how long is everyone treating for?

[GINGERPAL]

If you take incevik, riba and pegasys....how many weeks is your total treatment for ?
Is the total treatment time a standard length of time ?   Or does your viral load PCR results and when you go UND affect how long your treatment is?   And does whether or not you treated before affect how long you treat ?
Thanks....GingerP

[GINGERPAL]

I met with my doctor last week.  I had prepared my argument to support my 1000 mg dose of riba  (which was based on the great information I received from this forum) and to question his decision for the 800 mg of riba he ordered for me.  
I went with the intention of getting incevik since that was what his nurse told me I would be treated with, but during my visit, the doctor said victrelis.  
Since I was prepared to start with incevik, I decided not to entertain the idea of the victrelis – especially since I was requesting the 1000 mg of riba and I think the victrelis has more anemia issues.  Doctor was ok with the incevik.
Doctor then said I should take 800 mg of riba because he thought that was all I needed, even though I pointed out to him that the pkg insert and the trials said 1000 mg for under 75 kg (I am 117.5 lbs).  Doctor then agreed that I could take 1000 mg of riba !
I had to get a stress test for my heart, and eye dilation test, and should be able to start treatment soon:
Incevik  3 x 750 mg day, pegasys 180 ug/wk, and riba 1000 mg per day.
Thanks everyone…..gingerpal

[Dee1956]

Thank you, I have been reading so much that I am very confused now.  I am also anxious about tx starting Friday.  I will talk to my doctor.  Of course it could be like another person on here who found out at 12 weeks that they would have to do 48 not 24
Maybe they are getting people on the tx, seeing how they do and then deciding.
Thanks for caring enough to say something, I do appreciate and I will check
Dee

[willbb]

Hi Dee.. in Incivek trials ..chirrotics had somewhat better results treating for 48 weeks...regardless of when you go UND.

The actual.  dosing label  says:

Patients with chirrosis who are UND. at Wks.4 and 12   MAY   benefit from an additional 36 weeks of Peg/ Riba

The word  "may" is a little ambiguous ..however again in trials 48 did better than 24

Something to discuss possibly with your doctor....

Good luck...
Will

[Dee1956]

ok, re read everything and what my doc said was the case, I will do 24 weeks as long as I am und at 4 and 12.  Sorry
Hurricane brain :)

[Dee1956]

Hi, so glad I found this, I am so confused, I was told that as long as I was UND (or under1000) at week 4 and then UND at 12 I would do 24 weeks.  If not they would stop the tx at 12.  I have cirrhosis, guess I am going to go back to the docs to find out what the heck is going on.  Oh, I responded to first tx was und by week 6 - 8 and relapsed 6 weeks after stopping the drugs so I am a relapser
Thanks again,
D

[willbb]

cando...thats exactly what I was thinking. Well I sure hope they know what they are doing.. cause as  we know it is a little different than SOC...with resistance issues  still looming.. well .. you understand ......



  

[can-do-man]

I'm starting to think alot of these doctors are not doing their homework, wasn't involved with the trials and just going with the hype....... Sense its telaprevir then it means a shorter tx of only 24 weeks.

[GINGERPAL]

I am following these posts carefully, and once again learning a lot from everyone.  I have a call into my doctor to hopefully get an answer on my classification and my options for  lenght of treatment. Thanks all.....GingerP

[willbb]

my Doc said no one will treat for 48 weeks unless chirrotic
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Hopefully you will be UND. at week 4 and then yes a 24 week regime would be what  you would do...however I find the above statement odd given the drug companies labeling says that if not Und at week 4 and 12 then the recommended treatment is for 48 weeks..

It seems like all the treating doctors are all saying the same thing....everyone will just do 24...I sure hope so...I just wonder why with only 8 weeks in to this new drug.. the docs  seem to be throwing the recommendations of the drug company  to the wind?

Maybe I am missing something..?  wouldn't be the first time  :)

Will

[SunShineGirlie]

I am treating with Incevik, if undetected at weeks 4 8 and 12 the total treatment time for me will be 24 weeks. If I am not clear at week 12 they stop treatment, and I agree no sense staying on these toxins if it is not working - my Doc said no one will treat for 48 weeks unless chirrotic

[hrsepwrguy]

Thanks again lynda, I would like to blame that on the fog but I would be lying.

[lynda607]

If treating with Incivek and the patient is under 1000 IU/mL at wk 4 and UND at wk 12 it is advised they do the full 48 weeks.  They must be UND at wk 4 AND 12 to qualify for the 24 week treatment duration.

[can-do-man]

hrsepwrguy is spot on............. As a ciirhotic myself that treated with bocep and now svr my doctor wanted nothing less then 48 weeks........... You will do fine.

[willbb]

GINGREPAL

Not sure how I would be classified.  Partial Responder?   Or would I be considered a prior relapser
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If I was re-treating with your prior result ... altho you responded well   however with  still having VL at week12  and stopping early(proir to wk24) ..... for re-treating purposes I might consider myself a partial rather than a relapser. and think seriously about doing 48..also given the TT allele.
  just my thoughts... An experienced doctor hopefully helps with the right call  there

Will

[hrsepwrguy]

All cirrotics should treat for 48 wks regardless of beind UND at wks 4 and 12, and yes you are being treated just like a non responder. That would be the proper protocol that they decided in the trials. Hope that helps you feel a little better about it.

Keith

[crossroadsec]

Pardon my lack on knowledge of the lingo. Maybe they said they would treat me as relapser? I know when I attended the classes, I paid close attention to the tx naive info and ignored the other. Then I found out they would not consider my ESLD as tx naive. I haven't checked into it... but assume they know what they're doing. hmm. Now you've got me thinking. haha. If that's what you can call this brain fog.. Karen (:O

[can-do-man]

The old rule of thumb was, at least a two log drop by week 12, and und by week 24..... Your numbers show you were both........... Wishing you the best

[can-do-man]

This is just my thoughts, looks like you were und when you ended tx, so i would say you are a relapser..........

[can-do-man]

Null Responder: A null responder is someone who achieves little or no decrease in hepatitis C viral load during HCV treatment. Null responders are highly unlikely to respond to re-treatment with an interferon-based regimen.

Non-responder: Often referred to as a "treatment failure," a non-responder is someone who does not have an EVR or, if they stay on treatment for 24 weeks, does not ever have a 2-log (99%) drop in hepatitis C viral load or undetectable HCV RNA during hepatitis C treatment.

Partial Responder: A partial responder is someone who experiences at least a 2-log decrease in hepatitis C viral load during HCV treatment. Partial responders are more likely to respond to re-treatment than non-responders or null responders.

Relapser: The term relapser refers to someone who has had an EVR or ETR, but whose virus rebounded after they completed HCV treatment. People who had a relapse after completing HCV treatment are more likely to achieve SVR after re-treatment than partial responders, non-responders, or null responders.

[crossroadsec]

I'm tx naive, but was told I was going the full 48 even if I'm UND at week 4, which I was. My hospital team treats g4/s4 like a previous null responder. I was upset at first, but I'm going for it! Sounds like you've had steady decrease... Itsa good thang.. Karen:)

[hrsepwrguy]

can do is right on he also covered partial and non responders

[GINGERPAL]

I am GT 1 and treated in 2008 with Pegasys 180 mcg weekly and Ribavirin 1000 mg daily.  
2008 Pre tx VL =   2.8 million IU/ml  
2008 tx Viral Load tests done using HCV QuantaSure Plus (Non Graph) Hepatitis C Quantitation
2 wk VL =  136,000 IU/ml  
4 wk VL =    10,900 IU/ml  
8 wk VL =        270 IU/ml    
12 wk VL =        20 IU/ml    
16 wk VL =       < 10 IU   (less than 10 IU/ml indicates either complete absence of HCV RNA or in rate cases, low copy of number below the detectable limit of the assay).
Stopped tx.

Not sure how I would be classified.  Partial Responder?   Or would I be considered a prior relapser assuming I would have treated for 48 weeks,  and  that after completing treatment the virus would have come back because my chances of svr were low.  
BTW my current VL is 1.79 million and I am TT.
thanks....ginger p.

[joemc34606]

Hrsepwrguy nailed it on the head I'm doin 24 weeks.

[hrsepwrguy]

It is response guided, length of treatment will depend on your VL load at 4 and 12 weeks, if your VL is above 1000 at weeks 4 or 12 you will be stopped, if you are below 1000 at wk 4 and und at week 12 you will do 12 more weeks on peg/riba total 24 wks, if you are det but under 1000 at wk 4 and at wk 12 you will do 36 more wks on peg/riba total 48 wks. If you are not und at wk 24 you will be stopped. I hope that makes sense my brain is still foggy from yesterday.

Keith