Aa
2nd round HCV treatment
Okie-Dokie;
It took me 6 months to get this together, but I've finally got the 2nd round of Tx going again. Here is a brief overview of round 1:
51 year old Caucasian male
Genotype 1a
Grade 2, stage 3/4
254 lbs
Diabetes M. type 2
Dx with HCV 12/04
Treated with Pegasys/ Copegus total 56 weeks, from 2/05 through 3/06.
Slow viral response at 12 week assay, so increased riba from assigned 1200 mg/day to 1800 mg/day.
Became undetectable to <50 IU by week 20.
Relapsed within 30 days post Tx.
I started round 2 on 9/15/06 with Peg-Intron 0.50 mL/150 mcg/week, and ribavirin 2000 mg/day. For the first three injections, I've been drawing up the entire contents of the IFN vial, after reconstituting with 0.70 mL of the supplied diluent. This has given me an extrapolated dosage of 202 mcg Peg-Intron/week, based on a 0.68 mL injection. Although this IFN dosage isn't officially sanctioned by my new doctor, I have an appointment this Tuesday, and I'll disclose at that time. My three-week labs should be available for review by then, and hopefully will show some positive trends; if not, there's always dose reduction... :-).
Subjectively, I feel fine after three injections; no side effects have shown themselves yet, however this is still *way* early in the game. Last treatment, I was good until week 9 or 10 before this cr@p started creeping up on me, so I guess time will tell the story.
It's probably worth mentioning that I've made some changes regarding exercise and diet as well. As a diabetic, it's important that I maintain tight blood glucose control- particularly while on treatment. Over the last six months, I've managed to lose approx. 50 lbs; walking 8 miles daily in the hills here along with removing most processed foods as well as meats (salmon only now!) from my meals has been really helpful. More and more evidence is suggesting that obesity and insulin resistance are both negative prognostic indicators for SVR, so we'll see if this has any effect in the long run.
I don't expect to be posting very actively; however that just might change if these meds begin slowing me down. Until then, I'm trying to stay as active as possible. I think attitude is an effective tool for Sx; during my last treatment, I resigned myself to the fact that I'd get sick from these meds. This time, I'm going to keep going until I get Gumby-Legs and can't walk... In other words, if the side-effects knock the door off the hinges, I guess they're coming in; however, I'm not going to wait around for them.
My very best to all those folks that I recognize from days past, in addition to a whole lot of new ones as well. Keep plugging away at this stuff, and we'll eventually prevail--
Bill
It took me 6 months to get this together, but I've finally got the 2nd round of Tx going again. Here is a brief overview of round 1:
51 year old Caucasian male
Genotype 1a
Grade 2, stage 3/4
254 lbs
Diabetes M. type 2
Dx with HCV 12/04
Treated with Pegasys/ Copegus total 56 weeks, from 2/05 through 3/06.
Slow viral response at 12 week assay, so increased riba from assigned 1200 mg/day to 1800 mg/day.
Became undetectable to <50 IU by week 20.
Relapsed within 30 days post Tx.
I started round 2 on 9/15/06 with Peg-Intron 0.50 mL/150 mcg/week, and ribavirin 2000 mg/day. For the first three injections, I've been drawing up the entire contents of the IFN vial, after reconstituting with 0.70 mL of the supplied diluent. This has given me an extrapolated dosage of 202 mcg Peg-Intron/week, based on a 0.68 mL injection. Although this IFN dosage isn't officially sanctioned by my new doctor, I have an appointment this Tuesday, and I'll disclose at that time. My three-week labs should be available for review by then, and hopefully will show some positive trends; if not, there's always dose reduction... :-).
Subjectively, I feel fine after three injections; no side effects have shown themselves yet, however this is still *way* early in the game. Last treatment, I was good until week 9 or 10 before this cr@p started creeping up on me, so I guess time will tell the story.
It's probably worth mentioning that I've made some changes regarding exercise and diet as well. As a diabetic, it's important that I maintain tight blood glucose control- particularly while on treatment. Over the last six months, I've managed to lose approx. 50 lbs; walking 8 miles daily in the hills here along with removing most processed foods as well as meats (salmon only now!) from my meals has been really helpful. More and more evidence is suggesting that obesity and insulin resistance are both negative prognostic indicators for SVR, so we'll see if this has any effect in the long run.
I don't expect to be posting very actively; however that just might change if these meds begin slowing me down. Until then, I'm trying to stay as active as possible. I think attitude is an effective tool for Sx; during my last treatment, I resigned myself to the fact that I'd get sick from these meds. This time, I'm going to keep going until I get Gumby-Legs and can't walk... In other words, if the side-effects knock the door off the hinges, I guess they're coming in; however, I'm not going to wait around for them.
My very best to all those folks that I recognize from days past, in addition to a whole lot of new ones as well. Keep plugging away at this stuff, and we'll eventually prevail--
Bill
sure hope it works out for you...jim's comments on the 'fishdoc syndrome' may well be applicable- tho my hgb stayed within normal range until after i cleared @ week 12.....but i have been on procrit for 35 weeks now..i have always taken All the peg-intron that i could squeeze from the vial,seems o.k. in my very humble opinion.....weight loss sounds like a real good decision;i also lost 50 lbs before trx'ing..the walking will also do nothing but goodthings for ya...GOODLUCK & please keep posting
You have a great attitude. I admire your strength and determination to fight this think no matter what it takes. I know your determination will help you get through the rough times, and I hope there's not that many for you. Good luck!
Hi Bill,
Good to see you posting again and back on treatment.
If I remember correctly, even with all the riba you took last time, you had very little anemia and were still positive at 12 weeks? Are you planning anything different this time (like extending to 72 weeks) other than simply switching Pegs?
I flagged "Fishdoc" because I believe her consulting doctor suggested she may be riba-resistant or something like that given her lack of anemia. Certainly, there is enough data out there -- for me at least -- to suggest that ribavirin isn't absorbed by all of us in the same way, and that dosing riba by weight (as opposed to serum ribavirin levels) may not work for everyone.
I guess where I'm going is that you again mention "no side effects" like anemia. If you don't go anemic soon, it may suggest that you're not getting enough riba for your individual body chemistry.
Although there are obvious risk going above 2000mg/day, it's an approach you might want to discuss with your doctor. In the Sweedish high-dose riba study, I believe some took close to 4000 mg/day of riba, but of course they had the advantage of knowing serum riba levels. The best we have are viral response and anemia, certainly not as exact.
All the best.
-- Jim
Good to see you posting again and back on treatment.
If I remember correctly, even with all the riba you took last time, you had very little anemia and were still positive at 12 weeks? Are you planning anything different this time (like extending to 72 weeks) other than simply switching Pegs?
I flagged "Fishdoc" because I believe her consulting doctor suggested she may be riba-resistant or something like that given her lack of anemia. Certainly, there is enough data out there -- for me at least -- to suggest that ribavirin isn't absorbed by all of us in the same way, and that dosing riba by weight (as opposed to serum ribavirin levels) may not work for everyone.
I guess where I'm going is that you again mention "no side effects" like anemia. If you don't go anemic soon, it may suggest that you're not getting enough riba for your individual body chemistry.
Although there are obvious risk going above 2000mg/day, it's an approach you might want to discuss with your doctor. In the Sweedish high-dose riba study, I believe some took close to 4000 mg/day of riba, but of course they had the advantage of knowing serum riba levels. The best we have are viral response and anemia, certainly not as exact.
All the best.
-- Jim
I opted for the 72 wks peg/riba, gonna be a long trip,going to get 8wk PCR next fri. 4wk showed went from 4million 700thou to 54thou so hoping to clr at 8 wks.Thx for your support,we all need it.
Hey Bill and Coldfeet! Looks like you both have a very positive spirit about you and the virus doesn't have a chance!!! What is the plan for you both this round? 72 weeks? My heart goes out to anyone that has to resign up for interferon! You both must be very strong people!! Good Luck to you both!!
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