RVR and 4 weeks

[Upbeat]

I know that is is the normal time frame for checking on RVR.  I remember reading about a study that said you could gain the same info for just a couple of days.  Does anyone have a link to this study or any info?  

[newleaf09]

I read those and lost them in the big research shuffle.  I think Proactive has given you the correct links on viral kinetics.  I started with low VL and geno 1b and was undetectable at my 1st PCR at 10 days.  What that did for me was offer immediate encouragement and the will to put up with anything from the treatment that came along.  My blood has crashed repeatedly and I had to go off meds for a few days to recover platelets but it's all okay.  RVR is about 89% guaranteed for SVR.

I'm in a study so PCR's are frequent.  I know some people with private docs and limited finances may wait a long time for the first one and I would have found that unbearable.  I needed the encouragement.

[Proactive]

Kinda flies in the face of the predosing ribavirin benefit theory
"Ribavirin does not enhance the first or second viral elimination phases; however, a third elimination phase became apparent in some patients treated with peginterferon alfa-2a and ribavirin, but not in those treated with peginterferon alfa-2a alone."

[Proactive]

Viral Kinetic studies (24-48 hr response etc.)
http://jac.oxfordjournals.org/cgi/content/full/53/1/15
http://www.medigraphic.com/pdfs/hepato/ah-2002/ah022b.pdf

[orleans]

Alinia stuff----
http://www.hivandhepatitis.com/2008icr/easl/docs/050608_b.html
http://www.hivandhepatitis.com/2008icr/aasld/docs/120208_a.html
http://www.medhelp.org/posts/show/338944
http://www.medhelp.org/posts/show/342441

[Upbeat]

This would be my first treatment. No way I can see a hepatoloigst. There is only one here in Tucson and the wait would be over a year.  The best I can do is the hepatoloigsts nurse. my hemoglobin is 16.1 right now.  I tried to see the people at mayo in Phoenix but they don't like blue cross even with the fact I have a ppo. My way of thinking it would be over kill with a biopsy.  I understand blood work is not as accurate but on the far end of the numbers they are pretty good.  With me its ast 125 alt 203  platelets 121 even the protein numbers are a little elevated. Throw in the diabetes and it leaves little doubt. Again thanks for the insight it is much appreciated

[jmjm530]

Don't have the time frame handy but if you post a new thread with "Alinia" in the heading, I'm sure you will get lots of responses as many here have incorporated Alinia into their treatment. Pre-dosing ribavirin is not very well studied but if I had to do it, I'd probably start the riba 2-4 weeks prior to my first peg injection and have some Procrit (epo) on hand if possible. Will this be your first treatment or do you already know how your hemoglobin will react to the riba? Personally, I'd do the biopsy as blood numbers aren't that accurate unless perhaps a very good hepatoloigst convinced me that I didn't need it based on his clinical assessment, which leads to the next question -- will you be treating with a hepatologist? Very important as gastro's really don't know their stuff and would also be less apt to let you tweak things off SOC. In fact, a study showed better results with hepatologists versus gastros and that is not surprising. There have been a number of recent studies suggesting a negative relationship between IR and SVR, but not sure how that works with diabetes. Again, you might want to post to that and also check out some of the material in "CoWriters" journal.

[Upbeat]

Thanks.  I had forgot about Alinia.  Whats the time frame for pre-dosing?   I am 6'0 and only weight 165 lbs so I guess ny BMI is fine.  I do have diabetes  so I don't know about the IR.  I can't get an appointment until the 2nd of June so I have time to set my  program.  the best I can do is a nurse at the UMC here in Tucson and I have a feeling I will know about it than her.  They may want to do a biopsy but I will pass on that.  My blood numbers are bad and with every blood formula I have done it looks like f-3 to f-4.  

[jmjm530]

There have been smaller studies using 24 hours and 48 hours but the data is not quite as mature as the week 4 data. Personally, I was tested weekly until UND and while the earlier data may not have been mature it does offer a more cutting edge medical team some opportunities to tweak things. If I had to treat all over again, I'd probably do the 24 and 48 hour tests as well, insurance permitting. Not only would it feed my obsession and curiosity, but in the event of relapse this info might be very important as future studies may give us a more mature take at what that data actually means.

Are you putting together a treatment plan? Forgot your stats but consider pre-dosing ribavirin and Alinia and getting down to your ideal BMI as well as testing for Insulin Resistance (IR).

[HCA]

You can predict response to interferon after forty-eight hours,however this is not the same as RVR.
RVR trumps all other factors as viral suppression at four weeks means that the virus has not had time to mutate successfully before it is effectively anihalated.