Is there good reason for hope?

[pcds]

Type 1 hepatitis, started out at 1,7000,000, at week 9 I'm at 4800.  MY doc says I need to be undetected at week 12 or stop, my reading says it's at 24 weeks, what do you think?

Feel very fatigued but want to hang in there, even on neupogin 1x wk

[pcds]

I'm sure you are right.  Naturally after putting in time, like jail, of 12 weeks, all for nothing is hard to accept.  But I'm sure what you are saying is what my doc is going to recommend.  I have heard about increasing pegasys.

[HCVhost]

If you just contracted hep c or your liver is only mildly affected and you have not reached undetected viral load by week 12 of treatment, then I would recommend stopping. There is no point in going through the extra weeks of treatment now since new drugs will be available shortly which will work out much better in a much shorter time. I was simply saying that you need to consider ALL of your options and a simple, "quit treatment if viral load does not go to undetected by week 12" is not a hard and fast rule to apply to everyone.

[pcds]

Thanks for you answer.   But if I understand you correctly, I would need to be on medication not yet available such as Teleprevir.  So, if not clear by week 12 end, stop treatment, right? And wait for Teleprevir.  My liver is not badly damaged

[RCM829]

Great answer.  You are absolutely correct. Too often doctors use a blanket criteria when treating a patient with HCV without taking the time or possessing the knowledge to individually tailor treatment specifics. And that can make all the difference in reaching SVR.

Furthermore, I agree with every point you just made. Thank you for being so helpful.

Good luck to you pcds.

[HCVhost]

Many doctors take results too literally. Medicine is not an exact science, but studies have to select cut-off levels to report results and many doctors buy into this ignoring the fact that there is some distribution of results that transcends these levels.

Here are several reasons you may want to continue with treatment even if you DO NOT get undetected results by week 12:
- your viral load result is nearly undetected <1000
- you need to give your liver a break
- you don't know when you'll be able to take up treatment again

According to the accordion method of treatment, you need to take 4 times the amount of drug that you did to get you to undetected. If you get to undetected by week 15, then 60 weeks of treatment will give you the same chance as someone who did go undetected at week 12 and treated for 48 weeks. If you get to undetected by week 20, then you would need 80 weeks of treatment which is not only very demanding but may present problems with insurance. So obviously there is a practical limit to this method.

If your liver disease is advanced,  you are progressing through stages rapidly or your liver enzyme levels are very high, then you may want to consider staying on treatment. This may interrupt your liver disease progression or even reverse it. A little "breather" for your liver can actually go a long way.

Finally, if you don't know your circumstances more than 2 years out, then you may want to stay with treatment despite the results, but if you're not actually getting to undetected within a month or so past your 12 week date then by all means stop.

Don't overemphasize these options however. People who responded to treatment but did not go undetected by week 12 are shown to clear the virus with a 24 week regimen of interferon, ribavirin and teleprevir. Teleprevir should be available sometime in 2012.

[pcds]

You know the real answers here, thank you

[pcds]

Thank you copyman.  

[tashka]

Yes, it is better to stop if you are not undetected by week 12, because if this doesn't happen, your chances of clearing the virus are greatly decreased. I agree with what your doctor says.

On the positive side, you do show some response to interferon. As copyman mentioned, there will be new drugs available very soon-protease inhibitors. They are administered in combination with interferon and ribavirin. Not only they will help you to become undetected quickly (this is very important predictor of clearing the virus), but very possibly you can treat for only 24 weeks instead of 48 or more.

[copyman]

your doctor is correct. it use to be 2 log drop by 12 weeks but cutting edge doctors are using undetectable by 12 weeks or stopping treatment.
do you know what kind of liver damage you have? if minimal then perhaps waiting for new meds coming out in about a year.
best of luck