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Avatar universal

After 25 weeks of Treatment

Hello.  Thank you for your hard work.  My question is I have Hepatitis C, gender 1 (no previous drug use, no transfusions, only some accidents having to run to emergency for stiches several times), and have been on Ribavarin 1000mg per day and weekly injection of peginterferon alfa-2a for 25 weeks now.  Since starting this, my viral count was going down great in
the beginning of treatment.  Last HCV RNA  Detect/Quant was 178. That, I believe was after 15 weeks.  Now, 25 weeks my blood work says HCV RNA  Detect/Quant 398. Result in log IU/mL  2.60.  Also says Dynamic range of this assay is
50 IU/mL to 25,000,000 IU/mL (1.70 to 7.40 log IU/mL. Sample beyond the linear range will be confirmed by dilution and repeat testing.  When I discussed this with my doctor, I was devasted that she told me to stop treatment because after 25 weeks your viral count should be 0.  I told her that maybe it was because a couple times I wasn't sure if I took my morning Ribavarin and I either double dosed later, or then thought I took it and skipped.  I only did this about 5 times.  Some mornings I was just running out of the house.  But I really tried to remember because I realize how important this is to me.  I always took my weekly injections but it may have been not the same time that day.  So over the phone she said stop treatment, I'll have to  make a phone call and this phone call they never get back with me until the end of the week.  They could recommend just stopping, or you may now have to continue for an addtional 72 weeks.  I was devastated!  I still am emotionally.  Crying and waiting to hear back from her.  I guess I know the answer.  If I was to continue to 72 weeks instead of 48 weeks like originally planned, she wouldn't be telling me to stop treatment now.  Can you tell me what you think please.

This discussion is related to Hep C treatment.
5 Responses
Avatar universal
Your doctor is right. Unfortuately if you are not undetectable by 24 weeks you are not responding. Your chances of cure are around 2%. Even going 72 weeks will not help.
Sounds like your best option would be to stop and wait for the new drugs coming out in the next few years.
Don't feel to bad because even though you did not clear the treatment gives your liver a much needed break.
Best of luck
717272 tn?1277590780
I'm afraid that I agree with copyman.  You are showing only a limited response to interferon therapy.  Skipping a few doses did NOT make a difference in your response.  It's just the way you are made and there are many, many others who don't show a strong response either.  

Extension of treatment time is offered to patients who clear the virus between 12 and 24 weeks, as an added guarantee that they will remain clear.  If you are not yet clear at 24 weeks you will probably not clear the virus at all on the traditional interferon/ribavirin therapy, or you finally clear but the virus will activate again.  You will be needlessly suffering and being damaged by the chemo for a long time without positive results.   If it were me I would follow the doctor's advice, quit and get well so I could try again with the new drugs later.

The new class of drugs, protease inhibitors, work along with the standard therapy but act by inhibiting the reproduction of the actual virus.   Add that to the stimulation of your immune system done by the standard therapy and there is a much greater possibility of clearing the virus and staying clear.   The drugs are in the final phase of FDA testing now and will be approved for use in 2011.  They have been tested on people like you (non-responders to standard therapy) with good results.  There are more drugs with even better activity against the virus being tested, also, but they will not be finished with testing until after 2011.  Good luck.  Get well so you can try again later.
179856 tn?1333547362
I'm very sorry to hear your news I know how devastating it must  be.  It's another lesson on how truly important it is not to miss any doses (and if you can think of 5 there's probably more).

You don't fall into the category of 72 weeks (believe me I've been that route) as you have detectible virus at week 24 and it's too high to likely be a false positive at that number.  If you had cleared at after 15 but before 24 weeks you could have done 72 weeks but it does appear your had viral breakthrough.

I'm sorry.  Best chance is to wait for the PIs to become available as stated above.

Enjoy your life right now - you will have another chance another day to fight the disease and try to live as liver healthy as you can in the meanwhile.

Avatar universal
Thank you all for your comments.  I very much appreciate it.
Avatar universal
I am sorry to hear of your bad news.

Don't be too upset about treatment not working. It happens to lots of people who take every single pill and injection bang on time. Sounds like you took most of them which is good enough.

The best thing now is to really look after yourself during recovery. Do everything you can to make yourself as healthy as possible. If a better treatment is released then you will be strong enough to endure it. There really are lots of things you can do to look after your liver and your general health.

My advice right now:
1. Be kind to yourself for two or three weeks. Enjoy feeling better without the drugs!
2. Ask your doctor about the plan for tests to see how treatment affected you, and how you are recovering over the next six months.

Once you are feeling a bit better, start looking into a good daily exercise plan, the food you eat, and some of the alternatives that can help (if necessary). There was a hepatitis researcher on this site some time ago who recommended some supplements which a lot of people, including me, find very helpful. They are definitely not a cure but they do help. When you feel like it, take a look at supplements recommended by HepResearcher (doctor) in the health pages. Not sure if you already know this, but I will say it just in case. Some supplements/vitamins can be harmful, and some are just a waste of money so don't just rush into taking them. Diet and exercise first.

It isn't all over. Get strong!
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