JMJM530

I was hoping you might be able to answer a question for me in regards to genotype's 3a relapsing....saw this comment in an earlier thread and guess I should have saved the question for a different post. Are 3A's at a higher risk of relapsing? any particular reason? I was und at week4 on shot 17 of 24 and not sure if I can manage 6 more weeks but will probably persevere.....thanks for your words of wisdom on this....I always look forward to your posts.

[jmjm530]

My understanding is that both genotypes (2 and 3) are candidates for the shorter course if you're UND by week 4, esp if you're on weight based ribavirin. That said, I'm not as up on geno 2 and 3's as some others here, and I believe Zazza (or maybe Drofi) posted some more detailed stuff on the differences between the genotypes.

-- Jim

[zazza]

This is what you want to look at if you are a geno 3:

Are you on weight based dosing?
Were you UND by week 4?

What was your baseline viral load? High or low?
How much liver damage do you have?

If you are on weight based dosing, UND by week 4, and do not have cirrhosis, 24 weeks means looking at a 90% SVR rate. If you decide to do the short course of 16 weeks, the SVR rate is somewhat lower. I would go for the full 24 if I were you, unless you are having some very difficult adverse side effects. Good luck, Zazza

[Sunny37]

Thanks to both of you for getting back to me......My viral load was 242 000 in the beginning.....und at week 4....on weight based riba.....I had stage 1 liverdamage.....but I also have crohns disease and its taking its toll....will try nd manage if Ican .....but thanks to both of you for your response.

[CockSparrow]

I am a G3a Non Responder. The G3 stats below come from the Accelerate study.

The Accelerate trial noninferiority margin was 6%
The European Short course studies produced higher SVR rates but they used Weight Based Ribavirin.

Overall G3s have a lower SVR rate than G2s.

24 week No=369
16 week No=358

Response………………..: 24 Weeks 16 weeks
RVR rate…………………: 59%..........64%
Week 12 VR…………….: 85%..........87%
EOT VR………………….: 80%..........89%

ITT SVR………………….: 66%..........62%
Per Protocol SVR……….: 71%.........65%

Viral Load
LVL  800,000 IU/ml……: 59%........52%

F3/F4……………………..: 49%........43%
F0-F2……………………..: 70%........67%

Steatosis………………….: 55%.......53%
No Steatosis……………...: 71%.......65%

RVR ...…………………….: 85%.......80%
No RVR ...………………...: 39%......29%

Accelerate had an average Body weight of 79 kgs (174) lbs for G3s.
The difference between the EOT Viral Response was due to the higher drop out rate with 24 weeks

As can be seen the difference between 24 and 16 weeks for G3s didn’t reach the statistical significance level of 6% for most subgroups. For those with LVL or RVR 16 weeks appears long enough. The rest of us need to look at longer duration.

CS

[FlGuy]

A couple of things.  Although g2 and g3 are often lumped together, g3 is a little tougher animal.  Regardless of geno type there a few things to consider about individuals that may include level of liver condition, age, weight and other health conditions and then on-tx response factors.  Being und at 4 and not so many more to go, you have reason to be optimistic.  Good luck.

[CockSparrow]

The Viral Load Stats didnt post so here they are

LVL 400,001K IU/ml…….: 81%........81%
VL   401K–800K IU/ml….: 70%........64%
HVL 800,000 IU/ml ……..: 59%........52%

CS

[CockSparrow]

If your VL was only 242 000 and UND at week 4 you stand a good chance of getting away with 16 weeks.
CS

[zazza]

Just saw that it was my comment on another thread that scared you a bit.

"Go get that SVR for all the relapsed geno 3's to celebrate!"

FlGuy has just completed his second treatment, this time for 46 weeks with weight based dosing of ribavirin. First time was 24 weeks with fixed dosing (800 mg) of ribavirin. I personally know a geno 3 relapser planning to retreat, so of course I am very eager to see FlGuy show the way by attaining SVR.

Although 80% of geno 3's attain SVR with 24 weeks tx, there is 20% left who don't. So for these people an SVR for FlGuy with extended treatment would be a light of hope.