Relasped 48 weeks should I go for 72 week

[aquarius121]

Any data out there for success after relasped then doing the 72 weeks. I am genotype 3a but treated as 1a first time. I went neg week 9 and stayed there through tx then 3 mos the virus was back. My doc says I can retreat or wait 2 years for new drug. Any imput might help me decide. Thanks

[comeagain]

HI I`m a geno 3 same as you  relapsed first tx after 24 weeks.
Done a second one 48 weeks that ended  4 months ago.
Will have the result in june if I cleared or not.

As you probably can understand I`m also  interested in getting more facts from your treatment, such as:

How many pcr tests did you do and what sensetivity did they had and when were they done  at 4w, 12 w, end of tx post 4, 12 weeks etc, etc and of course the results?

Do you know how damaged your liver is, was ( done any biopsy)?

Whats your weight (BMI) what doses were you on, any missed doses or reductions?

Did you take any other meds during tx do you have any other diseases HIV, diabetes
or  anything else?

If you gonna retreat on regular soc you better do something new predosing  riba maybe alina  get rid of insulin resistance  maybe double dosing peg for a while.

Yes do everything in your power that possible can upper your chances of getting to SVR.
Thats another reason to get a doc that you can communicate with and are up to date and also willing to do something out of the box ( more than the regular recomended tx aproach!!)

If I my self were to retreat again I would wait for the best new meds and also do what ever I can to upper my chances meaning get as healthy as possible before treatment.

But thats because I have the luxury to do so due to little liver damage.

All the best and sorry to hear about your relaps!!

ca

[Trish77]

"Yeah, but as far as I know there is no such protocol nor is it based on any HCV principle."

Didn't say there was.  Just clarifying the details which is what I said in my post.   Which is why I then went on to ask other questions about the liver biopsy etc.  

"Yes, if she had some other negative pre-tx predictors such as being stage 4, then yes, extending to 48 might make sense, but not solely on pre-tx viral load as stated in the first post. I mean I will be the first to admit I know more about geno 1 protocols so please correct me or direct me to something if I am wrong."

'Zactly.  Which, again, is why I asked about the liver biopsy.  Not everybody gets clear communication from their doc and so I'm asking questions before accepting the situation is as stated, which could be a result of poor communication between doctor and patient.

Trish

[oneatenuff]

Definitely get all your lab work from the treating doc who told you could wait, and get a second opinion from a hepatologist.  If they agree you can wait,  ask how they determine that you are OK to wait.   Have them explain what labs they are or will be looking at to determine that you OK now to wait, and ask them what changes in your future labs would be a red flag to them that you possibly should not wait any long for "newer treatment."  Ask how often you need to be monitored during "waiting" (if you do decide to wait.)   Ask those questions of your current doc, too.

Good luck

[Willy50]

Information that could be useful; your liver damage staging and if you had a dose reduction or stoppage in this last TX.

My sense is that if you responded and cleared at week 9 that bodes well for you.  I also think it speaks well of the doctor if they are doing extra PCR's keeping an eye on your progress.

One question that bothers me is if there was a reason for the breakthrough.
Might it have been a dosage reduction?  If so; why?  
If it was due to low platelets that could call into question your staging.
or it could indicate that your Dr. reduced dosing too easily.....

See?  Not enough info.

If your staging is average and not advanced the new PI's tend to work well on responders.  Those are about 2 years out but the treatment would likely be 6 months and about 60-70% chance of SVR.  (my guess not knowing your particulars)

best,
willy

[Max60]

Aquarius,

Seeing another doctor is good advice. Make sure you contact your 'old' doc first and get a complete set of records detailing tx regimen and all labs done during tx including viral loads.

Someone with current knowledge should be able to give you a much clearer picture.

Or, do you already have copies of the labs and viral loads? Posting them here would generate much discussion. : )

good luck

Max

[copyman]

sorry about your relapse. There is no way in hell I would treat 72 weeks if I were you. Depending on your liver damage I would wait for the new drugs. Consult with a Hepatologist and get a plan together. Another option would be to participate in a trial.
Best of luck

[jmjm530]

Trish:  I'm thinking that might be your doc's way of saying we're going to treat you for 48 weeks the same as a 1a because you're a Geno 3 with high viral load.
------------
Yeah, but as far as I know there is no such protocol nor is it based on any HCV principle.

Yes, if she had some other negative pre-tx predictors such as being stage 4, then yes, extending to 48 might make sense, but not solely on pre-tx viral load as stated in the first post. I mean I will be the first to admit I know more about geno 1 protocols so please correct me or direct me to something if I am wrong.

And keep in mind, I'm still recovering from sleeping on a new outgassing toxic memory foam mattress last night soo I may be missing something or more likely gaining something like maybe an extra toe or finger.
http://www.medhelp.org/posts/show/792524


-- Jim

[Trish77]

Okay.  I'm thinking that might be your doc's way of saying we're going to treat you for 48 weeks the same as a 1a because you're a Geno 3 with high viral load.  Not saying I agree or disagree with that approach, just clarifying what your situation was / is.

I'm interested to know how your first treatment went.  Do you remember what your dosages were for the interferon and the ribavirin? And did you have any dosage reductions at any time?  

How were your side effects, particularly your blood results, your hemoglobin and did you have anemia?

Also, same question as Jim - how often were you tested for viral load during your treatment?

And, last question (for now :), did you have a biopsy and what stage / grade did it put you at?  And when did you have it? Wondering the extent of your liver damage at present.

Trish

[MYS]

I know of several Type 3 patients who treated for 48 weeks, due to chirrosis.  And, at least one who reached SVR after doing the 48 weeks.  
I don't know any type 3s who did 72 weeks after relapsing at the end of 48 weeks.  This is new ground here.
All the best,
MYS

[Nomadpixie]

A ,what sort of liver damage do you have.?....I know here in the Uk if its cirrhotic Geno 3s will get offered 48 weeks Tx..... Px

[jmjm530]

I am a 3a but I was treated as though I was 1a because of my high viral load.
-------------------------
Treatment duration does not get extended solely because of high pre-tx viral load therefore either there is more to this puzzle or miss communication with your doctor or perhaps your doctor is incompetent.

In any event, the first step for this type of decision is to find out exactly what went wrong the first time. That information pared with your stats, including level of fibrosis, should help you and your medical team decide on next steps, be it to treat now, how to treat now or to wait for newer drugs.

I also think it's allso a good idea to get a second disinterested opinion after a failed treatment, regardless of the credentials of your current doctor -- but even more so if your doctor isn't a liver specialist (hepatologist). And that second opinion should be from a hepatologist and ideally one not affiliated with the same group or hospital your current doctor is with.

Curious, you say you were UND at week 9, do you know the sensitivity of that test? Also, at what other weeks during treatment were you tested and what were the results? Did you have an end of treatment test at week 48?

-- Jim

-- Jim

[aquarius121]

Thanks for asking because I was confused too. I am a 3a but I was treated as though I was 1a because of my high viral load.

[Trish77]

Just to be clear ... are you saying you were genotype 1a when you went through treatment the first time .. and now you are genotype 3a?

Just wondering because genotypes don't change like that.  One possible reason for differing genotypes is that your first infection with Hep C got cured and then you got reinfected only with a different genotype.  If that's the scenario, you didn't relapse.