My guess is that if you are not UND at 12 weeks, rather than extend you to 72 weeks of treatment, with the PI's on the horizon, the GI would rather pull you from treatment instead. However - that is your decision as much as his. Frankly, if that's his thinking, I'd agree with him considering that you're minor liver damage and just keep an eye on your progression over the next while. If you're minor liver damage, you have some time on your side to wait out the PI's even if you'd like to get this all wrapped up and done with now. Here's hoping you're UND at 12 weeks however.
Trish
I will these numbers, much appreciated. I will also try to calm down. If there wasn't an alternative in the future I would go for it. However there is no guarantee that these new meds will be released to public. Stuff happens. I'm a worrier. Need to stay positive. Thanks again.
Your doctor is wrong in stating that patients "have less than a 5% chance of SVR" if they achieve a 2 log drop at 12 weeks but are still detectable.
Though there are many variables (dosage amount, degree of liver damage, BMI, adherance to dosage regimen etc.), the figures that I have are:
(and please don't everybody jump on me; these are the percentages I have collected)
UND at 4 weeks = 90% chance of SVR
UND at 12 weeks = 68% chance of SVR
UND b4 24 weeks = 45% chance of SVR (48 weeks of treatment)
UND b4 24 weeks = 57% chance of SVR (72 weeks of treatment)
I jotted them down last year when someone here was good enough to post a link to a video by a prominent hepatologist at a conference in San Diego. Perhaps someone else can remember the link?
Anyhow, see what your 12 weeks results say. My guess is you'll be UND anyway. If not, take it from there. As others have stated, you are a GT-1 who should respond much more favorably to the new PI's that are forthcoming in 2011-12.
Good luck!
Personally I would take the doc's advice and stop treatment if not undetected by week 12. Then wait for the PI's. Not only would you have to treat longer, but your chances of success would go way down if you're still detected by week 12. The odds speak for stopping.
looks to me like you had a 1.08 log drop first 4 wks and another 1.47 log drop
from wk4 to wk8. which means the viral decline speeded up. hopefully it keeps doing
that the next 4 wks+. either way you will have at least a 3 log drop by wk12 and
maybe und or close to it.
A 2 log drop by week 12 (in the absence of UND) is to calculate the decision to extend tx to 72 weeks, an option for those who want to take their chances or who don't have the luxury of waiting to see how the stat-c's play out off-trial. "
I treated for 72 weeks however I had stage 3 liver damage. With minimal damage I and the chance the PIs are coming out shortly, I would not do this - I would wait and retreat if I had that luxury.
There is every chance that you will be UND at your 12 week test - you just have to wait and see and then decide which you would rather do depending on what the VL is. If it were ten for example that would complicate the decision greatly.
If UND, you may still want to get a second opinion from a hepatologist, in case you want to switch to someone more experienced.
With minor liver damage and in today's climate of rapid development with stat-c drugs, I wouldn't hesitate to stop treatment if detected at week twelve; I'd watch and wait under the care of the best hepatologist I could find.
So best wishes on your PCR - the waiting is hard but be sure to tell your nurse to phone you asap and not let the lab report kick around on her desk.
And make sure to get your 12 week PCR done on the day of your thirteenth shot but before you actually do the shot. Or as close to the day as possible.
Regards,
Susan