Aa
decisions, decisions,
Well I will start off with so far so good, feeling not to bad BUT..... because I am not feeling "too bad" my Dr. has suggested doing 48 rather than 24 :( His feeling is,and I knew going into this that there would be a possibility I would perhaps need to do 48 because I am cirrotic stage 3 grade 2 if my memory serves me right. Did not have biopsy, determination was made via blood test, fibrosure. Had a ecg done and no varises(sp) had an ultra sound 2 weeks ago and all looked fine. I have been und since week 4 holding my own with my labs on full soc geno 2.My question for him is going to be, how many geno 2's have with cirrosis have relapsed on 24 and how many have on 48. If my chances are the same then WHY DO IT> I know its only another 24 weeks and truly it has gone by very fast. I just did shot 15 last night. Oh My! I hate decisions :( Any thoughts? I might add I do see a hepatologist in a transplant ctr. not just a GI. Hate to go against the Dr's suggestions but.........sometimes its easy for them to make suggestions when it isnt them who's life is on hold.
I was a G2 stage 3. I did 24 weeks and SVR'd.
I agree with will, I never heard of extending when you RVR. Stage 3 has nothing to do with anything. Either the virus is gone or it isn't. Seems totally unnecessary.
I agree with will, I never heard of extending when you RVR. Stage 3 has nothing to do with anything. Either the virus is gone or it isn't. Seems totally unnecessary.
mykids247: Good luck,sounds like you have an experienced doctor and always best to take their advice,..
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I said this above and my opinion is that if a doctor has extensive experience treating HCV then this is best,however I looked further(was just curious) and could not find " one" article or study data that states extending to 48 was at all beneficial (with an RVR),regardless of liver damage.(actually the contrary,that shorter may very well be better considering benefit vs. risk)
So personally his expertise would need to convince me unequivocally before I committed myself to 24 more weeks of INF.
jmo.
Good luck..
Will
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I said this above and my opinion is that if a doctor has extensive experience treating HCV then this is best,however I looked further(was just curious) and could not find " one" article or study data that states extending to 48 was at all beneficial (with an RVR),regardless of liver damage.(actually the contrary,that shorter may very well be better considering benefit vs. risk)
So personally his expertise would need to convince me unequivocally before I committed myself to 24 more weeks of INF.
jmo.
Good luck..
Will
Although we are both geno 2 doing SOC, our situations are different.
I'm post transplant, with stage 1, heading to stage 2.
My heptalogist said when I was und @ 4weeks, it meant I have a 90% chance of cure.
I know if I had become und later, he would have wanted me to do tx longer.
( The tp factor)
My feeling is your being und @ 4 weeks is the biggest thing you have going for you.I'd think the fact you were dealing well was a positive.
Ask about those statistics, when you see your doctor.
Like desrt said, the choice is yours.
Good luck and let us know how it goes.
OH
I'm post transplant, with stage 1, heading to stage 2.
My heptalogist said when I was und @ 4weeks, it meant I have a 90% chance of cure.
I know if I had become und later, he would have wanted me to do tx longer.
( The tp factor)
My feeling is your being und @ 4 weeks is the biggest thing you have going for you.I'd think the fact you were dealing well was a positive.
Ask about those statistics, when you see your doctor.
Like desrt said, the choice is yours.
Good luck and let us know how it goes.
OH
Well, it's nice to have your doctor's blessing to do 48 so your insurance will cover it. Now it's really up to you whether you do 24 or 48 or 36. Do your research. It's your body and your health. Your choice.
I don"t think I have read anything that says for Geno type 2"s extending to 48 from 24 weeks when achieving an RVR will increase SVR regardless of firosis progression..
This was the newest article I could find on treating G2"s and there was lots about actually shortening tx. from 24 to 16 if RVR " without " advanced fib. but I didn't see anything about extending to 48 weeks with advanced fibrosis or even cirrhosis
http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02710.x/full
.
mykids247: Good luck,sounds like you have an experienced doctor and always best to take their advice,..
Will
Will
This was the newest article I could find on treating G2"s and there was lots about actually shortening tx. from 24 to 16 if RVR " without " advanced fib. but I didn't see anything about extending to 48 weeks with advanced fibrosis or even cirrhosis
http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02710.x/full
.
mykids247: Good luck,sounds like you have an experienced doctor and always best to take their advice,..
Will
Will
Curious what your platelets was going into tx? That seems to be a good gage on cirrhosis. One problem you might have in trying to compare is the fact allot of doctors don't do a biopsy on geno 2 or 3's. I would want to know sense being und at week 4 how that compare to others that wasn't and their success and treating times.......... Best to you
Hi.
"because I am cirrotic stage 3 grade 2 if my memory serves me right."
Stage 4, is cirrhosis, not stage 3. Stage 3 is advanced fibrosis. A big difference.
If you are cirrhotic, 48 weeks of treatment will give you the best chances of SVR. 48 weeks is the standard duration for all cirrhotics.
Since your doc is a hepatologist at a transplant center he should be able to determine based on all factors (except biopsy which is the standard way to determine staging) whether you have cirrhosis or not. He would have to have factored that into your treatment from the beginning.
If you only have advanced fibrosis, stage 3, then your doctor may being erring on the safe side by recommending 48 weeks. There is not much data on this from the clinical trials so it is really the doctor's call.
'• Some data suggest that patients with stage F3 fibrosis may also benefit from fixed-duration therapy for both boceprevir and telaprevir, and some clinicians may wish to follow the same guidelines used for cirrhotic patients in these individuals with advanced fibrosis.''
As a hepatologist at a transplant center who works with HCV patients with advanced liver disease they should be the expert on this matter.
Best of luck with your treatment.
Hector
"because I am cirrotic stage 3 grade 2 if my memory serves me right."
Stage 4, is cirrhosis, not stage 3. Stage 3 is advanced fibrosis. A big difference.
If you are cirrhotic, 48 weeks of treatment will give you the best chances of SVR. 48 weeks is the standard duration for all cirrhotics.
Since your doc is a hepatologist at a transplant center he should be able to determine based on all factors (except biopsy which is the standard way to determine staging) whether you have cirrhosis or not. He would have to have factored that into your treatment from the beginning.
If you only have advanced fibrosis, stage 3, then your doctor may being erring on the safe side by recommending 48 weeks. There is not much data on this from the clinical trials so it is really the doctor's call.
'• Some data suggest that patients with stage F3 fibrosis may also benefit from fixed-duration therapy for both boceprevir and telaprevir, and some clinicians may wish to follow the same guidelines used for cirrhotic patients in these individuals with advanced fibrosis.''
As a hepatologist at a transplant center who works with HCV patients with advanced liver disease they should be the expert on this matter.
Best of luck with your treatment.
Hector
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