Aa
UND week 16
Just got my internet connection fixed it has been in and out for about a month. I just wanted to post my latest results. I made just made the 2 log drop at 12 weeks with a 4,375 V.L. went to checking V.L. every 2 weeks using Heptimax and just got the 16 week test back today UND <5 I take shot # 19 weds. Just a Few short weeks ago (week11) I was unsure if I could keep going. Today finds me looking at the next 29 weeks like a cake walk. Thanks to all of you for being here when I did not want to go on.
Hack
Hack
good for you. Take the Berg study with you or ask if he know about it. Any GI or Hepatologist worth his salt should know that study. If he doesn't want to talk about extending get another opinion. I am in a very restrictive HMO and there just aren't that many Hep patiets where I live. I had to complain to get seem by someone in the city that knows this stuff. At first I paid myself, then the ins. co picked it up and sent me to a comprable dr to tx me. We have to fight for ourselves, no one else will.
Best of luck on your visit and let us know. If you need any tips on how to move ins. co to your way of thinking let me know. Hopefully though you have a good dr already.
Linda
Best of luck on your visit and let us know. If you need any tips on how to move ins. co to your way of thinking let me know. Hopefully though you have a good dr already.
Linda
I am taking this info to my dr.next week. Thanks to all of you. You guys remember the lady that calls herself a "TX Nazi" Well she has company. LOL I really do mean Thanks. There is so much good info from ya'll.
Hack
Hack
I relapsed when I couldn't complete my extended tx due to illness beyond my control. I had to stop at 47 weeks and was planning on the whole 72 weeks as per that Berg study. Wasn't to be, but if you can do it, do it! I agree with the extenders!
Did you get anemia on tx? I dropped 3 pts in a few weeks and just felt awful. Got the rescue drug to keep my red count up and I kept going. So many here that have not taken enough Riba seem to not become UND. When and if I re tx, I will use all the knowledge here about drugs, doses etc to take to my dr. He knows what's up, so he will tell me.
Please do check out going 72 weeks, you don't want to do this tx again!
Linda
Did you get anemia on tx? I dropped 3 pts in a few weeks and just felt awful. Got the rescue drug to keep my red count up and I kept going. So many here that have not taken enough Riba seem to not become UND. When and if I re tx, I will use all the knowledge here about drugs, doses etc to take to my dr. He knows what's up, so he will tell me.
Please do check out going 72 weeks, you don't want to do this tx again!
Linda
I am not sure there are studies for increasing dosage of interferon where you are now (past week 12), but there have been studies about starting with higher doses up front. If you have not read any of the Clinical Care Option Modules, I highly recommend them. It is free to register. The modules are designed for continuing education credit for medical professionals and are very good. This one is one induction therapy.
http://clinicaloptions.com/Hepatitis/Conference%20Coverage/Boston%202007/Tracks/Approved%20HCV/Capsules/54.aspx
Another option is increasing ribavirin. One member here - fishdoc - did not get her 2-log drop at week 12. She also never had a significant drop in hemoglobin (and indicator that she was ribavirin resistent). She increased ribavirin substantially and cleared -- one of the few I know who cleared with viral load in the 1000s at week 12. She googled and found a specialist to consult with. Perhaps you could do tht too. Are helper drugs an option for you - that is Neupogen for drops in absolute neutrophils and procrit for drops in hemoglobin (at 11 where you are now, you don't want it to go too much lower)? It there drugs are available, upping doses is a possibility.
As for how extended treatment is -- I only extended 8 weeks but I will say that tx becomes a lifestyle and you just get through it. It doesn't become much worse with time, it is just wears you down over time. I still wish I did the 72. Prolem for me was my doctor thought I had it made in the shade. I had to really work on him to allow me to extend and I had to convince myself every Friday in overtime that the shot was merited. So, maybe my conviction was not as strong as it could have been.
frijole
http://clinicaloptions.com/Hepatitis/Conference%20Coverage/Boston%202007/Tracks/Approved%20HCV/Capsules/54.aspx
Another option is increasing ribavirin. One member here - fishdoc - did not get her 2-log drop at week 12. She also never had a significant drop in hemoglobin (and indicator that she was ribavirin resistent). She increased ribavirin substantially and cleared -- one of the few I know who cleared with viral load in the 1000s at week 12. She googled and found a specialist to consult with. Perhaps you could do tht too. Are helper drugs an option for you - that is Neupogen for drops in absolute neutrophils and procrit for drops in hemoglobin (at 11 where you are now, you don't want it to go too much lower)? It there drugs are available, upping doses is a possibility.
As for how extended treatment is -- I only extended 8 weeks but I will say that tx becomes a lifestyle and you just get through it. It doesn't become much worse with time, it is just wears you down over time. I still wish I did the 72. Prolem for me was my doctor thought I had it made in the shade. I had to really work on him to allow me to extend and I had to convince myself every Friday in overtime that the shot was merited. So, maybe my conviction was not as strong as it could have been.
frijole
Congratulations! You get to keep torturing yourself (a little black humor :)
I did not clear at 12 weeks, but had a 2-Log drop. My next (successful) test was at about 26 weeks and I was UND. Based on not clearing at 12 weeks, the studies show that the odds of SVR nearly double (19% - 29% in the study I read) if you extend from 48 week TX to the 72 week treatment.
Without a 2-Log drop at 12 weeks or without UND at 24 weeks, there is virtually no chance of SVR. Their seems to be more and more emphasis on the early indications (4 weeks and 8 weeks) as predictors.
So, I am planning on extending for the 72 weeks. By the time I get to 48 weeks I will have a lot of my life invested in TX, so another 24 weeks to almost double the odds seems like a wise chaice to me. I definitely would rather extend than do the whole thing over again.
I did not clear at 12 weeks, but had a 2-Log drop. My next (successful) test was at about 26 weeks and I was UND. Based on not clearing at 12 weeks, the studies show that the odds of SVR nearly double (19% - 29% in the study I read) if you extend from 48 week TX to the 72 week treatment.
Without a 2-Log drop at 12 weeks or without UND at 24 weeks, there is virtually no chance of SVR. Their seems to be more and more emphasis on the early indications (4 weeks and 8 weeks) as predictors.
So, I am planning on extending for the 72 weeks. By the time I get to 48 weeks I will have a lot of my life invested in TX, so another 24 weeks to almost double the odds seems like a wise chaice to me. I definitely would rather extend than do the whole thing over again.
................I suppose Deb and I come on like the gloom and doom tag team with everyone else cheerign about your UND..............................
No you don't! I thought the same but don't have the exp. in Geno 1, extended tx to advise and you have the knowledge, studies and been there/done that so it IS advice that needs said, you need to pass on. Not doom and gloom, advice to consider!
LL
No you don't! I thought the same but don't have the exp. in Geno 1, extended tx to advise and you have the knowledge, studies and been there/done that so it IS advice that needs said, you need to pass on. Not doom and gloom, advice to consider!
LL
O.K. 1st question to nygril. I know you had a ruff time was it all the way through or did it get worse? I am not saying that worse would tilt me either way I am in this for a cure now not later. The last thing I would want would be to finish at 48 and start feeling better and find out at 3 months post that I will have to start over with less of a chance. My Dr. will listen so it is up to me. When did your hgb drop below 10 I am holding mid 11;s now.
frijole, are there any studies on increasing dose at this point?
frijole, are there any studies on increasing dose at this point?
I just wanted to tell you congrats on your UND. I wish you well throughout the rest of your treatment.
Trish
Trish
I suppose Deb and I come on like the gloom and doom tag team with everyone else cheerign about your UND, but really, we are very concerned about anyone who does not clear at week 12. I think the 2-log drop data is outdated except for predicting failure if you don't get it. More and more the studies indicate 72 weeks for anyone not clearing at 12.. I have read something along the way about the life of the hepatcyte (liver cell) being 52 weeks and one reason why 72 weeks may have been chosen was so the interferon would be in the system long enough for every cell that could have detectible virus to die.
So nygirl is the positive side of doing 72 and I am the negative side of not. Right. Deb?
bean
So nygirl is the positive side of doing 72 and I am the negative side of not. Right. Deb?
bean
I did not clear until about the same time as you and took a long hard look at the data from Berg and Sanchez Tapias studies and realized that extending was really the way to go. Not hitting the 2 log drop till week 12 and not clearing until AFTER week 12 puts you in the prime group to extend to 72 - especially if you are finding it to be a cakewalk.
I chose to extend because they do tell us that the first treatment time is the most effective and I did not want to have to do it all over again later.
I would advise that you do read the information that Frijole provided and consider it. It's not much fun but...my chances of achieving SVR were very low because I did not clear until after 12 yet one year later here I am still clear and SVR.
Good luck.
I chose to extend because they do tell us that the first treatment time is the most effective and I did not want to have to do it all over again later.
I would advise that you do read the information that Frijole provided and consider it. It's not much fun but...my chances of achieving SVR were very low because I did not clear until after 12 yet one year later here I am still clear and SVR.
Good luck.
Congrats on the UND but i think you seriously need to consider extending. Please read my response to hassan down a couple of threads.
http://www.medhelp.org/posts/show/409984
48 weeks just may not be the answer for you but the good thing is that the Berg study .
THis is not the Berg study but a presentation at the AASLD conference in Boston in 06 and it is a good read ...
http://www.natap.org/2006/AASLD/AASLD_34.htm
In contrast, in a subgroup of patients who had an EVR but who had incomplete viral suppression (HCV RNA 350 IU/mL) at week 12, a longer treatment duration of 72 weeks was significantly (p<0.001) beneficial compared with the standard 48-week treatment duration (SVR rates of 37% vs 77%, respectively). These data are consistent with the recently published data by Berg et al,[9] indicating that patients with HCV RNA 350 IU/mL at week 12 benefited from a 24-week treatment extension. In the Berg study, SVR rates of 29% were achieved with 72 weeks of therapy with peginterferon alfa-2a plus ribavirin, compared with 17% achieved with 48 weeks of therapy (p=0.040), in patients who were HCV RNA positive at week 12. It should be noted that the findings of Berg et al. are for the intent-to-treat patient population, while our results refer only to those patients in the per-protocol population with an end-of-treatment response. Patients who do not achieve an EVR are unlikely to respond even with 72 weeks of treatment, which confirms the established EVR-based guidelines
frijole
http://www.medhelp.org/posts/show/409984
48 weeks just may not be the answer for you but the good thing is that the Berg study .
THis is not the Berg study but a presentation at the AASLD conference in Boston in 06 and it is a good read ...
http://www.natap.org/2006/AASLD/AASLD_34.htm
In contrast, in a subgroup of patients who had an EVR but who had incomplete viral suppression (HCV RNA 350 IU/mL) at week 12, a longer treatment duration of 72 weeks was significantly (p<0.001) beneficial compared with the standard 48-week treatment duration (SVR rates of 37% vs 77%, respectively). These data are consistent with the recently published data by Berg et al,[9] indicating that patients with HCV RNA 350 IU/mL at week 12 benefited from a 24-week treatment extension. In the Berg study, SVR rates of 29% were achieved with 72 weeks of therapy with peginterferon alfa-2a plus ribavirin, compared with 17% achieved with 48 weeks of therapy (p=0.040), in patients who were HCV RNA positive at week 12. It should be noted that the findings of Berg et al. are for the intent-to-treat patient population, while our results refer only to those patients in the per-protocol population with an end-of-treatment response. Patients who do not achieve an EVR are unlikely to respond even with 72 weeks of treatment, which confirms the established EVR-based guidelines
frijole
Okay, one more happy dance :}
Wonderful! You got it! Yes, it's what will keep you hanging in there. I am having a harder time thru week 15-now (18) so maybe it's just a down slope and you'll feel better soon. UP the roller coaster and DOWN the roller coaster!
Glad to hear it and feel better hack.
LL
Wonderful! You got it! Yes, it's what will keep you hanging in there. I am having a harder time thru week 15-now (18) so maybe it's just a down slope and you'll feel better soon. UP the roller coaster and DOWN the roller coaster!
Glad to hear it and feel better hack.
LL
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