whens the likely hood of relaps, after TX .

This is my 4 week post after TX. It's been just comfirmed that im still UND' at this stage, with my liver function test lower than ever before:) So its all looking good thus far.
   Question is, when is the likely hood of someone relapsing, first 12 weeks perhaps? My next test will be at 8 weeks(hence, making it 12 weeks...4/4/07) keep ya'll posted with that. Here is a lil profile of my situation before TX for those who don't have a clue..

male/38, got the virus when i was about 24
geno 1a
stage 1
vl 260 000 , before tx
was on the double dose of INF for the first 12 weeks and was on 1200mcg RIB
UND 8, 12, 24, 48wks

ps; I hope this gives some/all of u some hope that there could be a light at the end of this tunnel.  Good luck to you ALL!

[wyntre9]

Congrats hepper, on finishing TX and wishing you continued UND.

May I ask, why were you on double dose of INF for the first 12 weeks and do you think that helped your response?

[hepper38]

Hello there, Thanx for your good wishes. Assuming you also are a victim here, i also wish u luck and good health. Whats your statis, if you dont mind me asking?
   In answer to your question, it was a trial thing they had happening here.  your name would go in the computer and if you were "lucky" your name would be called out and you were on the double dose. I guess the double dose would mean double trouble for the virus... it's still a trial and i dont know whether or not its better, maybe someone can come along and answer this for me/us.

[wyntre9]

My stats are the same as yours, 1A, Stage one, but my VL was 1,140,000 and I'm a LOT older than you.

I've been on regular TX for 9 weeks, 1,000 Riba, peg 1x per week and just added neupogen, 480, 2x per month.

I've read in other posts about the double dosing and, from what I gather, patients who treat that way often get good results.

Since I'm evidently a 'slow' responder, (not UND yet) it's been suggested by some that I ask my Dr about DD, but he said no, I'm on the right TX for my weight, stage, etc.

I can't help noticing that those on clinical trials seem to get more aggressive and possibly more effective treatment.  I have another 39 weeks to find out whether I'm right about that. :)

Again, congrats on SVR and GREAT luck to you.  I know it's hard, but try not to worry too much.

[jmjm530]

Being non-detectible at 4 weeks post tx with a very sensitive test correlates around 90 per cent with SVR. A negative 12 week test correlates around 98 per cent. A slightly guarded congratulations!

-- Jim

[najeen]

There are no hard and fast rules when it comes to relapse that I know about.

That said, I would guess if the virus is coming back you will notice elevated ALT/AST liver enzymes and they will shoot very high.

I would guess if the thing is coming back it does so withing a month or so, give or take.

[Alady1620]

Congrats on being UND.  I hear the 12 week post test is the big one before the 6 month post test.

I am surprised about the double dose of INF.  I had not heard of that.  May I ask how your side effects are subsiding?  

Specifically, your vision, energy level, and memory.

Also, how much of your hair came out?

You are a real trooper for sticking out those large doses!  I hope you get SVR.

[NYCMark]

Congratulations on finishing treatment and being und at week 4 post. Let's hope you stay this way after such a difficult treatment.

I did double dose for 12 weeks too (I'm now at week 38 of ?? weeks). We did double dose because I relapsed previously, and an early viral response in reaction to this double dose seems to help some folks remain undetectable. Also possible (for me) is to extend treatment past 48 weeks).

I didn't do this in a study, but just because my doctor now thinks this is a better way for us relapsers. The trick is getting the insurance company to go along with a non-approved treatment.

Hoping all your blood tests are good ones for you!

Mark

[jmjm530]

I see "72" has magically changed to "??". LOL. Same thing happened to me around week 38 -- in fact, I started expressing it exactly the same way in my posts here. Eventually you will decide on the right treatment length in consult with your doctors. I didn't make the final decision to extend to week 54 until week 47.

Hope all is well,

-- Jim

[jmjm530]

There are a couple of excellent modules that include double-dosing on the Clinical Care Options Web site. One is "doc eye for the hep guy" with Drs Dieterich and Jensen.

Studies show that double-dosing early-on in treatment can increase the chance of SVR and it is a strategy being used by many good clinicians both in hard to treat cases as well as with those who were slow responders their first round of treatment. The idea, of course, is to get to non-detectible sooner.

I double-dosed myself after I switched doctors at week 1 and then double dosed for the next three weeks. Usually, in this protocol, they start you with a double dose and then go back to single dose once non-detecible. Because the double-dosing is short term, most do not find the side effects significantly different. I didn't either. IMO staying on interferon long term -- and I personally define that as anything longer than 24 weeks which means all us geno 1's -- does far more potential harm than a short stretch of double dosing. Just conjecture, no studies I know of on this although studies do back up that double dosing doesn't result in any more significant side effects or drop outs.

-- Jim

[nygirl7]

Said "I've read in other posts about the double dosing and, from what I gather, patients who treat that way often get good results."

Wyntre - just taking normal dose IFN caused me SEVERE problems - destroyed my thyroid and caused a lot of autoimmune problems which are NOT uncommon.

While double dosing and taking higher riba SOUNDS good and logical in effect it can RUIN your chances of SVR because you are so affected it can cause you to have to QUIT.

I can't remember seeing any results from your PCRs but honestly - be careful with the idea of Double Dosing. I would not do it unless perhaps I had done treatment and had a relapse - and even then I'd probably try the infergen first.

Knowing how damaging the IFN can be now...gads. I just hope that after 72 weeks of the **** I am able to detox to a point where my problems do finally go away.

There is no guarantee that I will ever have thyroid function again for example. That's a pretty big deal to me.

[wyntre9]

I just saw this post.  Sorry.

Thanks very much for the info.

Next time I see the Dr., if my VL hasn't gone down at least 2log, I'm gonna bring up the option of double dosing.

They do that now with allergy immunotherapy, bringing patients up to maintenance dose in a week instead of a year.