Need Advice on Tx course

[BostonGirl]

I know many of you have done tx 2, 3 times and have a lot of experience, so I trust your judgements. I really need some help here.

I recently had my 12 week PCR. I was previously 55,967,000 and dropped to 19,000. That is a great drop and I am pleased. ( I am 1A, so 48 weeks required )But now, all my doctor agree that 18 months, possibly longer GGGRRR> of tx will be required.

Now here's the part that is confusing. Early into the tx,like the 3rd week my PCR dropped to 303,000 which means 9 weeks later ( at the 12 week mark )I didn't really drop that much.

I e-mailed Dr. Cecil and asked for his advice. His opinion is that I need double doses of Peg or I should switch to daily infergen.

I am also having progression in my cryo. So, I will be seeing another specialist about possibly adding another drug to tx the cryo during the Peg treatmemts.

My questions to slow responders > would it be beneficial to do double doses of Peg at this point or switch to infergen? My doctors seem to think I should continue the current 180 per week and just extend the tx.

Also Dave, I know you did that additional drug for your cryo and I would like to know at what point into tx did you clear the HCV and cryo? were you also a late responder to the Peg? And do I need to be clear of HCV to start the rutuxin? The Hemo said she has mixed feelings on using this drug, but we will talk about it if I still have cryo at 6 months. meanwhile, I am getting a second opinion on the cryo and doing a lot of praying.

Thanks ahead of time for all your resposes. ((( Sue ))

[willing]

a very rapid initial drop in viral count which slows until the virus drops below the detectable level is the standard response and doesn't indicate there's anything wrong (virus begets more virus, also as the ifn turbo-charges your immune response, it's much easier for it to first eliminate free virions in blood serum than virus replicating in cells). In making  decisions about how long to go and how much ifn to take it's worth taking the time to evaluate the basis of advice you receive. The most reliable recommendations are those based on the large-scale studies since they yield believable odds for various outcomes. Unfortunately, as in your case, there's never enough data and it comes down to judgment, or informed guesses. I haven't kept up with recent studies since I finished tx but, with  all due respect, I doubt Dr. Cecil has much data to support his advice. If you look at the response rates you'll find that most of the time when combo tx works it starts working early on. Your 3.2 log drop is pretty compelling evidence it's working, but the fact that you're not undetectable at 12 lowers your response odds significantly.  To find out whether going to 72weeks will really help those odds it's probably worth digging through the current studies. I went through the same issue around my 12th week and decided not to extend past 48 since what little data there was  showed little benefit. However I'm sure more studies have been published in the past 1.5 years, and your drop is typical of the  "slow responder" most likely to benefit from extented tx (besides, the cryo may provide its own reasons for continuing)..best wishes

[bon_vivant]

Hey.... I say the longer the better... & especially in your situation... (because you did not clear completely at 12 weeks)

On my first round, I had over a 4&1/2 log drop at 12 weeks...  but was not completely clear.... (This should have automatically bumped me up to the 72 week mile marker)....

I was Undetectable by 24 weeks (even with the wrong dosage) so I am definately a responder.... I was still clear 2 weeks after my TX ended the first time... but by the 3 month ck up... I had relapsed....

I wish I would have extended THEN.... because, in all probability, I'd already be done with it by now, & not doing this second round...

So YES, YES... extend as much as possible the first time...
Why Risk it.... better to add to an already existing 48 weeks... then to have to start all over from square one again!!!!

Just My Opinion!!!!
:)