followed your situation a little. Assuming that you are indeed undetectable for virus at this point (and therefore genotyping would be unavailable); it appears the doctor would have two choices:

1) Treat you as a genotype 1 for 48 weeks; this could potentially expose you to excessive treatment drugs, and is not cost effective. However, it would assure that you would receive the Standard of Care for genotype 1, giving you the best chances for clearing that particular genotype.

2) The doctor could review the predominant HCV genotype for your geographical area, and make treatment assumptions based on odds.

Here is a paper showing the geographical distribution of HCV genotypes for Pakistan; this is a very large (and recent) study involving 3351 patients; and therefore hopefully representative:

http://www.biomedcentral.com/1471-2334/8/69

as well as a table from the same study breaking these statistics down into regions; i.e. Punjab, NWFP, Sindh and Balochistan:

http://www.biomedcentral.com/1471-2334/8/69/table/T2

If possible, you might want to print these and take them to your consult with the doctor to help drive treatment decisions. Your doctor might have other solutions; this is only my take, and I’m not a physician. I hope this helps,

Good luck—

Bill

[alijee]

but i dont know my genotype yet. then how can i decide how long should i get tx??

[lalapple]

geno 1 tx for 48 wks my doc told me they consider taking people off tx if they are not und by 24th week.  
geno 2 and 3 tx for about 24 wks