is it true 24 weeks could be enough?

I've been reading here for sometime, months before starting tx and it was all about doing at 48 weeks of tx

before the treatment the HCV-RNA was 36990 IU/ml and the liver functions results was showing that all of them were high, then I decided to just start the tx and I was UND after 4 weeks and the Dr. was excited more than me, all the lever functions test were going down so after 8 weeks the test shows that they were in normal range except the bilirubin which never got stabilized until now, sometimes it get up to 50 and it goes down to 38 and so on also there's a test for RETICULOCTYE COUNT 1.5 which is slightly higher than it should but the Dr. said that its ok.

Now the Dr. is saying the treatment is successful and i should just complete 24 weeks, does it sound right? safe? can I get SVR with 24 weeks of tx? what are the odds here?

[meakea]

Shehabi....congratulations on having such a great response to your treatment!

It is true that some docs are getting on board with the studies that show it is possible to reduce treatment to 24 weeks for geno 1 people who have a rapid response to treatment (undetectable by week 4) and who start with a low viral load.  Seems that you fit that pattern.  I also fit that pattern but my doc wanted me to go the distance and do 48 weeks, which I did.  I consider my doc to be a bit behind the times as far as up-to-date studies about treatment so it didn't surprise me that he wanted me to go 48.

There are other geno 1 people on this site who were able to stop treatment around 24 weeks because of being rapid responders and I hope they see your post and chime in.

Again, congratulations on your great response to treatment.  

I don't know the odds but I do know that there have been odds published and someone here might have that.

[Bill1954]

Hello Shehabi—

There are studies that support shortened treatment duration for genotype 1 patients with low viral load and RVR (rapid viral response, undetectable at four weeks).

See this link for more information:

http://www.hivandhepatitis.com/hep_c/news/2009/040309_a.html

It is my understanding that this is accepted by the European Union, but has not been adopted by the U.S. yet.

If it were me, I would definitely follow my doctor’s advice; there is no point in taking too much interferon!

Good luck,

Bill

[Bill1954]

http://www.schering-plough.com/news/news_article.aspx?reqid=764605

“KENILWORTH, N.J., Oct. 5, 2005 -- Schering-Plough Corporation (NYSE: SGP) today announced that the European Commission has approved revised dosing instructions allowing for a shorter, 24-week course of PEGINTRON® (1.5 mcg/kg once weekly) and REBETOL® (800 -- 1,200 mg daily) combination therapy among a subgroup of patients with chronic hepatitis C virus (HCV) genotype 1 infection and low viral load (< 600,000 IU/ml) who have achieved rapid virologic response, defined as undetectable virus (HCV-RNA negative) at week 4 of treatment that is maintained through week 24. The approval follows a positive opinion granted on July 28, 2005, by the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMEA).

Approval of this shorter PEGINTRON and REBETOL combination treatment regimen cuts by half the duration of therapy for a subset of hepatitis C patients with genotype 1 and low viral load. This is the only treatment regimen approved in the European Union (EU) for a 24-week course of therapy in certain genotype 1 patients. In clinical studies supporting the approval, 92 percent of patients who met the criteria for early response achieved a sustained virologic response (SVR) with 24 weeks of treatment.

"Physicians now have the opportunity to consider a shorter course of therapy for their patients with hepatitis C genotype 1 who meet specific criteria," said Professor Stefan Zeuzem, M.D., Saarland University, Homburg, Germany, and lead investigator of the study supporting the approval. "Tailoring treatment so that those with an early response are treated for only 24 weeks rather than 48 weeks may make therapy more appealing to patients, providing comparable efficacy with better tolerability," he said.”

Bill

[chevyelcam79]

I was one of thos lucky rapid responders at week 2 and only had to do 24 weeks.  I also had a low vl at 97,000.  Had HCV for approx 20 years before deciding to treat.  

I finished treatment 2 years ago and remain UND!

So, if the doc says 24, go for 24!

Best of luck!
Shari

[Shehabi]

Thank you guys for the posts

Bill thanks for the links and the information

if tx will be just 24 weeks then i have 6 weeks left, wish me luck

[becksta29]

GOOD LUCK,i hope 1 day that geno 1 will be shorter 4 every1,im a 3 a and im only doing 26 wks,the extra 2 wks cos of reduced interferon since the end of the 2nd month.

[Bill1954]

All the best of luck to you, Shehabi— let us know the outcome, if you find the time,

Bill

[newleaf09]

You had a low starting VL and I'm not surprised that your doctor was so enthusiastic at your rapid response.  He won't have to watch you suffer for so long.  I also recently read the Rebetol label Bill is referring to and if it's on the label, it must be a good recommendation.  Drug companies have to prove everything to get the FDA label language changed.  Your doctor's opinion at 24 weeks is more important than any other opinion.  Now just follow his instructions and let him manage any side effects for the remaining 5 mos.  That's great news.

Here are a few links to the studies Bill mentioned on natap for 24 wk. TX:
http://www.natap.org/2005/AASLD/aasld_55.htm
http://www.natap.org/2007/AASLD/AASLD_62.htm
http://www.natap.org/2007/HCV/021207_01.htm
http://www.natap.org/2006/HCV/042106_02.htm

[meakea]

Thus the reason EVERYONE should be getting a VL at 4 weeks.  Unfortunately, there are a lot of docs out there who still use the 12 week mark for the first VL.