Aa
Interferon tx for HBV vs. genotype
As a reminder, I have both Hep C & B. I was planning on tx Hep C for 24 weeks and then managing the HBV with an antiviral after that.
Dr. now thinks I should continue on Interferon tx for 48 weeks total (an additional 24 weeks) for HBV because I had such a great initial response to it (UND at 4 weeks) and because of my HBV genotype being “type A”
They said I had a 40% chance of getting rid of HBV with all things considered in my case with IFN. I don’t know where they got this figure from, but if anyone has any insight I would appreciate it.
I know that genotype A can be the easiest to tx, but my main concerns were autoimmune problems developing from the IFN and the way the drug makes me feel. They said that at 24 weeks when I am able to stop taking the Ribavirin for Hep C that my symptoms would improve because the symptoms are more related to the Ribavirin than the IFN.
I could handle an additional 24 weeks of IFN if I truly have a 40% chance of clearing HBV and the symptoms subside after stopping the Riba. I’m just having a hard time figuring out if it is worth it and where they got this figure from. I’m also ready to start feeling better and want my old self back.
Anyone ever heard of a HBV genotype A clearing from IFN mono therapy? Especially when VL was UND after only 4 weeks of tx? Would my chances really go up with 48 weeks of IFN tx versus only 24?
Thoughts anyone?
Anyone currently on or have taken IFN mono therapy? How does the IFN alone make you feel? What was/is your genotype and result?
Dr. now thinks I should continue on Interferon tx for 48 weeks total (an additional 24 weeks) for HBV because I had such a great initial response to it (UND at 4 weeks) and because of my HBV genotype being “type A”
They said I had a 40% chance of getting rid of HBV with all things considered in my case with IFN. I don’t know where they got this figure from, but if anyone has any insight I would appreciate it.
I know that genotype A can be the easiest to tx, but my main concerns were autoimmune problems developing from the IFN and the way the drug makes me feel. They said that at 24 weeks when I am able to stop taking the Ribavirin for Hep C that my symptoms would improve because the symptoms are more related to the Ribavirin than the IFN.
I could handle an additional 24 weeks of IFN if I truly have a 40% chance of clearing HBV and the symptoms subside after stopping the Riba. I’m just having a hard time figuring out if it is worth it and where they got this figure from. I’m also ready to start feeling better and want my old self back.
Anyone ever heard of a HBV genotype A clearing from IFN mono therapy? Especially when VL was UND after only 4 weeks of tx? Would my chances really go up with 48 weeks of IFN tx versus only 24?
Thoughts anyone?
Anyone currently on or have taken IFN mono therapy? How does the IFN alone make you feel? What was/is your genotype and result?
Cajim….first of all, thank you for all the research articles you have posted. You’re a great asset to the forum.
I don’t think I have found the one you have referenced but I have found many informative articles about IFN tx for HBV and have learned a lot. Many point to IFN being first line therapy for certain genotypes.
Here is just a sample of some of the articles in the URT relating to HBV and IFN for anyone interested, and also for my future reference:
Jun 12, 2008 06:07PM
Jun 14, 2008 01:32PM
Jun 14, 2008 01:46PM
Jun 22, 2008 04:41PM
Jul 06, 2008 10:09AM
I don’t think I have found the one you have referenced but I have found many informative articles about IFN tx for HBV and have learned a lot. Many point to IFN being first line therapy for certain genotypes.
Here is just a sample of some of the articles in the URT relating to HBV and IFN for anyone interested, and also for my future reference:
Jun 12, 2008 06:07PM
Jun 14, 2008 01:32PM
Jun 14, 2008 01:46PM
Jun 22, 2008 04:41PM
Jul 06, 2008 10:09AM
>>>Know if I could only find a study of the effect of PEG IFN on HBV genotype “A” that were UND at 4 weeks….. then I would be set.
Somewhere here: http://www.medhelp.org/posts/show/492008, it was stated that speedy VL suppresion within 24 weeks is the optimal treatment result. Yours was 4 weeks, even better than optimal. Somewhere there too it was stated that genotypes A and B respond better to IFN than C and D.
Hopefully you have time to leaf through the studies and find them.
Best.
Somewhere here: http://www.medhelp.org/posts/show/492008, it was stated that speedy VL suppresion within 24 weeks is the optimal treatment result. Yours was 4 weeks, even better than optimal. Somewhere there too it was stated that genotypes A and B respond better to IFN than C and D.
Hopefully you have time to leaf through the studies and find them.
Best.
Here are some results from section 991 of the following article:
http://www.hbvadvocate.org/news/reports/HBV_AASLD_2007/Abstracts/interferon.htm
It says:
The cumulative incidence of HBsAg seroconversion was significantly higher in patients who developed SVR compared with those who failed interferon treatment during the whole follow-up period (40% vs. 8% at year 5, and 60% vs. 18% at year 10 and 80% vs. 30% at year 15).
So it looks like the key is for me to first obtain the SVR of which I have anywhere from a 4 to 11% chance with PEG IFN and THEN I have a 40% chance of HBsAg seroconversion after 5 years or 60% after 10 years. Does this sound right?
Still this isn’t specific to my particular case.
http://www.hbvadvocate.org/news/reports/HBV_AASLD_2007/Abstracts/interferon.htm
It says:
The cumulative incidence of HBsAg seroconversion was significantly higher in patients who developed SVR compared with those who failed interferon treatment during the whole follow-up period (40% vs. 8% at year 5, and 60% vs. 18% at year 10 and 80% vs. 30% at year 15).
So it looks like the key is for me to first obtain the SVR of which I have anywhere from a 4 to 11% chance with PEG IFN and THEN I have a 40% chance of HBsAg seroconversion after 5 years or 60% after 10 years. Does this sound right?
Still this isn’t specific to my particular case.
Meki,
Just to clarify, I am on Pegasys/Riba at the moment for HCV GT2. No Alinia.
They tell me I have as much as a 40% chance of clearing HBV but I think a lot of stars have to align in order for this to happen. Of course I do have some things working in my favor i.e. HBV GT “A” and HBV DNA and HCV RNA both being UND at 4 weeks into tx.
Yes this figure can be considered comparable to HCV GT1 but as Zellyf had mentioned, I don’t think clearance immediately happens when tx stops. My chances go up with each passing year and I think; only if I remain HBV DNA UND after stopping tx. So many more factors come into play to achieve this 40% figure than would have to happen for someone with HCV GT1.
This is part of my dilemma….when you consider that my chance will go up with each year, is the additional 24 weeks of PEG IFN really going to make a difference? Maybe the additional 24 weeks of Pegasys will help me to stay UND and thus give me a better chance. I just don’t know at this point. I have not really found any studies to support or contradict this.
Once I’m done with HCV tx, then HBV tx will be mono therapy of Pegasys. I don’t know of any studies on the effects of Ribavirin on HBV and don’t believe Riba plays any role as far as HBV goes. Also studies I’ve seen with PEG IFN coupled with an HBV antiviral don’t seem to make any difference either.
Know if I could only find a study of the effect of PEG IFN on HBV genotype “A” that were UND at 4 weeks….. then I would be set. I think the problem is that there are not enough genotype A’s as compared to the other genotypes so studies usually include all GT’s lumped together and most people don’t go UND so quickly, if at all. Even when reading studies of PEG IFN tx for HBV, they usually don’t take into account an HCV/HBV co-infection. So in a way, I’m am kind of my own study with my own unique situation.
It’s crazy and keeps getting crazier. Lucky for me, my sx on tx have improved a lot over the last month or so. I contribute a lot of it to a new way of positive thinking and not dwelling on the negatives of Hepatitis like I did in the beginning and that has helped tremendously. I learn what I NEED to know and try to block out the negatives.
Just to clarify, I am on Pegasys/Riba at the moment for HCV GT2. No Alinia.
They tell me I have as much as a 40% chance of clearing HBV but I think a lot of stars have to align in order for this to happen. Of course I do have some things working in my favor i.e. HBV GT “A” and HBV DNA and HCV RNA both being UND at 4 weeks into tx.
Yes this figure can be considered comparable to HCV GT1 but as Zellyf had mentioned, I don’t think clearance immediately happens when tx stops. My chances go up with each passing year and I think; only if I remain HBV DNA UND after stopping tx. So many more factors come into play to achieve this 40% figure than would have to happen for someone with HCV GT1.
This is part of my dilemma….when you consider that my chance will go up with each year, is the additional 24 weeks of PEG IFN really going to make a difference? Maybe the additional 24 weeks of Pegasys will help me to stay UND and thus give me a better chance. I just don’t know at this point. I have not really found any studies to support or contradict this.
Once I’m done with HCV tx, then HBV tx will be mono therapy of Pegasys. I don’t know of any studies on the effects of Ribavirin on HBV and don’t believe Riba plays any role as far as HBV goes. Also studies I’ve seen with PEG IFN coupled with an HBV antiviral don’t seem to make any difference either.
Know if I could only find a study of the effect of PEG IFN on HBV genotype “A” that were UND at 4 weeks….. then I would be set. I think the problem is that there are not enough genotype A’s as compared to the other genotypes so studies usually include all GT’s lumped together and most people don’t go UND so quickly, if at all. Even when reading studies of PEG IFN tx for HBV, they usually don’t take into account an HCV/HBV co-infection. So in a way, I’m am kind of my own study with my own unique situation.
It’s crazy and keeps getting crazier. Lucky for me, my sx on tx have improved a lot over the last month or so. I contribute a lot of it to a new way of positive thinking and not dwelling on the negatives of Hepatitis like I did in the beginning and that has helped tremendously. I learn what I NEED to know and try to block out the negatives.
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