Triple Therapy: Apparent Complete Failure

[AHNOLD]

Hi everyone. I'm new to this board but I've followed it for the past few weeks.

I'm a 29 year-old male and I was diagnosed with Hep C (genotype 1a) in November 2010 after a routine blood test. I, for the life of me, have no idea how I got it. The most likely candidate is that I got it just after birth in 1981 (I was a blue baby and needed some blood transfusions).

Anyway, I got a biopsy done this past January and the results were good: Stage 1 Fibrosis, no red flags.

I started triple therapy with Incivek, Ribavirin, and Pegasys around mid-September. Other than the first night of my shot, I have had basically zero side-effects. I still lift heavily, row, go to work, travel almost weekly,etc... Weekly blood tests hardly registered any changes in my hemoglobin levels, platelet levels, etc... However, the 4-week results were surprising, to say the least.

My viral load count went from 840,000 before to 620,000 after 4-weeks of strict treatment. Obviously treatment has failed and I'm curious to see if anyone here has received similiar results. I know data is limited on this, but does anyone know (either through personal experience or anecdotally) how I could be such a significant non-responder? Are there any indicators that could explain this?

I'm very active and I have a large appetite so I've had no problem eating the gobs of fat necessary to consume Incivek and, to a degree, Ribavirin. My diet is pretty good. I avoid fast food, I don't eat out often, I eat organic when I can, and I consume plenty of protein and water (a gallon+ a day) given my active, gym-going lifesyle.

I'm going to see the doctor on Tuesday to get answers to my questions and map out a plan. But I just want to see what I could glean from this community. Thanks!

-J

[can-do-man]

Sorry about the news, fact is you had no response, while 1400 riba might have been better 1200 would not have caused this, nor would have changing, testing or doing anything else i've read here........ You gave it your best shot and hopefully new drugs will provide you better results. Though i do agree the lead in would have spared you the third drug and your case is a good reason for one.

You have time on your side so i wouldn't dwell over this..... Best to you going forward.

[Willy50]

My 2 cents; what paen said; you may not have had quite enough riba.(although you took the prescribed amount).  Occasionally it seems to me that a lead in would be a good idea, as if one had been done here you might not even have been administered a PI.

Some folks also find that IR issues may weaken immune response, although that doesn't sound like a probable in your case, but one never knows.

Vit D levels might be checked...

FWIW the geno 1a is harder to treat than 1b, and one may have increased resistance issues; not due to your response per se, but the PI may be less effective on 1a than 1b.

Did you do the fats intake w/ incivek dosing?

The good news is that you found out relatively soon.  You stopped before significant resistant virii generated.  You can wait and when you treat next you'll probably find that the new forms of treatment will be shorter, more efficacious and easier.

I am sorry that it didn't work out....

best,
Willy

[AHNOLD]

Thank you very much for the well wishes and expressions of hope. While I was disappointed with results of treatment, I do feel optimistic about my health and the incoming generation of new treatments!

[AHNOLD]

I'm approximately 6'1 and 225-230 lbs. While I haven't measured it in a while, I'd say I have 15-20% (probably closer to 20%) body fat. In light of this, my Ribavirin dose was 1200 mg per day.

While I was told my blood work showed *some* impacts from the treatment (I never asked for specifics as I always felt great and I was told I was responding swimmingly), I never really felt off, ill, tired, under-the-weather, or any of the side effects discussed in this community. In other words, I wasn't restricted at all from living my life normally.

Given the preponderance of patients that seem to have noticeable side effects, I do think it's odd I didn't seem to have any. Maybe this could (partly) explain why I didn't respond? Again, I'll ask my doctor.

[AHNOLD]

Thank you very much for the well wishes and the insight. That's a very interesting regarding the IL28B gene - I've never head of that before. I assume you know much more than me at this point, but I found an article (http://www.hivandhepatitis.com/2011_conference/easl2011/docs/0404_2010_a.html) saying that Telepravir improves the chances of SVR regardless of IL28B type. Have you heard of this?

Regardless, I'll bring it up with my doctor on Tuesday. Thanks!

[paen53]

Curious to know if your Ribavirin was dosed high enough for your weight.  You mentioned that your hemoglobin hardly budged even with the Incivek....