Geno 3a NOT RVR

Dear Dr. Dieterich,

First I would like to thank you for taking the time to advise us so well on this forum. It is always a joy to read your replies. You were so kind to answer my questions about treatment for geno 3 a few months ago and I have now been treating for 5 weeks and run into a problem.

I received my 4 week PCR result and to my great disappointment, the result was still detected with a sensitivity test of <80 IU/ml.

45 yrs old, female, half African American half Swedish
56 kg, 800mg Rebetol - 180mcg Pegasys
could not have biopsy due to slow coagulation factor,
but no cirrhosis or other irregularities of any organs where seen on two ultrasound scans, even though it looks like I probably  have had it for ca 25 years

Baseline VL  1.3 million
4weeks <80 detected

I live in Copenhagen Denmark and am being treated at Denmark's main hospital by Dr. Mette Kjær and Dr. Mette Rye Clausen at the Rigshospitalet.

[Marcia2202]

After reading the ACCELERATE study, I understand that my shot at SVR with 24 weeks of treatment might just have dropped from 90% to 49%, or somewhere in between, due to not reaching RVR4.

A few months ago you advised that one should add 24 weeks of treatment to the time of EVR. I will have my next PCR at 8 weeks and was discussing with my Doctor to extend to 32 months, if EVR8. (which seems very likely, as I am almost UND)

Here they usually do not extend tx, but she is open to the fact to prolong, due to me being partially Afro American and also being concerned because of that.  She just does not have any studies to back up my suggestion and is looking to find something. I have two questions:

1. How would you suggest we proceed,according to the facts I presented. On a note, they will not do another PCR before week 8, so I will not know when I cleared between 4 and 8.

2. Do you have any written papers you could direct me to, to back up the theory of prolonging 24 weeks after EVR. Any reports written by yourself or your university or hospital.

Thank you very much in advance


Kind regards,

Marcia Coleman Diallo

[Marcia2202]

I just wanted to add that I just received the results of my 8 week PCR and that it showed NEGATIVE.

[Marcia2202]

My hepatologist has just been to The Liver Meeting and was going to get some info on extending genotype 3 and on treatment of African American patients, as I am half African American. I will have a meeting with her Tuesday 18th and would be so thankful, if I had some input from you to bring to her.

Kind regards, Marcia

[Marcia2202]

Dr. Dieterich,

I just wanted to let you know that my hepatologist has decided to treat me for 32 weeks. EVR8 + 24 weeks.

Kind regards,

Marcia