UND at week 28, finally!

[smaug48]

I just heard that my week 28 PCR was negative - YES!!!  What a relief.

I'd like to take this opportunity to thank everyone for being here - you guys are helping me keep my sanity while going through tx!

According to a new study posted by drofi (I'll call it the Arase study, the first author's name), these were the SVR %'s for super late virological responders, which was defined as achieving und between weeks 25-48.  The patients in the study were geno 1b.

Continuing tx for:
20-29 weeks after und - 18% (2 out of 11 people)
30-39 weeks after und - 20% (1/5)
40-49 weeks after und - 40% (4/10)
50-59 weeks after und - ND  (couldn't find in the study what this stands for)
>=60 weeks after und - 100% (2/2)

I wish people would stop saying that not getting to und by week 24 means a 2% chance of SVR!!!

Here is the link for the study
http://www.jstage.jst.go.jp/article/internalmedicine/47/14/1301/_pdf
or  http://tinyurl.com/5efhmy

I am geno 1a.  My understanding is that tx for g1a  and 1b is identical, so I can apply these results to my case.  Does anyone have a different opinion on that?

smaug

[jmjm530]

Behave yourself or I'll make it disappear again :)

[Trinity4]

Ooops!!  Must be on my end - I must be the one having the senior moment!  It really wasn't there a minute ago.

[Trinity4]

Are you having another senior moment -  you name is showing 2 min ago but no post?  Where did it go to?

[jmjm530]

Smaug: Didn't you mean to say those who are still detectable at week 24?
--------------------------
Yes, thanks for the correction! And yes, have a good weekend !

[smaug48]

from Jim's post: ""I agree that Shiffman is clearly saying that they won't SVR." with "they" being those who are still detectible at week 12.""

Didn't you mean to say those who are still detectable at week 24?  In my post "they" are those who are still detectable at week 24.

Thanks for the good wishes, drofi!!

Just like it doesn't make sense to treat two people the same amount of time if one is UND at week 13 and one is UND at week 24, I think it doesn't make sense to say that someone who isn't UND at week 24 has no chance of getting to UND at all (which is what Shiffman is saying).

Each individual case should be considered. In my case, I had a 2-log drop at week 12, and a very clear downward trend to UND.  If I had listened to Shiffman, I would have given up by now, which I hope everyone would agree would have been the wrong thing to do, because I did make it to UND.

That is why I don't think it is right to say flatly that people who are not UND by week 24 have no or 2% chance of SVR - it's not that simple.

But anyway, I really liked the last line of drofi's first post - let's enjoy the weekend!!!

:-)

smaug

[drofi]

btw, there is a new publication from Berg, published some days ago:

Tailored Treatment for Hepatitis C
Thomas Berg MD , a,  
aMedical Department Hepatology and Gastroenterology, Charité, Campus Virchow-Klinikum, Universitätsmedizin Berlin, Berlin, Germany

Available online 12 July 2008.

Considering the high number of global cases of hepatitis C virus (HCV) infection (around 175 million), effective, individualized, tailored treatment approaches are imperative. In this respect, defining patients according to their initial response profiles was shown to have great impact on choosing the optimal treatment duration. The application of new more sensitive HCV RNA tests may further help to improve treatment individualization. In spite of the many relevant studies conducted in the past and at present, however, this problem is far from being resolved. Generally, it can be said that the presence of a rapid virologic response is a significant predictor of favorable outcome and permits an abbreviated treatment period. In contrast, patients who have a slow response have a high risk for relapse but seem to profit from extending treatment duration. This viral kinetically driven approach to tailor treatment is generally applicable to all genotypes.
Article Outline
Principles of tailored treatment in hepatitis C virus type 1
Importance of the sensitivity of the hepatitis C virus RNA test
Experiences with shortening treatment duration in hepatitis C virus type 1 infection
Definition of a new hepatitis C virus RNA cutoff to predict sustained virologic response
Experiences with extending treatment duration in hepatitis C virus type 1
Predicting relapse according to the hepatitis C virus RNA-negative interval during treatment?
Summary of the current concepts of tailoring treatment duration in patients who have hepatitis C virus type 1
Principles of tailored treatment in hepatitis C virus type 2 and 3 infection
Experiences with shortening treatment duration in hepatitis C virus type 2 and 3 infection
Extending treatment duration in those who are slow to respond
Summary: tailored treatment for hepatitis C virus type 2 and 3
References