How long to wait to re-treat? Post TX PCR.

[jmjm530]

Feeling very positive finishing my 2nd week without Peg and my first without riba -- but being the pro-active soul I am, a couple of questions:

(1) Some of you like Calio, have jumped right back on the treatment bandwagon within days/weeks of relapse. Goofy, I believe has indicated he'd do the same thing in case of relapse.

Others, have indicated their doctors wanted them to rest/heal like 6-months or so before re-treating, as mine once suggested.

First, for all those who re-treated, how long did you treat and how long did you wait before re-treating, and what logic if any did your doctor give you?

And related, did any of your doctors discuss in detail the why's or why nots of re-treating sooner or later. I ask this second part because one way of looking at it is to hit it hard again before the virus has time to get strong. Another way, is to take a rest and let the immune system get strong before re-treating.

(2) So when exactly is the 4-week post-tx PCR/TMA?
When we count our treating weeks, we start with the Peg shot. So our treating week 4 PCR would be the day before our 5th shot. I'm assuming it works similar post treatment, except the difference is post tx we already start with drugs in our system. So do you start counting from the day of your last shot. Or, do you start counting from the day of your last riba?

Here's my example. Last shot Wed March 8th. Last Riba Wed March 15th. I therefore think my week 4 PCR/TMA should  be Tuesday April 4th. But counting from last riba would make it April 11th. Any input welcome.

Thanks.

-- Jim

[rifleman]

I asked my Br. that while on tx.  He said that I couldn't reinfect myself with a toothbrush.  I did, however, switch them out after the first undetectable pcr.  Razor cartridges I changed weekly.
DJL

[jmjm530]

Go get a dog...
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Easy for you short-course guys to say. LOL. Try 54 weeks instead of 12 sometime :)
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Listen, thanks again for your intelligent thoughts, a couple of things...

First, I had weekly PCR's starting at week 1, so I know what week I became non-detec. Second, I'm not sure that your optimism of 1b super-responders is documented. By that I mean, what per cent of 1b's actually have a 4-week PCR? I'd say it is very small. So in other words, the number of 'super responders' may be very understated with many who cleared at week 12, actually clearing earlier.

As I said before, I am positive regarding SVR but reality (various medical opinions) suggest 70-90% plus but with some here suggesting re-treating earlier than later -- a little contingency planning isn't a bad thing -- also takes my mind off of things in a weird way.

I do like you're positive, gung-ho attitude. If I ever find myself in big sh*t trouble in Florida, I'll know who to call. LOL.

-- Jim

[rifleman]

No, I'll pass on the 54 week thing, but thanks for asking.
I wouldn't be able to help you in Florida.  I live and work in Maine, and I only eat saltwater fish that swim off the George's Bank.  Had some Mahi-Mahi (Dorado) once.  They said it was a delicacy.  Tasted like bluefish to me.
DJL

[DoubleDose]

I think the retreating issue has more to do with how you feel after finishing tx.  If you are still feeling pretty strong, not burned out, and then show a quick relapse, in that case I think you could conceivably begin again as early as you liked.  I do not know that there is much comparative data out there regarding efficacy of quick retreatment, versus delayed retreatment.  None that I am aware of, anyway.

I think you might get more meaningful info. from a 4 week post-tx PCR, than a 2 week test.  The one month PCR would give the virus time to reassert itself, if it is still around, and it would probably show up on the ultra sensitive qual. or quant. test.  If you are undetected at one month post-tx, I think your odds are very good...probably over 90% or even higher, that you will become SVR.

Stay confident, and try to relax...I think your odds are good, judging from your early response, and having gone almost a full year being undetected.  Did you keep your inf. and riba. at the same levels throughout???   I think you are in good shape on this issue, and I am really expecting to see an ongoing set of 'undetected' PCR results over the coming months, and throughout the first year off tx.  I think you are probably feeling pretty confident as well, so don't do TOO MUCH homework on retreatment unless your PCR outcome is radically different than expected.  Enjoy your initial weeks and months off therapy...it is a wonderful feeling!!!!!

Good luck Jim, we are all pulling for you.  I enjoy your input and contributions to the forum.  You are ready to be promoted to one of the 'Senior Consulting SVR Alumni Member' roles on this forum.  Be prepared to change hats!

DoubleDose

[Algernon]

I suggest a 3 year old black standard poodle with no training.  He is very affectionate, very adorable, babe magnet.  Only eats Moist and Meaty so requires occasional toothbrushing (HCV immune, so you can use your old toothbrush).  FREE SHIPPING.

[jmjm530]

I didn't understand logic of the 2-week post-tx PCR either (he also does a 4-week, 3 month, 6 month, etc) but as always, he leaves it more or less up to me. Basically, I was going to let his whole thing lie for about 3-months, but than Kalio's doctor wanted her to start treating right away and got me thinking if there's a compelling reason to do it or not. The feeling I'm getting, however, is that there's nothing documented in this regard and simply differing opinions.  And then there's THIS...

Cuteus posted a study recently about controlled tx interruption. My doc didn't particularly like it for a number of reasons (he likes to rest folks for six months at least ) but I find it sort of fascinating if the data holds behond a cohort of 2. LOL. The thing I like is that it theoretically minimizes drug exposrure. If it works that is. :)

http://tinyurl.com/oryb5

-- Jim