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tips of fingernails yellow?
I have chronic acute Hepatitis B and the tips of my fingernails are yellow. Is this a sign of liver problems, or is it something unrelated, like fungus or from smoking?
"You know who" is a great clinician but has a very strong treatment bias, as you probably know. Regardless, by all means get the original study data he's referring to and you might want to slide the in vitro study I posted in front of him.
As to "Rock Star", I think what he's referring to are current treatments which is correct. You might want to ask "Rock Star" what he thinks about using Telaprevir for geno 2's if and when it gets approved for geno 1's.
And what about that Boston fellow? Why don't you email him and ask if he thinks you should treat now (and with what protocol) or wait for better stuff. You might want to update him with your RVR, etc, to refresh.
I'm not saying you shouldn't treat, just maybe wait a year and see what the tx landscape looks like then. Don't have to tell you how fast the HCV world is changing these days. Cause if you do re-treat with SOC, then anything less than 48 would be tempting fate -- and that's a whole lot of interferon on top of the 24 you already did.
-- Jim
As to "Rock Star", I think what he's referring to are current treatments which is correct. You might want to ask "Rock Star" what he thinks about using Telaprevir for geno 2's if and when it gets approved for geno 1's.
And what about that Boston fellow? Why don't you email him and ask if he thinks you should treat now (and with what protocol) or wait for better stuff. You might want to update him with your RVR, etc, to refresh.
I'm not saying you shouldn't treat, just maybe wait a year and see what the tx landscape looks like then. Don't have to tell you how fast the HCV world is changing these days. Cause if you do re-treat with SOC, then anything less than 48 would be tempting fate -- and that's a whole lot of interferon on top of the 24 you already did.
-- Jim
You mentioned something recently about Telaprevir not working for genotype 2's. Maybe what you heard was that they don't currently have trials, but according to this presentation at AASLD 2007, it works quite well in Vitro and hopefully trials will follow if they aren't being recruited already. Also, keep in mind that once Telaprevir gets FDA approval, there's nothing to stop a doctor from prescribing it for genotypes other than genotype 1.
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After I relapsed, I asked (you know who) if he thinks I should wait for Vertex and he said geno 2's only had a 2 log drop. Thats exactly what he said. I will definitely ask him where this info is. I was shocked when he said that and didn't even think to ask if he meant 4 week or what. So I said,"So there is nothing out there for me?" He said no, and then said 'well there is ,,,and he named a drug (can't think of the name of it - I think it started with an "A.") But he said by the time approval blah blah blah,,,you have to take into account that you are 53 years old and he said I feel you just need to tx longer - a minimum of 36, but best to go 48,,,you don't want to have to do it again.
I went on a rant on how geno 2's are left high and dry and its not fair and all of that.
Then recently I went to another rock star for a consult and he told me that there is nothing out there for geno 2 except SOC and that I need to tx longer and it will give me 90% chance of clearing. That doesn't impress me cause I heard that the last time. He said that because I am a geno 2 relapser that I would be waiting even longer to see how studies went for relapsers.
It's obvious that geno 2's are the homeless of the heppers - really, its ashame.
But anyhow thanks for posting this, cause I will be seeing the doctor that had said the 2 log drop and ask him about that - but he definitely said it.
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thanks goofy.
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After I relapsed, I asked (you know who) if he thinks I should wait for Vertex and he said geno 2's only had a 2 log drop. Thats exactly what he said. I will definitely ask him where this info is. I was shocked when he said that and didn't even think to ask if he meant 4 week or what. So I said,"So there is nothing out there for me?" He said no, and then said 'well there is ,,,and he named a drug (can't think of the name of it - I think it started with an "A.") But he said by the time approval blah blah blah,,,you have to take into account that you are 53 years old and he said I feel you just need to tx longer - a minimum of 36, but best to go 48,,,you don't want to have to do it again.
I went on a rant on how geno 2's are left high and dry and its not fair and all of that.
Then recently I went to another rock star for a consult and he told me that there is nothing out there for geno 2 except SOC and that I need to tx longer and it will give me 90% chance of clearing. That doesn't impress me cause I heard that the last time. He said that because I am a geno 2 relapser that I would be waiting even longer to see how studies went for relapsers.
It's obvious that geno 2's are the homeless of the heppers - really, its ashame.
But anyhow thanks for posting this, cause I will be seeing the doctor that had said the 2 log drop and ask him about that - but he definitely said it.
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thanks goofy.
In the Mangia study 10 of 10 relapsers on 16 weeks went back and retreated for 24 wks (~2/3 GT2, 1/3 GT3) and SVR'd. I think I got that right.
The short tx studies for the GT2/3 populations (Mangia, von Wagner?, someoneelseewhosenameeescapesme) have some interesting facts that are secondary to the short tx aspect - like how the 24 weekers did, how the retreaters did, what were the predictive conditions, etc.
As for the yellow fingernails that started this thread - if one were in te habit of smoking roaches right down to the nib, and got yellow fingernails, wouldn't that be proof positive of pot and liver damage????
The short tx studies for the GT2/3 populations (Mangia, von Wagner?, someoneelseewhosenameeescapesme) have some interesting facts that are secondary to the short tx aspect - like how the 24 weekers did, how the retreaters did, what were the predictive conditions, etc.
As for the yellow fingernails that started this thread - if one were in te habit of smoking roaches right down to the nib, and got yellow fingernails, wouldn't that be proof positive of pot and liver damage????
You mentioned something recently about Telaprevir not working for genotype 2's. Maybe what you heard was that they don't currently have trials, but according to this presentation at AASLD 2007, it works quite well in Vitro and hopefully trials will follow if they aren't being recruited already. Also, keep in mind that once Telaprevir gets FDA approval, there's nothing to stop a doctor from prescribing it for genotypes other than genotype 1.
"Oral Presentation: Telaprevir Demonstrates Potency Against Genotype 2, 3 and 4 in vitro Chao Lin, Ph.D., of Vertex, will present an abstract titled, "Telaprevir (VX-950) is a Potent Inhibitor of HCV-NS3 Proteases Derived from Genotype Non-1 HCV-Infected Patients" at 6:15 p.m. CEST (12:15 p.m. EDT) on Thursday, April 12.
"While genotype 1 accounts for the majority of hepatitis C cases, the proportion of those living with genotypes 2, 3 and 4 is significant," continued Dr. Alam. "In this in vitro study, telaprevir demonstrated similar potency against the NS3-4A protease derived from those patients with genotype 2, 3 and 4 to the in vitro results demonstrated with telaprevir in genotype 1. These results support our plans to begin to study telaprevir in genotypes 2, 3 and 4 in 2007."
http://www.hcvadvocate.org/news/reports/EASL_2007/EASL_07-1.htm
I know there are not alot of geno 2's on forum, but do any of you guys remember any geno 2's that relapsed after 24 weeks of tx and then treated for 48 and SVR'd. I can't think of anyone. Tator Tot came to mind, but I'm not sure. I think (?) I remember reading she was a geno 2 and relapsed, but not sure. If you guys think of anyone let me know. Thanks.
Thanks Mike, I did see that article. Fortunately, I have very mild psoriasis both now and pre-treatment. The only major problem was during treatment which is very common because of the interferon. Of interest in the article is that further study is needed to determine whether those mortality rates are because of the psoriasis itself, or the harsh systemic treatments that many with severe psoriasis go through.
Goofy,
Never would have thought of that, thanks.
Goofy,
Never would have thought of that, thanks.
I just saw this today at Medscape and thought you might want to take a look at it.
Severe, But Not Mild, Psoriasis May Increase Mortality by 50%
http://www.medscape.com/viewarticle/567777
Mike
Severe, But Not Mild, Psoriasis May Increase Mortality by 50%
http://www.medscape.com/viewarticle/567777
Mike
I imagine he's pretty sure of exposure - since he's got HBV....
mets - I don't kow the answer - but I seriously doubt it's you liver.
mets - I don't kow the answer - but I seriously doubt it's you liver.
It's a sign of nail psoriasis or perhaps a fungal infection. If you think you've been exposed to Hepatitis B, or have other liver-related or general health issues, best to see your doctor. No doctors here.
-- Jim
-- Jim
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