Aa
Genotype 3a treatment
Hi,
I have joined this forum on behalf of my 54 year old wife who tested positive for HCV about4 weeks back while undergoing a series of blood tests for her cervical problem. Now while severe pain persists in the upper neck, the focus has shifted to HCV. We have no idea how she got this. She last tested negative about 16 months back. We have since carried out all the tests. The viral load was 2.76 and our doctor has put her on weekly pegasys + ribavarin. 3 injections later, she still is doing alright. I hope you will bear with me as I am a novice here and don't know all the terms etc. What are the different stages, the prognosis and can she be treated for both problems simultaneously? Can someone explain what it means to be a genotype 3a in terms of responding to the treatment and what are we looking forward to in the short to medium term? Thanks
I have joined this forum on behalf of my 54 year old wife who tested positive for HCV about4 weeks back while undergoing a series of blood tests for her cervical problem. Now while severe pain persists in the upper neck, the focus has shifted to HCV. We have no idea how she got this. She last tested negative about 16 months back. We have since carried out all the tests. The viral load was 2.76 and our doctor has put her on weekly pegasys + ribavarin. 3 injections later, she still is doing alright. I hope you will bear with me as I am a novice here and don't know all the terms etc. What are the different stages, the prognosis and can she be treated for both problems simultaneously? Can someone explain what it means to be a genotype 3a in terms of responding to the treatment and what are we looking forward to in the short to medium term? Thanks
There are different protocols for the dosing of Ribavirin for GT 3a patients. Some clinics will use a fixed dose of 800 mg/day, others will use a weight based dose that usually results in about 1,200 mg per day. A strong case can be made for the weight based dosing scheme.
As mentioned, you definitely want a viral load (PCR) test at 4 weeks.
Good luck.
As mentioned, you definitely want a viral load (PCR) test at 4 weeks.
Good luck.
Hiya!
I am also a 3A and I can vouch for it's responsiveness to treatment. At 4 weeks, the Hep C was undetectable and has remained so since then. (It has been nearly 2 1/2 years since treatment.) My liver enzymes are perfect, and the only lasting effect I've had is a pesky thyroid issue (very doable in exchange for ditching the Hep C!)
As she progresses in the treatment, don't be surprised if she becomes irritable and sleeps a lot. Be sure she maintains her nutritional support -especially vitamin B complex and folic acid as these help the red blood cells to rebuild and this treatment is notorious for causing severe anemia -the kind that can't be fixed by taking iron supplements. Do not be surprised if she has "dragon lady" moments and seems irrational or hyper -emotional at times.
Typically, the meds make a person feel like they are fighting the flu -general chills, body aches, fatigue, etc. but some are lucky enough to skate through with few issues.
The best things about having the 3A geno is that not only is it responsive 80% of the time, but the treatment time is the shortest at 24 weeks. Some unfortunate souls with other more resistant genotypes have to treat as long as 72 weeks (a mind-boggling 1 1/2 years!)
If you have any questions (no matter how dumb or insane they sound) please come here and ask. You (or she) will become an expert at reading lab tests and by the time you finish, may know WAY more about liver issues and hep C than any other person you know...Welcome to the forum! ~MM
I am also a 3A and I can vouch for it's responsiveness to treatment. At 4 weeks, the Hep C was undetectable and has remained so since then. (It has been nearly 2 1/2 years since treatment.) My liver enzymes are perfect, and the only lasting effect I've had is a pesky thyroid issue (very doable in exchange for ditching the Hep C!)
As she progresses in the treatment, don't be surprised if she becomes irritable and sleeps a lot. Be sure she maintains her nutritional support -especially vitamin B complex and folic acid as these help the red blood cells to rebuild and this treatment is notorious for causing severe anemia -the kind that can't be fixed by taking iron supplements. Do not be surprised if she has "dragon lady" moments and seems irrational or hyper -emotional at times.
Typically, the meds make a person feel like they are fighting the flu -general chills, body aches, fatigue, etc. but some are lucky enough to skate through with few issues.
The best things about having the 3A geno is that not only is it responsive 80% of the time, but the treatment time is the shortest at 24 weeks. Some unfortunate souls with other more resistant genotypes have to treat as long as 72 weeks (a mind-boggling 1 1/2 years!)
If you have any questions (no matter how dumb or insane they sound) please come here and ask. You (or she) will become an expert at reading lab tests and by the time you finish, may know WAY more about liver issues and hep C than any other person you know...Welcome to the forum! ~MM
Hi Bob,
What you and your wife are in for with the treatment depends on her as an individual. Please tell her not to assume she will get every side effect on treatment. I am a genotype 3a and went through combo therapy a couple years ago. For the first month I had a ton of energy and felt great (which isn't normal) despite my red blood cell count plummeting. I was able to do things like work and travel (and buy a house) while on treatment. It did make me feel a bit like a different person though and I was dealing with mood/brain changes while on it but nothing severe. If your wife achieves rapid response (test at 4 weeks shows undetectable) that is great, however stick with the treatment and try to be the best patient she can. She should try to stay away from stress because I believe that is one of the reasons my treatment ended up failing. I achieved RVR and then a few weeks later there was a viral breakthrough (relapse) while still on treatment. This is a very odd occurrance, so don't expect that to happen with her, but also please have her be careful and don't take it for granted that RVR means cure or that no RVR means failure. Everyone is different. There are no molds to fit with this virus.
What you and your wife are in for with the treatment depends on her as an individual. Please tell her not to assume she will get every side effect on treatment. I am a genotype 3a and went through combo therapy a couple years ago. For the first month I had a ton of energy and felt great (which isn't normal) despite my red blood cell count plummeting. I was able to do things like work and travel (and buy a house) while on treatment. It did make me feel a bit like a different person though and I was dealing with mood/brain changes while on it but nothing severe. If your wife achieves rapid response (test at 4 weeks shows undetectable) that is great, however stick with the treatment and try to be the best patient she can. She should try to stay away from stress because I believe that is one of the reasons my treatment ended up failing. I achieved RVR and then a few weeks later there was a viral breakthrough (relapse) while still on treatment. This is a very odd occurrance, so don't expect that to happen with her, but also please have her be careful and don't take it for granted that RVR means cure or that no RVR means failure. Everyone is different. There are no molds to fit with this virus.
You guys are incredibly helpful and make a scared newcomer feel really welcome! Hats off to ya!
Since your wife has already had 3 injections it appears her doctor is aware she is not a candidate for the new treatment drugs, just be sure she has a pcr run after her 4 weeks and right before her 5th shot.
As for her other health issue it wouldn't be fair for us to guess on that only her treating doctor could make that decision.... Again best of luck.
As for her other health issue it wouldn't be fair for us to guess on that only her treating doctor could make that decision.... Again best of luck.
Hiya, Bob— and welcome to the discussion group.
Genotype 3 patients tend to be relatively responsive to interferon therapy; the odds of success are considered to be about 70%. This compares to 45-50% for genotype 1, and roughly 80% for genotype 2.
I think it’s probably a wise decision to go ahead and treat for genotype 3 now. There are new drugs in the fire that will eventually be used adjunctively with interferon/ribavirin, but their focus is on genotype 1 (and perhaps 2). They didn’t perform well in clinical trial for GT-3:
~~~~~~~~~~~~~~~~
http://www.natap.org/2009/EASL/EASL_13.htm
“Telaprevir Effective for Genotype 2 But Not For Genotype 3
EASL April 23-26 2009
Copenhagen, Denmark
Reported by Jules Levin
In phase IIb studies in treatment-naives, mostly caucasians, telaprevir in combination with peg/RBV improved SVR rates in half the time of treatment compared with standard of care:
--PROVE1: 61% vs 41% (p=0.02)
--PROVE2: 69% vs 46% (p=.004)
In this study genotype 2 treatment naive patients achieved a mean 4 log reduction in viral load after 6 days on monotherapy with telaprevir. The triple combination of telaprevir + peg/RBV achieved a mean 5.3 log reduction in viral load at day 16. But genotype 3 patients only achieved a -.80 reduction in viral load so therapy for genotype 3 won't be pursued.”
~~~~~~~~~~~~~
Viral load isn’t too important until the patient begins therapy; after that, it’s used as a barometer for response to treatment. Perhaps you could elaborate on your wife’s viral load again; were the results perhaps 2.76 million (IU/mL)? Or maybe log 2.79? There are different ways of expressing viral load, and it’s often confusing.
Speaking of confusing, we tend to use a lot of acronyms in here; this alphabet soup actually begins to make sense if you look here:
http://www.medhelp.org/health_pages/Hepatitis/Common-Hepatitis-C-Acronyms/show/3?cid=64
This page can also be found in the lower-right hand margin of this page, in a box entitled ‘Most Viewed Health Pages”
Many of us request hard copies of lab and procedure results, and begin a medical file at home; this helps us communicate more effectively in here, as well as with other specialists, if the need arises.
Good luck to you both,
--Bill
Genotype 3 patients tend to be relatively responsive to interferon therapy; the odds of success are considered to be about 70%. This compares to 45-50% for genotype 1, and roughly 80% for genotype 2.
I think it’s probably a wise decision to go ahead and treat for genotype 3 now. There are new drugs in the fire that will eventually be used adjunctively with interferon/ribavirin, but their focus is on genotype 1 (and perhaps 2). They didn’t perform well in clinical trial for GT-3:
~~~~~~~~~~~~~~~~
http://www.natap.org/2009/EASL/EASL_13.htm
“Telaprevir Effective for Genotype 2 But Not For Genotype 3
EASL April 23-26 2009
Copenhagen, Denmark
Reported by Jules Levin
In phase IIb studies in treatment-naives, mostly caucasians, telaprevir in combination with peg/RBV improved SVR rates in half the time of treatment compared with standard of care:
--PROVE1: 61% vs 41% (p=0.02)
--PROVE2: 69% vs 46% (p=.004)
In this study genotype 2 treatment naive patients achieved a mean 4 log reduction in viral load after 6 days on monotherapy with telaprevir. The triple combination of telaprevir + peg/RBV achieved a mean 5.3 log reduction in viral load at day 16. But genotype 3 patients only achieved a -.80 reduction in viral load so therapy for genotype 3 won't be pursued.”
~~~~~~~~~~~~~
Viral load isn’t too important until the patient begins therapy; after that, it’s used as a barometer for response to treatment. Perhaps you could elaborate on your wife’s viral load again; were the results perhaps 2.76 million (IU/mL)? Or maybe log 2.79? There are different ways of expressing viral load, and it’s often confusing.
Speaking of confusing, we tend to use a lot of acronyms in here; this alphabet soup actually begins to make sense if you look here:
http://www.medhelp.org/health_pages/Hepatitis/Common-Hepatitis-C-Acronyms/show/3?cid=64
This page can also be found in the lower-right hand margin of this page, in a box entitled ‘Most Viewed Health Pages”
Many of us request hard copies of lab and procedure results, and begin a medical file at home; this helps us communicate more effectively in here, as well as with other specialists, if the need arises.
Good luck to you both,
--Bill
First welcome to the forum, genotype 3 can be one of the easier types to treat. What you should be hoping for is a negative viral load (PCR) after 4 weeks of treatment, if so then her treatment time should be a total of 24 weeks............ Best of luck to you both.
Cando
Cando
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