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24 Weeks for Selected Geno 1's.

http://tinyurl.com/c8kus

So..let's see I'm on week 22 of 48 or maybe 72 or maybe 96 ... but wait...maybe I really only have two weeks left. PLEASE MAKE THIS TRUE. LOL.

It does get confusing with all these studies, but the one trend that keeps appearing is that EVR is a very important guide both to treatment length and odds of SVR.

Just wish they broke the study out to take into consideration other variables like age, biopsy stage, etc.  Maybe I'll write and ask if they have the data.

For those who don't want to read the entire study, the 24-week recommendation is only for those geno 1's with undectable virus at week 4 and with low pre-treatment viral loads (<600,000). In this sub-group, with 24 weeks of treatment, the SVR was a very impressive 92%. The drugs used were Peg Intron and Riba.
34 Responses
Avatar universal
The study conclusion has a number of interesing implications for treatment strategy.

Many geno 1's with little liver damage (stage 0 or 1) have chosen not to treat now and adopt a wait and see attitude. It's a  valid choice in my opinion, because of the 48 weeks of treatment required with only around a 50% chance of success.

But this new study suggests that in certain geno 1 populations, both treatment length and rate of success (92%) is similar (actually better) than with geno 2's.

So...one strategy for stage 0 or 1 geno 1's with low pre-treatment viral loads (<600,000) would be to treat with a week #4 PCR.

If the virus is undectable at week #4,then continue on for the 24 week course. Accoring to the study your chances are of success are 92%. Howeer if virus is detectable at week #4, then stop treatment, re-biopsy in 3-5 years, and hopefully by then there will be better treatments around.




Avatar universal
Carp...I agree that the two drugs seem to perform the same but if I were just starting treatment and  a geno 1 with low viral load, I'd probably give Peg Intron a second look.

Tony...Yes! Yes! Yes!  24 weeks is so much more workable and achievable than 48 and/or 72 weeks. Hopefully, it will draw more people into treatment who fit this very specific profile.

But keep in mind, this study suggests 24 weeks only for a very specfic patient population.

So, in my case, for example, the 24 weeks (versus 48 or 72) is unfortunately just a day dream. LOL.

First, my pre-treatment viral load was 1.2 million. Second, while I was close to clearing the virus at week #4 (53) I didn't clear until week #6.

And most important, I'm a stage 3, which is known to have a higher relapse rate. So, until a study comes along with good stats on stage 3's, then it's 48 or 72 weeks for me.

Avatar universal
That is astounding news.  I am like you - too high of a viral load (1.52mil) but it gives me pause.  After my 4th shot next Friday, I am definitley pushing for a PCR (which the GI says he normally does not do at 4).

You are right.  It would be such an incentive to get more people into treatment.  You know, Rifleman who is a 3 or 4 said that his doc is only treating for 12 weeks since he cleared at 4.  I had not heard of that short of a treatment before.

Yeah, Tony is good with the html!
Kathy
Avatar universal
Boy, with a viral load of only 714 IU/mL and Stage 0-1, this really gives me something to think about. A 92% chance of success?!! Wow!  Thanks for sharing this information.

Susan
Avatar universal
That would be a skip in the park for 1's!  Great News Jim!  However,,I won't beat myself over the head after finishing 52 LONG weeks,,,,as I started with 8 mil viral load so I'm sure I needed every bit of what I did to kick it out!
Avatar universal
the study was posted a while back by snookman, and the ensuing discussion is probably in archives.  they mention svr 92% but do not state how long post tx was that test?
I have seen many people here post EVR and still relapse after 48 wks, it is a gamble I would not take.
Cindee comes to mind, and Scott, weren't you EVR?  Too early to embrace 24wks for geno 1.
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