24 VS.48 WEEKS TX

[chevyelcam79]

Im sure this has been posted prior but..... I've been thinking(with some help, u know who u are)...  

here is my scenerio:  1A begin vl of 26,000. Stage 2 inflammation grade 2-3 fibrosis (I think thats right)  UND at week 2 and have continued to stay that way yipee.  tx 180 mcg and 1000 mg riba.  Doc has decided to let me do 24 weeks tx.  Only two more weeks to go.  Female, 140ish lbs. good health(cept for this), caucasion, 41 yo.  the doc said that with all of these factors, there is a very slim chance that I will relapse.

Bloodwork not too bad; last month WBC 1010, hemo 11.3.  Not feeling too bad, did have the throat thing going on not too far back but all in all, not too bad.  The doc did decrease shot to 135 when I continued to have the throat thing.

I do go to a hepatologist at John Hopkins University. supposed to be one of the best and not at all doubting that.

Any studies out there that show 24 wks as opposed to 48 with the above factors?  I guess Ive been thinking and I realize that the next 6 months I will be terrified that I will relapse.  Who in their right mind wouldnt?  

Anything that I should be concerned about?

Thanks for the input!
Shari

[alagirl]

As to "I will always think I'm not worthy of this gift since I didn't fight as hard", that's poppycock!!!
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Agree with that one completely.  Man, this disease seems to generate such moral high ground all over the place.  This is a virus.  A medical issue.  Like the flu.  People don't "deserve" to get and they definitely don't deserve to keep it.  I am always over the moon when anyone clears the damn thing, PARTICULARLY if they have less illness and fewer side effects in the process.  I would love to see a note on here some day about somebody having cleared it naturally in the first two months.  Haven't seen that one yet.  But I'd be overjoyed.  I may be afraid for people if they stop tx'ing "early" but if it works there is nothing that makes me happier.

[jmjm530]

As you so wisely suggest, telling people to treat shorter is no different from telling people to treat longer. None of us here are doctors, so all we can do is offer opinions, but more important our experiences and whatever "stats"/studies are out there for us to study and then go over with our medical team. I'm sure that's how you approached things and so happy it worked out for you.

As to "I will always think I'm not worthy of this gift since I didn't fight as hard", that's poppycock!!! You're not only worthy but you made a difficult decision weighing your symptons (and the possiblity of lingering sfx) against a longer treatment. Cutting treatment shorter can often be a more difficult decision than going longer, so hold your SVR head up high and none of this not worthy sh*t :)

All the best,

-- Jim

[ladybug52]

Anything that I should be concerned about?
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Yes, be concerned about panic and anxiety for the next 6 months!  I would never tell anyone to stop early....I would never tell anyone to extend, either.
The stats are always going to be on the side of 48 weeks tx minimum for geno 1, and 24 minimum for geno 2. My biopsy showed stage 1 grade 2.
I had a starting viral load of 11 million and am a geno 2. I was und to <50 at week three, and und to < 5 at weeks 4, 12 and 15. I made the decision to stop at week 16 when I got the heptimax back for week 15.
I was still clear last month at 7 months post.
Did I regret my decision?
I had many doubts for the first three months, hearing about relapses is difficult. I will always think I'm not worthy of this gift since I didn't fight as hard......
but I'm thankful that I was given the choice, and the idea by someone who posted the stats......
(you know who you are)
Bug

[jmjm530]

Just to be clear, I'm not trying to make up Chev's mind, one way or another, and in my first post of this thread I pretty much outlined the approach I would take in making a decision. In the end, it comes down to a personal decision, as two people can look at the sam data and reasonably come to different conclusions. Personally, I happen to like the shorter course for folks with certain stats -- but everyone should really order up the full-text articles, discuss with their docs, and then make a decision they are comfortable with.

Night all.

-- Jim

[jmjm530]

You need two prerequisties for the shorter course. Low pre-tx viral load and week 4 RVR. (See the two studies posted by "GoldenRule above). I believe your exerpt is just a straight comparision of tx lenghts for geno 4's, regardless of pre-tx viral load and RVR. Geno 1's also do better with 48 weeks if they don't have an RVR.

-- Jim

[alagirl]

This doesn't perfectly fit your situation either but it is still something I thought you should probably see - Before you look up the research, keep in mind that this study was conducted on genotype 4's:

http://clinicaltrials.gov/ct/show/NCT00502099;jsessionid=39F64C388DE200A7769752B97A2EB298?order=1

excerpt:

Overall, SVR rates were significantly higher in patients receiving treatment for 36 or 48 weeks than in those treated for 24 weeks (66 and 69% vs. 29%; p = 0.001 for each comparison) (Fig. 2). Relapse appeared to be a major factor in determining treatment outcomes: virologic relapse during follow-up was highest among patients treated for 24 weeks (20 of 45, 44%) but relatively rare among the longer treatment arms.

There was no significant difference between the 36-week and 48-week treatment regimens for the overall cohort.