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hep c genotype 1a...or 1b...or 1...what is the difference
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hep c genotype 1a...or 1b...or 1...what is the difference

is the hep c genotype 1a resistant to treament...what is the difference between type 1 and type 1a....and does 1a respond to treatments...as  compared to type 1

thanks

jerry
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Avatar_n_tn
I am a combo 1 a & b ....
although that is a bit more rare, (Like 5 % of us or something) it still doesn't matter...

They treat all 1's the same...

I did hear that 1b was known for faster progression though ... not sure if that is true or not.
:)
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Avatar_n_tn
Welcome to the board.  There are quite a few type 1's (1A, 1B) here at the forum.  There's not a big difference between 1A/1B.  It's tougher to treat type 1's than the type 2's and 3's.  Treatment is typically 48 weeks for type 1's and 24 weeks for types 2 and 3.  I'm a 1A (hopefully former).  Finished 48 weeks of Pegasys/Copeg 6 mos ago.  Undetectable 4 mos post treatment.  About 12 weeks into treatment your Dr. will test to see if you are a "responder" or "non-responder" to the meds.  If you are a responder (undetectable or significantly lowered viral load), the odds are in your favor.

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Avatar_n_tn
Jerry,,,,Sounds like everyone has given you great answers here already.  My doc did tell me not really any difference between 1A and 1B,,,same treatment of 48 weeks.  There is any here beating it so odds have been running really good here at medhelp.  I just did my 3 month post test,,,,Clear,,,I'm 1A!

Honest Answer From All Please,,,,My birthday is coming up and we are planning family get together at nice Italian place. Of course a glass of wine would be great with some pasta! yum!  But,,,,,What does everyone think?  I have read so much about drinking and hep or being negative and maybe alcohol could disrupt something.  Would you have a glass or not and why?
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Avatar_n_tn
I say have a glass and celebrate. (maybe just one). Why? From reading your post's and responses I believe your wise enough to know what's good for you. One glass of wine on a very special occasion, being with your family, laughing, having a great dinner, that's what's lifes about. Have FUN Honey!
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87972_tn?1322664839
My apologies for not remembering if you're treating or not, Honey;
If you are indeed on Tx, my understanding is that alchohol NEGATES the effect that peg/riba has on viral replication. I would interpret that as the time from the first drink until the alchohol is totaly metabolized by the body as lost time, possibly as long as 48 to 72 hours. In other words, similar to 2 to 3 days without meds, plenty of time to let the bug get moving again.
If you have succesfully Tx'd and cleared, then I suppose you might want to consider your last biopsy numbers, and have a very long discussion with yourself about the durability of SVR, etc,. Personaly, I'm not fully convinced of the term "cure".
This is fairly simple, anecdotal info, but maybe somthing to chew on.
Best,

Bill
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Avatar_n_tn
I would not drink alcohol on tx. Why chance it with all it takes I am sure you know alcohol affects almost all meds as it does with this tx. Personally I think once you have one glass next time it's just why not just one and so on. As for being SVR I think it depends on your liver. If you have no damage I see no reason why not and my doc agreed but if you have any liver damage we all know alcohol is very bad. Again this is just my personal thoughts on this subject since you asked. I know this is a sensative subject for many. What does your doc think? My doc told me if I want to have a glass of wine with SVR go ahead. I had no liver damage after 28 years with HCV. Only you know your own drinking habits. I hope you have a wonderful birthday! LL
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Avatar_n_tn
My specialist explained it to me as geno type 1 whether it is a, b is the most common and hardest cured. Geno type 2 is easiest cure.  I am only going with what was explained to me.  I a geno type 1b and my treatment is for 48 weeks. I have been on it for 9 months and my tests are coming back undetectable.  My husband is geno type 2 and his treatment was only 6 months and he is undetectable. If this is new to you then you have reached an excellent web site. I have found this place extremely comforting when I am having a hard time and with any questions I may have.  They have heard everything before but seem to not mind answering the same questions everytime someone new comes along.  I hope you find this place very resorceful like I do. Excellent support group here. Good luck and don't ever give up.
Gina
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80575_tn?1207135964
Have you ever had a drinking problem?  I quit the day of my dx and it was one of the blessings that came from HCV.  My relationships are stronger, I feel better and I don't miss the hangovers.  For me, one drink may push me over the line.  By the way, I do miss the social aspect of drinking.
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Avatar_n_tn
HONEY, aw that's a tough decision...we all love you and would hate to advise you and then if something happened we'd feel terrible for giving you bad advice...wish you had a biopsy and knew if your liver was damaged then i'd say not worth it...but this whole question of the virus comming back and not really being gone all the way really does freak me out...i have asked myself the same question cause i used to love my glass of wine on occasion...i mean i really enjoyed it and do miss it...

i'd love to say go for it but i feel safer and more loving saying find a special bottle of sparkling grape juice with strawberry and have a ton of laughs and you won't know the difference...i would feel safer telling you to wait longer perhaps until the one year post? i know for sure you will feel better the next day...and you did work so hard getting rid of this virus...

but honey just pray and follow your heart...do what you think would be best for you right now...i'll pray God gives you wisdom...

you know we love ya and want the best for you,

sandi
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Avatar_n_tn
Because you never had a biopsy and don't know the real condition of your liver, I guess it is something you have to wrestle with. But I actually asked my doc the other day about having the occasional cold beer (on a hot day) and he said because my bx didn't show any damage that it would be okay once in a while. "Just don't turn into a booze hound", he said.

I think if you feel like having one, it is your business and your decision. You are wise, right? Have fun either way, and Happy Birthday Honey.

Mattie
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Avatar_f_tn
I finished my tx in Nov, went to PR in Dec, celebrated my firstborn's wedding and it was with champagne.  My 6 wk post tx( after the wedding) was negative and so was the 3 mo post.  I also had an occassional drink during tx, about 6 total in the 18 months of tx, but all of them after a negative PCR at wk 26 of tx.  My damage is stage one. I don't feel there is any harm to my liver in moderate alcohol drinking.  You do not know your level, but chances are it was not severe. ENJOY a nice glass of red. Happy B day!
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Avatar_n_tn
Thanks Imagine,,,,A little celebration on the b-day,,,you wouldn't think would be out of order would you lol

Bill & Layla,,,Thanks for the reply and noooo I'm not on tx. I just received my 3 month post pcr and its negative.  Bill,,,I'm like you in the fact,,,I'm still pondering that word CURE for hep and don't want to let my guard down haha  The only idea that I toss around is if small amount of alcohol could get the virus going again,,,,what about any kind of meds I take in future,,or even something in diet. There is alot of things not great for liver.  Trouble is I never had a biopsy so don't know that answer either.  Just wondered what everyone thought or even people that are post now and clear,,,are they still staying totally alcohol free?  

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Avatar_n_tn
Honey - I know I will be in the minority on this one, but I think if you want to have one (or even two) glasses of wine with your dinner, you will be fine.  I am a 1b, cleared on my 3 mo post tx PCR in March and am not having another PCR till my 1 year post tx.  I have had wine in the past 3 months.  Not a lot, a glass here and there, and I never even think twice about it.  There is something to be said about quality of life, and I enjoy having a glass of wine now and then.  I don't think it's going to hurt, and I think if it is going to make you happy on your birthday, that is good quality of life.  You have always seemed like a very logical, down to earth person, and I don't expect that you will down a whole bottle of wine in one sitting, nor do I expect that you would be the type to drink a lot of wine every night.  Everything in moderation!  Drink your glass of wine, celebrate your birthday, celebrate your 3 month PCR, and don't give it a second thought.  Stressing about it is probably more damaging to your liver than the actual glass of wine!
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Avatar_f_tn
ur last sentence said " if ur a responder, the odds are in ur favor"  What if ur not a responder? (I'm type 1; end of my 2nd week of tx; biopsy result 2)  I know I wont find out if im a responder till 1 month of tx is completed.
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Avatar_n_tn
would love to hear from more who have had alchohol after tx and still remain clear on followup pcr. i think that's the real question...

if one is an alchoholic or has liver damage to worry about then it's a no brainer...
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Avatar_n_tn
Some great advice and I appreciate it. Sandi,,,I would also love to hear more from people off tx and what they are doing.  Cuteus,,,Thanks so much for your honest answer and look where you are now,,,clear!  Couch,,,you are so right,,,ultimate decision is your business only.  Fubar,,,Yep,,stress can do alot alone and if I'm going to come across this everytime with so much stress and wondering if this or that will bring it back or shake it up again,,,its not worth it.
Miked,,,I never had a drinking problem,,,probably drank more in my highschool days and college then lifetime lol  Occasional drinker until a year and half ago on finding out I had this.  It means alot,,,your answers because there is so much information from this site and so many have been there a lot longer then I have so I hope more will answer what you are doing after finishing tx.  If I knew for a fact,,,my biopsy was moderate damage,,,I know for a fact,,,,I would not even second guess on having a glass of wine or 2 here and there but,,,,,That is my dilemma,,,,if I happened to be a stage 3,,,I would definitely want to try to reverse more damage.
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Avatar_f_tn
ne reason u didnt get a biopsy?
as soon as my hep c was diagnosed;
bloodwork for type and viral load and then the biopsy.
it was automatic
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Avatar_n_tn
really...can't believe someone did tx without a biop?!

I was a heavy drinker, not alcoholic but pretty heavy, my damage is stage 2 and I think most of that is probably from past drinking.  I know I have had this for over 20 years.  I did not respond to virimadine/peg tx clinical trial...I drank a little bit on tx, maybe 3-4 times, no more than a glass or 2 of beer or wine, think I had like 5 drinks once...I really don't think that had anything to do with not responding, there have been absolutely NO studies about minimal drinking having any effect at all on the hep or on tx...the level of alcohol in the system is really too small to measure. But of course regular heavy drinking is a no-no studies prove it, helps the hep work to attack your liver and if you drink heavy on tx chances are slim to none that you will clear.
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Avatar_n_tn
Yep,,,,no biopsy.  The dr I went to originally when finding out,,,Says,,,You are geno 1 so no question,,,you need to treat. He did bloodwork and ultrasound and said he didn't like to do biopsies soooooo,,,,I was scared and knew nothing about this disease and just ordered the meds to begin as quick as possible.  If I could send one important message to all newbies is,,,,,how very important it is to get one before treating. If you dr won't do it,,,,find one that will.  I will not even know if the tx did some good to compare to before and after biopsies.
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Avatar_m_tn
I drank 2 glasses of wine one time while on tx for a very special occasion.  Recently, knowing I was clear at my 3 mo post PCR, I had a couple of glasses of wine while at dinner with an old friend.  I don't believe either occasion hurt me, and I had a good time.  I never had an alcohol problem, though I drank wine moderately at least weekly.  I don't plan on drinking any more than a very rare special occasion now.  That is mostly because my pre-tx biopsy showed fibrosis (stage 3).

On the biopsy subject, my understanding is that many docs do not do biopsies for stage 2's and 3's where tx success rates are so high.  I believe it is still standard to do a biopsy for Type 1's, and I assume that is because of the different decision making process involved (ie. most will strongly suggest tx for those with more damage, but holding off may be considered an option for those with minimal damage).

To all those taking shots tonight, I wish you minimal sides this weekend,  Dave
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Avatar_n_tn
Was you doctor a g.i.? The first one I went to after I was diagnosed was and he was ignorant as hell but at least he sent me for a biop before he suggested tx...but he could not answer (or did not want to answer?!) any of my hep questions, I got on a clincal trial at a univ hospital and now I have a great team of dr's, they are all hepatologists - they specialize in diseases of the liver.  I did not respond to the virimadine trial i was on but they said there are more trials and options out there, captease inhibitors, infergen, maintenance and dosage trials, etc.   I might take a break before trying anything else, my side effects were not bad with tx but they do wear you down a bit...
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Avatar_n_tn
Yes,,,My first dr was GI,,,,notice I say first lol  Because I then went to heptalogist at 6 month mark.  When I got anemic,,,the first one told me to stop meds for a week and then we would retest red blood and go from there.  We argued in his office and I said I'm not stopping my meds and told him all I needed was procrit. Well he wasn't familiar with procrit so pretty much I went home and found specialist and said see ya to first.  I wouldn't have known any better if it wasn't for everyone here at medhelp though and if I would have stopped for a week and then restarted,,,,I bet you money,,,I wouldn't be clear today.  Hey,,good luck to you when you decide to start back up.  Tx does tend to take the wind out of ya so you will jump back in there again after a break!
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Avatar_n_tn
Doc,,,Thanks for the report from your dr. Especially saying the 3 month mark,,,I honestly figured if I asked a dr,,,there response would have been 1 year marker.  See you are at finish line!  Wonderful,,,,You will in no time start feeling alive again!  And then the sweet smell of food...LOL
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Avatar_n_tn
A "non-responder" to treatment is someone who has been taking the meds but their viral load is not cleared or significantly lessened around 12 weeks.  At this point, it' between you and your Dr. to determine next steps.  There are a few folks here who extended treatment beyond the 48 weeks.  There are other options as well.  

Since you are on your second week, I wouldn't worry about what could happen.  It's excrutiating enough waiting for the 12 week test, but you can drive yourself even more BONKERS by worrying about it : )

Take it easy on yourself and keep your eye on THE PRIZE.

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Avatar_n_tn
On my last visit to the doc I asked his opinion about alcohol after tx and what he said was if my 3 month post-PCR is negative then I may have an occasional glass of wine.  If I wanted to drink wine would not be my choice, it would be a marguerita or some amoretta on the rocks, so I guess I will not partake.  I say enjoy your birthday.
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Avatar_f_tn
i take my shot sunday nite...i'm scared from about friday on because i just kinda start to feel better.  and for all this wine discussion - i've never been a drinker at all; cant stand the taste of anything HOWEVER i wouldn't mind smoking a big fat one to calm my nerves...haven't thought about that in many many moons.  i smoked in the 70's and i hear its a little different now - i probably couldn't hang.  I must do something for nerves/depression
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Avatar_f_tn
drinking alcohol while on tx, if you are not negative could have  an impact on clearing the virus. studies have shown the alcohol aids hcv replication. so while it is still in your blood, it is not reccomended to drink. I waited until I was negative to have my occassional drink, one in 6 months period. why chance it?
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Avatar_n_tn
My doctor did not tell me what stage I was in after the liver biopsy, other than to say that my condition was not good and it was not bad, and the report also stated that my liver had been moderately affected. How would you interrpert that report. I have geno. 2 and now am 11/24

Gary
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Avatar_f_tn
there is no way to know what your doctor meant about your biopsy./ Get a copy of the report and read the results yourself, why be in the dark?
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85135_tn?1227293372
chellski. Many of our fellow heppers are in legal MM states and it seems that a bit of herb does no harm and they say it helps with the sx, including anxiety, mood and insomnia. Sad to report that it did not help me, when I tried on 2 weekends.

Dana
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Avatar_n_tn
I say have a glass of wine to celebrate your birthday but take your milk thistle before dinner, a goodly amount of it.   It's not a magic bullet, but it does coat the liver cells and makes it much harder for toxins to penetrate.   And happy birthday, girl!   You surely fought good and hard for this one.  But madre mia, this discussion has got me imagining the taste of a good Rutherford cabernet, something I thought I had put out of my mind completely.   It's not easy living in wine country where vineyards are popping up like 7-11's.
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Avatar_n_tn
The only difference between genotype 1a and 1b is the type of mutations off the 1.  The hepatitis C virus likes to mutate, which is why there are so many forms of it.  I'm a 1b, have never been on treatment, have had hep C since 1969, and my liver disease has not progressed.  I'm stage 1, grade 1 as indicated by two biopsies four years apart.  Genotype 1's are more likely to be nonresponders, even with 48 weeks of treatment.
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Avatar_f_tn
I was recently diagnosed 1A I go tomorrow for my liver biopsy. Since I am 1a what are the chances I may have spread this horrible diseaase to my 3 year old son? He was delivered by C-section.  And what about my other older children and new husband of only about 1-1/2 years? I am scared to death and worry constantly about the children and my husband.  I am thinking I should have everyone tested just for piece of mind but without insurance the biopsy and everything is sooooo expensive. My husband refuses to get tested  until his insurance kicks back in in Feb 09.... I am going crazy worrying, My liver is not swollen or has any nodules or lesions but doesn't being 1a mean you have had the virus for a long time? I got a few tattoos years ago from unprofessional artists i am terrified that I must have gotten the virus then? and that was about 11or more years ago :o(
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1114764_tn?1261491074
Hello  =o)

I am a genotype 1a and am on Ribavirin and Pegasys. I will be on week 11 tomorrow.

I just got my blood test results from week 9 of treatment and my viral load dropped to 7,776 (started at 526,000). HOWEVER, my doctor told me that if I do not clear by week 12 that I have a zero % chance of clearing.

Has anyone's doctor ever told them this? If this is the case then why have I always heard of the 48 week treatment?

I am worried that I will not clear  =o(
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419309_tn?1326506891
There are almost no absolutes in this treatment.  It's true that geno 1 is the hardest to treat, and there are certainly lower chances of clearance the longer it takes you to get to undetected virus, but not getting to undetected by week 12 does NOT mean you have "zero % chance" -- if it did, my husband, a geno 1, would not be treating for 72 weeks.  (He was undetected at week 13.)

That being said, this is a disease and treatment that affects everyone differently.  If you are handling treatment well and have few side effects and want to be rid of this virus, it's worth discussing with your doctor (or a second opinion doc, hopefully a hepatologist) if he would consider the option of extending.  On the other hand, if you have not sustained much liver damage from your hep c and time is not of an urgent matter, you could consider that newer, more effective, and shorter treatments are on the horizon.

You may not get many responses your questions due to the fact that you commented on an old post.  I notice you're a new member, so welcome to the forum.  You'll find that if you use the "Post a question" button to start a new discussion, you're likely to get more responses and comments.  Best wishes.
~eureka
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Avatar_f_tn
My mom will start her treatment soon for Hep C genotype 1b. Can anyone tell me a little bit about the symptoms that she should expect to have once she will start the treatment? I beg you. I am so scared because I understood that the treatment is rough and can affect some other organs.
Thank you so much!
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Avatar_m_tn

Hi there. you have asked your question on a very old thread..so you may want to start one of your own to be seen by more people by ..going to the green  "Post a Question box at the top,and posing your question there.

  Side effects from treatment seem tpo vary from person to person. Many people have little or very mild side effects and others have more severe ones. There is really no way to know what your mom will experience until she is in treatment.
One thing that helps is to make sure she drinks lots of water everyday .as  the drugs tend to dehydrate.

  it may be a good idea to take a tylenol or two when doing here first shot .as very often  a flu like feeling will be experienced.

Feel free to ask any questions you have ,there are lots of knowlegable folks here and many currently treating

Good luck to you and your mom..

Will.

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Avatar_m_tn
my husband has been on treatment for 3 years and if they take him off the virvus comes back now they what to keep him on the treatment hes on and add the neww drug that just came out he has 1a do you think 3 years of being sick will ever get better
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1747881_tn?1358189534
New drugs Incivek and victrelis are showing good results in gt 1 patients that were relapsers, partial responders and null responders you can look at SVR stats for incivek at

http://pi.vrtx.com/files/uspi_telaprevir.pdf

and victrelis at

http://www.merck.com/product/usa/pi_circulars/v/victrelis/victrelis_pi.pdf
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1669790_tn?1333666195
Since your question is not related to the title of this thread you likely won't get many responses.  I'd encourage you to start a new thread with your question by clicking "Post a question" at the top of this white space.  Giving some basic information will help others respond to your question.

Can you tell us what treatment your husband has been on for 3 yrs (156 weeks)?  
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