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87972 tn?1322664839

Treatment Revision

Hi all,

I recently met with a hepatologist to discuss end of treatment details; I was previously scheduled to conclude treatment tomorrow, January 25. Based on new data, we determined it would be in my best interest to continue with my current regime for a total treatment period of two years.

Soooo… I’m currently in treatment week 71 of 104, with PEG-Intron 204 µg/week, and riba 2.0 g/day. Currently, I’m now scheduled to conclude treatment Sept 15, ’08.

A quick overview of my history and stats for anyone interested:

Dx 11/04 with HCV GT-1
Grade 3, Stage 3/4 per biopsy 1/05
Commence treatment 2/05 with Pegasys/Riba
Slow response at 12-week juncture; did not achieve 2-log drop
Increase riba dosage to 1800 mg/day, and extend Tx to 56 weeks.
Achieve UND (<50 IU/mL) by week 20
Experienced moderate sides with mild depression, severe fatigue, and significant diarrhea.
Relapsed at 30 days post Tx.

Commence re-treatment with PEG-Intron/riba 9/06.
Assigned dosages are as follows:
PEG-Intron 204 µg/week (~2.31µg/kg/week)
2.0 g ribavirin/day (~23.1 mg/kg/day)
Baseline HGB was 17.4; currently at 13.1 (no EPO required)
HCV serum RNA negative per bDNA (<615 IU/mL) assay week 4
HCV serum RNA negative per TMA (.74 = F-4, cirrhosis). While these specimen results may have been skewed due to gross hemolysis/haptoglobin results (the test sample was taken during treatment), my proven histology from biopsy in early ’05 indicated late stage 3, early stage 4 damage. Given that I have demonstrated progressive liver disease, it’s not out of line to assume I have indeed entered into cirrhosis since the last biopsy.

The rather disappointing results from the HALT-C study just released in the ’07 AASLD meeting in Boston played a roll as well; there are very few options outside of eventual transplant available for me in the event of potential relapse, *at this time*.

My liver is fully compensated, my lab values remain strong, and I tolerate treatment relatively well, from a subjective as well as hematological standpoint. I’m pre-approved for meds through Schering-Ploughs Commitment to Care patient assistance program; additionally, I was approved for SSI last year. I’m socially, financially and psychologically in decent shape; might as well take my lumps while my health holds up.

I thought I’d post this info to help others gain perspective into their own treatment protocol, maybe some of us can learn from this.

Here’s to wishing everyone well in there own travels;

Take good care, all—

Bill

27 Responses
87972 tn?1322664839
Copy and paste let me down. From the line "HCV serum RNA negative per TMA *should have read*:
~~~~~~~~~~~~

HCV serum RNA negative per TMA (<05 IU/mL) week 8

No exogenous EPO or GCSF meds have been required over the last three years.

*To date*, side effects  have been tolerable; I no longer walk or run, and this has had a negative effect on  my blood glucose control somewhat. I’ve experienced some moderate fatigue and occasional nausea to date. I know there’s plenty of time left for that to change ;o), but I’ll take what I can get.

The decision to push longer treatment was based on a number of factors; I recently scored .93 on a Fibrosure test. While these specimen results may have been skewed due to gross hemolysis/haptoglobin results (the test sample was taken during treatment), my proven histology from biopsy in early ’05 indicated late stage 3, early stage 4 damage. Given that I have demonstrated progressive liver disease, it’s not out of line to assume I have indeed entered into cirrhosis since the last biopsy.

The rather disappointing results from the HALT-C study just released in the ’07 AASLD meeting in Boston played a roll as well; there are very few options outside of eventual transplant available for me in the event of potential relapse, *at this time*.

My liver is fully compensated, my lab values remain strong, and I tolerate treatment relatively well, from a subjective as well as hematological standpoint. I’m pre-approved for meds through Schering-Ploughs Commitment to Care patient assistance program; additionally, I was approved for SSI last year. I’m socially, financially and psychologically in decent shape; might as well take my lumps while my health holds up.

I thought I’d post this info to help others gain perspective into their own treatment protocol, maybe some of us can learn from this.

Here’s to wishing everyone well in there own travels;

Take good care, all—

Bill

Avatar universal
Well Bill, you have a great attitude and tremendous determination. I do admire you. I wish you a great result this time around and you're certainly off to a good start. Congratulations on that and good luck. Mike
87972 tn?1322664839
Thanks for the good words, Mike; Take care of yourself;

Bill
Avatar universal
You have balls of brass my friend....I will never mention again my taking nearly 4000 ribas during my 72 week excursion....quick hand calcs say you will have taken 7500 ribas + of the little ctitters on your trip....unreal!! ...I hope at least you get tablets, the big white generic capsules suck!!!....can even fit them in the am/pm pill box! (g).
Best of luck in your continued journey...pro
Avatar universal
god bless america and all the ships at sea. what a tour of duty, 104 weeks!
yikes!   glad to see you are holding up well though. i dont see how you do it
but evidently youve got the patience.
go ahead and blaze that trail warrior.
223152 tn?1346981971
Oh, my friend, what a long haul.  September 08 you say now?  So you will have been txing with only a short break since Feb 05. Throughout it all, you have maintained your witt and humor.  Heck, Bill, if I didn't know better, I would say a doctor wrote your post!  Boy we do become knowledgable in the ways of this disease, don't we.  

You are taking it well, better than most, I suspect.  I am glad you have a good team.  
bean

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