Aa
On triple tx with incevik – but not sure how long I should treat for ? (24 weeks or 48 weeks?)
Genotype 1a. Grade 2 Stage 2. Female. ILB28 is TT.
First time treated starting Jan 8, 2008 with Pegasys 180 mcg weekly and Ribavirin 1000 mg daily.
Pre tx VL = 2.8 million IU/ml 2008 Viral Load tests done using HCV QuantaSure Plus (Non Graph) Hepatitis C Quantitation (down to <10 IU/ml ) 2 wk VL = 136,000 IU/ml
4 wk VL = 10,900 IU/ml
8 wk VL = 270 IU/ml 12 wk VL = 20 IU/ml 16 wk VL = < 10 IU (less than 10 IU/ml indicates either complete absence of HCV RNA or in rate cases, low copy of number below the detectable limit of the assay). But stopped treatment as I was told I had a low chance of SVR.
Current triple treatment information: Viral load prior to current triple treatments is 1.79 million or 3.12 million (see below) Current VL results using Quest Heptimax (Hep C Viral RNA, Quantitative TMA ( 24 weeks vs. 48 weeks ? Based on my previous treatment in 2008, I was wondering if I can be classified? (as a Relapser or a Partial Responder or do I not fall into a category?)
Thanks. Ginger
First time treated starting Jan 8, 2008 with Pegasys 180 mcg weekly and Ribavirin 1000 mg daily.
Pre tx VL = 2.8 million IU/ml 2008 Viral Load tests done using HCV QuantaSure Plus (Non Graph) Hepatitis C Quantitation (down to <10 IU/ml ) 2 wk VL = 136,000 IU/ml
4 wk VL = 10,900 IU/ml
8 wk VL = 270 IU/ml 12 wk VL = 20 IU/ml 16 wk VL = < 10 IU (less than 10 IU/ml indicates either complete absence of HCV RNA or in rate cases, low copy of number below the detectable limit of the assay). But stopped treatment as I was told I had a low chance of SVR.
Current triple treatment information: Viral load prior to current triple treatments is 1.79 million or 3.12 million (see below) Current VL results using Quest Heptimax (Hep C Viral RNA, Quantitative TMA ( 24 weeks vs. 48 weeks ? Based on my previous treatment in 2008, I was wondering if I can be classified? (as a Relapser or a Partial Responder or do I not fall into a category?)
Thanks. Ginger
this was really frustrating to me when I started. I got a little pissed at the docs: it was 12 weeks, or 24 or 48. I was like wth? The Table 1 in this explained a lot for me and cleared it up. Sounds like you are not treatment naive (you have been treated before) and it depends at what your blood work says at certain intervals.
http://pi.vrtx.com/files/uspi_telaprevir.pdf
http://pi.vrtx.com/files/uspi_telaprevir.pdf
This data is from the results of the phase III trials with telaprevir.
http://www.clinicaloptions.com/Hepatitis/Annual%20Updates/2011%20Annual%20Update/Modules/DAA%20Naive/Pages/Page%206.aspx
http://www.clinicaloptions.com/Hepatitis/Annual%20Updates/2011%20Annual%20Update/Modules/DAA%20Naive/Pages/Page%206.aspx
thanks again. my doctor said that type TT gene did not play a role with triple tx....is that relatively new info you posted on TT gene?
Influence of IL28B Polymorphism on Response to Telaprevir
In a retrospective analysis of the ADVANCE trial, patients with the IL28B CC genotype achieved higher SVR rates vs patients with the CT or TT genotypes. Indeed, in the T12PR arm, patients with the CC genotype achieved an SVR rate of 90% vs only 71% and 73% of patients with the CT and TT genotypes, respectively.
---------------------------
as you can see type TT did not fare as well as CC, maybe something to think about and talk to your doctor about.
In a retrospective analysis of the ADVANCE trial, patients with the IL28B CC genotype achieved higher SVR rates vs patients with the CT or TT genotypes. Indeed, in the T12PR arm, patients with the CC genotype achieved an SVR rate of 90% vs only 71% and 73% of patients with the CT and TT genotypes, respectively.
---------------------------
as you can see type TT did not fare as well as CC, maybe something to think about and talk to your doctor about.
If nothing else i would extend as long as possible, i take a sledge hammer approach when it comes to treating, the thought of going thru this and not giving it your all just scares me.......... I couldn't sleep at night with the way some doctors are doing this treatment.
Wishing you the best on whatever you decide.
Wishing you the best on whatever you decide.
After I posted I was thinking your prev. status was a bit of a grey area and that your doctor may want you to extend to be on the safe side.
Personally Ginger , .in your position ,unless I was having just a (not-doable time ) with tx. I would give serious thought to the extended time and then you know, as the doctor seems to be suggesting, you did all you could.
However ,it is always an individual decision to made made with your doctor....
Good luck ...
Will
Personally Ginger , .in your position ,unless I was having just a (not-doable time ) with tx. I would give serious thought to the extended time and then you know, as the doctor seems to be suggesting, you did all you could.
However ,it is always an individual decision to made made with your doctor....
Good luck ...
Will
yes, when I said "post tx" i did mean UND at week 2 with the triple tx. My doctor said he did not think I could be classified, and he is wondering if 48 weeks is best for me. I am not having an easy time with treatment and 24 weeks of treatment certainly sounds better than 48 weeks, but I do want to give myself the best chance....if the extra 24 weeks were to make a difference. thanks all. ginger
Prior Relapser: Defined as a person whose hepatitis C virus was undetectable at the completion of at least 42 weeks of a prior course of therapy but whose virus became detectable during the follow-up period.
Prior Partial Responder: Defined as a person who achieved at least a 2 log10 reduction in HCV RNA at week 12, but whose hepatitis C virus never became undetectable by week 24 of a prior course of therapy.
Prior Null Responder: Defined as a person who achieved a less than 2 log10 reduction in HCV RNA at week 12 of a prior course of therapy.
http://www.hivandhepatitis.com/2011_conference/easl2011/docs/0401_2010_b.html
Since you had a 2 log drop at week 12, and were und by week 24 even though you didn't do 42 weeks of treatment to be an offical relapser thats what i would call you.... The only difference it seems is your doctor was smart and saved you from going on only to relapsed at EOT.
Prior Partial Responder: Defined as a person who achieved at least a 2 log10 reduction in HCV RNA at week 12, but whose hepatitis C virus never became undetectable by week 24 of a prior course of therapy.
Prior Null Responder: Defined as a person who achieved a less than 2 log10 reduction in HCV RNA at week 12 of a prior course of therapy.
http://www.hivandhepatitis.com/2011_conference/easl2011/docs/0401_2010_b.html
Since you had a 2 log drop at week 12, and were und by week 24 even though you didn't do 42 weeks of treatment to be an offical relapser thats what i would call you.... The only difference it seems is your doctor was smart and saved you from going on only to relapsed at EOT.
Hi Ginger...
If in fact the PCR at the 16 week mark was considered UND. then as cando mentions it would put you in the "relapser" category and the INCI.dosing label recommends that prior relapsers who get an eRVR(which you have ) do 24 weeks.
It also mentions that cirrhotics "may" benefit from doing 48 weeks,so your fibrosis score should also be taken into consideration.
If you doctor is knowledgeable with treating HCV and possibly has some experience with Incivek in trials,he/she would be the best one to make this call.
If he/she has no experience with Inci. possibly he can contact someone who would best guide him ,as this is an important decision for you.
Good luck..
Will
When you say "post tx" i guess you mean und at week 2 of tx? Sounds like you were a relapser sense you became und during your first tx. I would say 24 weeks..........good luck
Sorry for the confusing format. Here is my Current treatment information: Viral load prior to current triple treatments is 1.79 million or 3.12 million (see below)
Current VL results using Quest H.eptimax (Hep C Viral RNA, Quantitative TMA (<5 IU/mL))
6/22/11 vl (pre-tx )was 1,793,525.
9/23/11 vl (pre-tx) was 3,122,098.
Started tx on 9/28/11: taking Incevik 2250 mg/day, along with Ribavirin 1000 mg/day and Pegasys 180 mcg/wk.
Post treatment viral load results:
10/5/11 vl (1 wk) was 129.
10/12/11 (2 wk) vl is UND.
I am still UND
Current VL results using Quest H.eptimax (Hep C Viral RNA, Quantitative TMA (<5 IU/mL))
6/22/11 vl (pre-tx )was 1,793,525.
9/23/11 vl (pre-tx) was 3,122,098.
Started tx on 9/28/11: taking Incevik 2250 mg/day, along with Ribavirin 1000 mg/day and Pegasys 180 mcg/wk.
Post treatment viral load results:
10/5/11 vl (1 wk) was 129.
10/12/11 (2 wk) vl is UND.
I am still UND
Have an Answer?
You are reading content posted in the Hepatitis C Community
Learn about this treatable virus.
Getting tested for this viral infection.
3 key steps to getting on treatment.
4 steps to getting on therapy.
What you need to know about Hep C drugs.
How the drugs might affect you.
These tips may up your chances of a cure.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
