genotype 4

[exaddict24]

Hi, my Doctor says i have genotype 4 hep c virus.How difficult to clear is it?What are my chances of a SVR? I am on ribavirin and peginterferon for 14 weeks now. und since week 4. thanks.

[Boobert]

Wow another 4. I never did find out what subtype I am. Maybe i'll take another Genotype test.

exaddict24 Congrats on the und at week 4, thats huge.

[Bali05]

I posted a link on your thread to a presentation that shows a map with all the subtypes and their origin.
4F seems to be coming from Africa just like 4c.
I am/was 4a,c. You often see 4 with multiple subtypes.
There seems to be evidence that 4a (90%HCV in Egypt) is easier than non-4a.
You and I are non-4a.
I would run the IL28b test next and FibroSure+FibroScan and if you decide not to tx
do a biopsy.

b

[zako7]

I am G4f with 2.7 vl. Bali, please do you know anything about 4f?

[exaddict24]

I will check with my doctor next week. Thanks. God bless.

[Bali05]

Genotype 4a seems to be responding better than non-4a.

[exaddict24]

My fibroScan says 7.3 stiffness (KPa), 2.5 IQR (KPa), 8.7 CS (KPa). I do not know my subtype yet, have to ask the doctor next week. Any inputs? Thanks Bali05.

[exaddict24]

My viral load stated on results on week 4, week 10 and week 12 + 4 days, says- RTPCR NOT DETECTED < 15 IU/mL (<1.18 LOG).   Before meds was 3.96 x 10 4 IU/mL (4.60 LOG). My Haemoglobin was 17.0 g/dL just before meds, at week 4 was 13.3, week 10 10.8, week 12 + 4 days 10.1. My Neutrophils was 2.48 x 10 9/L before meds, now 0.71. Doctor is giving me neupogen injection once at a week for 2 weeks, blood test again next week. I am treating for 48 weeks. Your input will be greatly valued. Thanks Dave.

[Bali05]

Depending on some other predictors like fibrosis , baseline viral load ect....
you could possibly shorten your tx.
If I would have had an RVR my hepatologist was recommending 36wks.
BTW , genotype 4 is a mixed bag. Sometimes it responds better than geno 1
sometimes worse.
Do you happen to know your subtype ?

b

[exaddict24]

I do not know how sensitive the PCR my doctor use. I will find out next week i see him.I am now in week 14, no dose reduction but i accidentally took less 200mg of ribavirin when my medication ran out one day. my haemogiobin is now 10.1, but the doctor is now giving me neupogen for low white blood count.Any questions i should ask my doctor when i see him next week.My doctor don't talk much.Thanks spectra, for your reply.

[spectda]

According to this study if you are rvr and geno 4 you have a 83% chance of SVR. Do you know how sensitive the PCR you used was? Have you had any dose reductions?
Best of luck,
Dave

http://www.ncbi.nlm.nih.gov/pubmed/18090387
RESULTS:
Overall, SVR was achieved by 193 patients (49.6%), 68/191 (35.6%) with genotype 1, 110/152 (72.4%) with genotypes 2/3 and 15/46 (32.6%) with genotype 4. RVR was the best predictor of SVR regardless of HCV genotype. Only for HCV-1 patients, baseline HCV-RNA less than 500 000 IU/ml was also associated with SVR. In HCV-3 patients RVR had a positive predictive value (PPV) for SVR of 90%, with treatment for 24 or 48 weeks. The PPV of SVR for patients with RVR was 69% for HCV-1 and 83% for HCV-4.

[exaddict24]

Thanks for your information. I will you all updated about my progress. Thanks.

[can-do-man]

Odds wise theres not alot of difference between geno 1 and geno 4, that said since you were und at week 4 you are a RVR so your odds are very good for becoming SVR. It doesn't get much better then that......... Great going

cando