Bob Gish is an excellent hepatologist (as is Mike Fried, also mentioned in this site).
My guess is that you are genotype 1 (I didn't see this in your posts), in which case 48 weeks is standard (and optimal) advice; While your RVR STRONGLY suggests you will clear virus, and this it is POSSIBLE this might occur with 24 weeks therapy, your best bet (assuming you are genotype 1a/b) is to go for 48 weeks therapy. Pain in the butt, but Bob is trying to be sure you don't relapse.
I hope that you get things resolved to something comfortable and effective for you. As an aside, he's too far from me, but I would love to consult with Dr. Gish, he works with and co-authored a book on Hepatitis C with conventional therapies- and Chinese herbs with Misha Cohen (if this is the same Doctor I'm thinking of)...he must be a very open minded Doctor and I've heard so many good things about him...he sure is famous in the hepatitis community...
Hi, while I have your attention (if I do) just wondering which one of the new clinical trials peak your interest the most? Sorry if you've answered this question already (haven't been around in awhile) I wouldn't be surprised if you have...course, if you have time, thanks so much!
Debnevada: sorry about the hi-jack, only figure it would be a short exchange...thanks!
Like everyone else I am really interested to see the long-er term data on the protease inhibitors (any and all of them), although I am not optimistic (but hope to be proved very wrong). I think the albuferon trials will show pretty much what we see with PEG-IFN, maybe a few points better, but with reduced side effect profiles (and that will be good). I think the real interest will be in the small molecule - polypeptide inhibitors of HCV-RNA-polymerase function, some of which may get to clinical trials in the next 12-18 months. Iam looking forward to the next AASLD (Nov 2-6, 2007) and EASL (2008) meetings as these will likely showcase some of this stuff.
Gee, thanks so much for your quick response! Much obliged! My doc told me at the last conference, guess it was Barcelona? That he spoke to some trial docs re the albufuron, and a few had told him that their patients only SVRed a few points more on average (guess any points are better then none, statistically speaking) but, they did report a better side effect profile, on average...guess it's a question of thanking the heavens for small favors, I'm all for fewer side effects!...
I, maybe too optimistically, get encouraged by a lot of the results I'm seeing with the Vertex trial participants here on this board, but like you said, it's a question of watching for some more data to come in...And now, there are more trials being run out of my hospital, with exotic sounding names of course, that I know nothing about....
Once again, thanks so much for your response...I imagine you go to the Austrailian board as well? Such nice folks...I love the sense of humor and lack of pretention in the culture, how's that for a broad swath of a general statement?:) anyway, be well...
Yes, I believe Deb is geno 1 (not 100% sure) but the reason for the surprise is that Deb said she was diagnosed as acute and treated within the acute window. My understanding is that acute cases are often treated with different protocols (including shorter periods) with excellent results. Add that Deb being non-detectible at week 2, mix in what appears to be some significant side effects from the treatment drugs, and you would think she would treat less than 48 weeks.
I understand you might not want to comment directly on a case handled by another doctor (one you appear to know or at least know about) but maybe you could at least comment in general on acute treatment protocols.
My guess is that perhaps her doctor might have doubts about whether she was actually acute and/or have concerns about her weight -- perhaps he believes she has fatty liver.
My suggestion was first to ask her doctor the reasons why he wants to treat 48 weeks. Depending on what he says, Deb then might pursue a second opinion, regardless of the excelllent reputation of Dr. G. -- if for nothing other than peace of mind. My liver specialist also had an excellent reputation, but I ended up consulting with additional hepatologists regarding some critical treatment decisions -- because as you know, even the "top dogs" don't always agree on the best way to chew a bone (or even whether to chew it), and in the end it's your liver that's being treated, not theirs.