Geno 1's with low pre-tx viral loads (<600,000 IU/ml) who test non-detectible by sensitive assay at 4-weeks, may be candidates for a shorter course, 24-week treatment. My personal opinion is that this makes the most sense for those without significant liver damage. In fact, if I had little or no liver damage, and wanted to try treatment, I'd quit if still detectible at 4 weeks rather than subject my body to 48-weeks of the treatment drugs with no guarantee of success. Probably not a mainstream view but that's how I see it.
Be careful what your looking for, you may find it. I say this because I have 1a, and went in with a very low vl, and the virus was undetectable after my first check which was 8 weeks. It may have been undetectible at 4 weeks, don't know. The point here is, I started to think "Do I really need to continue this for a whole fricken year". I searched and searched and found a study that seemed legitimate for 1a patients that said success rates were high to quit early if starting with low VL and quick non detections. Against the advice of my doctor, I went with the study and quit after 6 months. Well.... its back and I am kicking myself for not, as our fearless leader says, staying the course. Stick with it!! I wish I did.
Although data can support doing a shorter course of treatment for those with a LOW viral load - there are PLENTY of us who started with a Low VL who had a hell of a time killing them all. Sometimes - it TRULY seems to be a DISADVANTAGE - regardless of what the study might say.
I would NEVER advise a geno1 person to do LESS than 48 weeks and anyone who is not UND with a very sensitive test to do the 72 that is advised.
If you are going to treat you might as well take it seriously and make sure you don't have to do it ever again.
With already such a high relapse rate of 50% it is not worth it. At least to me.
My brother in law thought the same way and stopped after 8 months. Needless to say he is now looking at treating for 72 weeks. He is kicking his own butt he didn't just finish the 48.
Well, seems that there are very different opinions out there. Not that anyones opinion is wrong, just wanted to see what you guys thought. I guess it is truly something that my doc and I need to discuss. Not sure what her thoughts are on this. I do know that when I treat, I only want to do this once but then again if it is nondetectable after some time, I don't want to put myself through it for 48 weeks either.
Will just have to see what the doc says and how I respond! Thanks for all comments!
The important thing about this is, in order to even consider it, you have to have an UD by 4 weeks, preferably sooner. That's the key. Ask your nurse but I'd love to hear your doctor's point of view on this. Just from commments made, and my general perception, I think your doctor is very enthusiastic about this for the right candidate.
I'm committted to the study for 48 weeks, so naturally he can't encourage me to do this and we've had several discussions about it and about studies related to it, but listen carefully and report back because I'm very curious about his real thoughts on this.
As I did abov3, I always try and specify which are my opinions, as opposed to study data, although I didn't use the word "study" in this particular thread. Yes, studies do suggest the shorter course as an option for selected geno 1's, as mentioned. I'll post the actual study a little later in Chevy's more recent thread above this. The part about "stopping treatment at week 4" for selected non-responders is my opinion, again as stated.
Jim, is your repsonse on this subject based on some studies or the history of 1a's or is this more of an opinon. I am curious about this because I must admit, I always look for your response for these postings. You seem to be on it, but I have had a hard time finding any proof that quiting early, even with the low VL and the early non-detectible's. Especially not the 24 week.
Forget opinions as everyone knows what they say about them!
I recommend sticking with the facts as they have been tried and proven by medical studies. Furthermore as Beat1a has pointed out,if I see 5 studies which say A and one which says B, I'll go with the 5.
Another thing I recommend considering when looking at studies is the sample size. Best rule of thumb there is the larger the better.
From there one can increase the focus to look at the rules followed, etc. to see which one is more scientific sound.
I think Beta1A makes another good observation that seems to be a common problem found with most infections in that if you only take meds until you feel better or tests look better then stop, one generally does not completely knock the bug down. Often times it seems that it will return more virulent than when you started.
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