Re: phase 1a

Posted By HFHSM.D.-D.M. on April 16, 1999 at 14:44:04

Topic Area: Hepatitis C
My husband has been told that his HepC is catorgorized as Phase
1A and his doctor has suggested that Rebetron Combination
Therapy might help, although the Dr. wasn't very optomistic
about the prognosis. We have heard terrible things about this
treatment and need to feel that it is a viable avenue. While we
are willing to do what is needed, we aren't sure.  Please shed
some light on this for us.  Your sight has been very helpful.  
Thank you.




Dear Mary:
I am not certain what you mean by Phase 1A.  At the risk of offending my MedHelp participants I try to get them to be precise as possible and to type from actual lab reports when possible.  Subtle differences in notations to patients can be critical to us physicians.  
I think but am not sure that the term Phase 1A refers to genotype 1A.  It might also refer to the biopsy results if your husband had a biopsy.  You might want to pin this down.  However, I will go ahead and talk about genotype 1A.  
Hepatitis C comes in different flavors or strains and we call these genotypes.  There are five major genotypes of hepatitis C.   Only genotypes 1, 2 and 3 are seen with much frequency in the US and the majority of Americans have genotype 1. Genotype 1 is further divided into genotype 1A and genotype 1B.  Genotype 1 tends to respond less well to therapy than the other genotypes but that does not mean that patients with genotype 1 do not respond at all.  Recently, a very large multi-center trial was completed using interferon and ribavirin in patients with hepatitis C.  The overall sustained response (cure) rate was 38% and patients with genotype 1 had a sustained response rate of 28%.  While I would prefer the response rate be 100%, this result is not trivial.  We typically do treat patients with genotype 1 at Henry Ford.  In fact, so many Americans have genotype 1, I usually do not even check the genotype.  
Rebetron does have significant side effects and they include fatigue, muscle aches, flu-like symptoms, depression, headaches, anemia, loss of appetite.   However, symptoms are worse early on and then improve.  Most of my patients tolerate it reasonably well and most are able to continue work.  In addition, the medications are surprisingly safe despite the side effects.  A decision to treat hepatitis C is rarely simple and involves a meaningful discussion between the patient and an experienced physician.  However, simply having genotype 1A is not a reason for pessimism.  
I hope this information is helpful to you. If you have additional questions or concerns, I invite you to get back to me through MedHelp or contact us at Henry Ford.  Our direct phone number is  [phone]. We have an active group of liver specialists and we have strong interest in the care and research of hepatitis C.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation.  Always check with your personal physician when you have a question pertaining to your health.  












Follow Ups: