Extend TX - need YOUR thoughts

[MrsOckert]

Hey guys, how's everyone.  Sorry I haven't been able to post much.  Work has been really busy and I'm training someone new.  I don't have internet at home so can't leave msgs from there.

I have an opportunity and need some of your advice and thoughts.  My liver doctor is being sent to IRAQ and will be gone for the next 4 months.

My tx is supposed to end on Sept 15, that will be 48 weeks.  I actually have enough refills on the TX meds and procrit to take me to 60 weeks.

The reason I've always been concerned about relapsing is that I'm overweight and do have NAFLD in addition to the HCV.

How much do you think my odds would increase if I finish out my meds at 60 weeks as opposed to stopping at the 48?  This would be my decision as my doctor wouldn't even know I was still on the meds.  MY GP has been great about following my progress and would be able to step in if any problems came up.

[fishdoc]

new article related to fatty liver:

Steatosis in Chronic Hepatitis C: Relationship to the Virus and Host Risk Factors
Posted 07/25/2006

Carla AL Matos; Renata M Perez; Mauricio S Pacheco; Claudio G Figueiredo-Mendes; Edmundo Lopes-Neto; Evandro B Oliveira Jr; Valeria P Lanzoni; Antonio EB Silva; Maria LG Ferraz  


Abstract
Background: Steatosis occurs frequently in hepatitis C. However, the mechanisms leading to this lesion are still unknown, and the role of steatosis in the progression of the disease remains controversial. The aim of the present paper was to determine the prevalence of steatosis in hepatitis C and its association with hepatitis C virus (HCV) genotype, viral load and the presence of risk factors for steatosis, and to analyze the association between steatosis and the intensity of liver disease.
Methods: Patients infected with HCV who underwent liver biopsy were included. Patients coinfected with hepatitis B virus and/or human immunodeficiency virus and those previously treated for hepatitis C were excluded. The following risk factors for steatosis were investigated: obesity (body mass index [BMI] > 25 kg/m2), diabetes mellitus, hyperlipidemia, alcoholism, and use of potential steatosis-inducing drugs. Histological analysis evaluated the presence of steatosis, the degree of periportal activity and staging. Patients with and without steatosis were compared regarding demographic, epidemiological, laboratory and histological characteristics. Logistic regression analysis was applied to identify variables that were independently associated with the presence of steatosis.
Results: Ninety patients (55 men, 35 women) with a mean age of 45

[jmjm530]

Thanks, I'll take better than Serf but certainly no King re reference as there are others much better organized in that respect. How about Knight Templar? They were pretty monastic and that about sums up my life right now :) Regarding extended tx, the big determiner appears to be viral response. All the doctors I consulted with (except my treating doc :) ) said there was no rhyme or reason to extend beyond 48 weeks unless you were a slower responder. I ended up doing 54 weeks at my doc's urging because of age and histology but even my NP was against it. Looking back I don't think I needed the xtra weeks but of course it's all speculation looking back.

-- Jim

[Dale_Ray]

That's funny Jim I've read four books on Knight Templars in the past three years. None notable or on the best seller's list. I haven't read since I started treatment because of short attention span and blurred vision. I can't wait to start again. No, No my friend for me you have been king and stayed clear of the emotional aspects therefor Mucho respect to you. We need to get you over to the Middle-East. Mrs O was the one looking for the answer on extended treatment. My doctor, like yours simply doesn't want to extend because if a patient fits a certain criteria then certain things are known factors. He is pretty much by the book. I've had some real begging sessions with him lately about the low platelets and leaving me on treatment. Guess I'll know more this evening when I see him. Lot of pressure on kings isn't there? Dale

[jakish]

Didn't mean to come off as a smart a$$, or downplay any ones sides, sometimes you get answers quicker here than elsewhere.

Actually my 2 and 4 year old just woke up so I will have to get back to the ants later.

[jmjm530]

I've been to Israel, Lebanon, Syria, Iran, Afghanistan etc,  many, many years ago, and it's not surprising they can't get along. H*ll, the individual sects in most of those countries hate each other, so not suprising they can't get along with other countries.  But what places to visit. Wow. Had an Iranian girlfriend for my brief stay and was told I'd get my throat cut if her brother found us holding hands. LOL. Nothing like being young, in love, and with a little element of danger :) Yup, those were the days -- Hep C wasn't "invented" yet, not to mention combo treatment --  and not a care in the world until my Orient Express train wreck, but that's another story :)

-- Jim

[jmjm530]

Didn't think you came off that way, and frankly I'm a bit on "edge" lately for a number of reasons, so any apologies in tone are mine. Take care of your little flock and then get back to those ants :)

-- Jim