Aa
Maintenance Therapy
Scott (revenire) had said that he was considering "maintenance therapy" when he relapsed after 88 weeks of tx. The following trials are underway for maintenance therapy to reduce or slow the progression of HCV disease:HALT-C, EPIC-3, COPILOT, PROI-C, AEGIS. The data that I'm finding is early. Does anyone have any data about the effectiveness of maintenance therapy?
Hey Scott,
Haven't been around for a while and was catching up. Read about your relapse and wanted to express my sorrow and provide some encouragement to you and all. Regression of fibrosis and even cirrhosis can happen, even without clearing the HCV. If you recall, I had my first biopsy in September of 02. Stage at that time was a 4 on the Metavir system. Compensated cirrhosis. I went on tx with Peg/Riba combo in January of 03 and stayed on for 9 months. Never cleared. I switched to the Mayo clinic where they reevaluated my old Biopsy samples and graded them a 5/6 on the Ishak scale, confirming early cirrhosis. Was off tx for 6 weeks then started on the alfa(daily CIFN)/gamma/riba tx. Was on for 48 weeks and never cleared. After completion, a second Biopsy was done and was graded 2/3 on the Ishak scale. Not an easy road, but there is hope. I am sure your improvement will be just as great as mine was.
Hoping you have success with your next attempt,
Steve
Haven't been around for a while and was catching up. Read about your relapse and wanted to express my sorrow and provide some encouragement to you and all. Regression of fibrosis and even cirrhosis can happen, even without clearing the HCV. If you recall, I had my first biopsy in September of 02. Stage at that time was a 4 on the Metavir system. Compensated cirrhosis. I went on tx with Peg/Riba combo in January of 03 and stayed on for 9 months. Never cleared. I switched to the Mayo clinic where they reevaluated my old Biopsy samples and graded them a 5/6 on the Ishak scale, confirming early cirrhosis. Was off tx for 6 weeks then started on the alfa(daily CIFN)/gamma/riba tx. Was on for 48 weeks and never cleared. After completion, a second Biopsy was done and was graded 2/3 on the Ishak scale. Not an easy road, but there is hope. I am sure your improvement will be just as great as mine was.
Hoping you have success with your next attempt,
Steve
Scott, is this the paper that you are looking for? It's over 2 years old and was written by the heavyweights....McHutchinson, Poynard, Davis.
HEPATOLOGY, Vol. 35, No. 3, 2002 - "Hepatic HCV RNA Before and After Treatment With Interferon Alone or Combined With Ribavirin".
"Of 400 SVRs, 393 (98%) had undetectable hepatic HCV RNA, whereas 7 (2%) had detectable HCV RNA; 5 have been followed and 2 have had reappearance of serum HCV RNA 12 months after therapy. In conclusion, measurement of heptatic HCV RNA before or after therapy reflects changes observed in serum HCV RNA and correlates inversely with heptatic inflammation and fibrosis, but otherwise has minimal clinical use."
I have a PDF copy but no way to post the entire document here. Try Googling the above title.
Hang in there Scott. I hate this thing with all my heart too and I'm determined to do everthing to kill it.
Mike.
HEPATOLOGY, Vol. 35, No. 3, 2002 - "Hepatic HCV RNA Before and After Treatment With Interferon Alone or Combined With Ribavirin".
"Of 400 SVRs, 393 (98%) had undetectable hepatic HCV RNA, whereas 7 (2%) had detectable HCV RNA; 5 have been followed and 2 have had reappearance of serum HCV RNA 12 months after therapy. In conclusion, measurement of heptatic HCV RNA before or after therapy reflects changes observed in serum HCV RNA and correlates inversely with heptatic inflammation and fibrosis, but otherwise has minimal clinical use."
I have a PDF copy but no way to post the entire document here. Try Googling the above title.
Hang in there Scott. I hate this thing with all my heart too and I'm determined to do everthing to kill it.
Mike.
I am having a problem with posting here and I don't know why?? Anyway, I've done maintenance therapy on the old interferon, Intron-A.
Susan
Susan
I go to the same clinic as you and that is not the info I am getting. While you did do 88 weeks of tx you did just a year of full tx dropping the riba after a year and continually lowering the peg dose after the first year. With the amount of damage you had to your liver, which does affect your SVR percentages, I think going full dose for 72 weeks would have been recommended. I am and was surprised your doc did not recommend this. This is not at all meant to question your choices but just a thought I've wondered about. LL
As a follow up, please note the studies cited in the HCV Advocate newsletter regarding ABSENCE of HCV in hepatic tissue AFTER SVR, after many years. Most studies have borne this out. There are several studies referenced in the linked issue.
Please let me know what studies have shown otherwise. I am not aware that HCV is being found routinely in the liver cells AFTER SVR status is achieved...either shortly after, or many years after. In fact, it seems that in the great majority of cases, the liver continues to improve over a span of years, often going back to low or no damage status. If there were virus 'hanging out' you would have to believe that it would begin replicating at some point, and cause continued damage to the liver.
Of course, I will keep an open mind, and consider any other contrary research...but I do not want to start assuming something that may not be true at all. If we are going to start freaking out about possible liver related HCV coming back to 'get us' we need to see some proof that this is happening...or has a certain probability of happening.
See the link below:
http://www.hcvadvocate.org/news/NewsUpdates_pdf/2.4.3_HCV_Advocate_2001/advocate0107.pdf#search='is%20hcv%20gone%20from%20liver%20after%20svr'
Doubledose
Please let me know what studies have shown otherwise. I am not aware that HCV is being found routinely in the liver cells AFTER SVR status is achieved...either shortly after, or many years after. In fact, it seems that in the great majority of cases, the liver continues to improve over a span of years, often going back to low or no damage status. If there were virus 'hanging out' you would have to believe that it would begin replicating at some point, and cause continued damage to the liver.
Of course, I will keep an open mind, and consider any other contrary research...but I do not want to start assuming something that may not be true at all. If we are going to start freaking out about possible liver related HCV coming back to 'get us' we need to see some proof that this is happening...or has a certain probability of happening.
See the link below:
http://www.hcvadvocate.org/news/NewsUpdates_pdf/2.4.3_HCV_Advocate_2001/advocate0107.pdf#search='is%20hcv%20gone%20from%20liver%20after%20svr'
Doubledose
haha I'm with Britgirl and if I make it to 6 month or 1 year post,,,,Clear! I don't even want to think about that still hiding,,,ready to pop out at any time that my immune system is down.
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