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

[drofi]

Smaug, great news! This is the next milestone for you.
I have done shot 82 today and hope to do 88 or better 90. My sides do not increase in a linear way, week 80 was not worse than week 60, even better. IFN and riba are strong drugs and each decision is an indiviual decision of course. What is possible for me might not be possible for another person.
Some weeks ago I met Berg myself and he supports my decision to continue. The problem with all the studies about 48 or 72 weeks is simple: these studies looked at 48 or 72 only, nothing else. There is no rationale at all to treat two persons for the same length of time, if person A was UND at week 13 and person B was UND at week 23 or even 24. The old studies jused low riba concentrations and there are several other drawbacks of the studies. I probably have all the publications here, unfortuantely some good reviews are written in German, eg http://www.kup.at/kup/pdf/6497.pdf
Sure, there is no guarantee. But I myself would feel much better with a relapse after week 88 than after week 72.
All the best for you and all other heppis around :-)
Have a nice weekend and don't forget there is more to do at a weekend than thinking about a virus.
drofi

[jmjm530]

I really don't know what more I can say. Shiffman's paper is relevant because he clearly states that one should stop at week 24 if still detectible. "Smaug" appears to agree that this is what Shiffman is saying  (see Smaug's last post) when he says "I agree that Shiffman is clearly saying that they won't SVR." with "they" being those who are still detectible at week 12. This doesn't mean he agrees with Shiffman, just agrees that is what Shiffman is saying. For those interested, hopefully they will read the entire thread as well as the Shiffman paper and come to their own conclusions as to relevancy. Better that for me to keep repeating myself because I have nothing more to add.

[Proactive]

Does anyone have access to this article? I hit on "96 weeks", but can't view the article TIA.
"Treatment of relapsers after combination therapy for chronic hepatitis C .  Gastroenterology Clinics of North America , Volume 33 , Issue 3 , Pages 513 - 526 F . Ahmed , I . Jacobson"
http://linkinghub.elsevier.com/retrieve/pii/S0889855304000548

[zazza]

Too bad you will not read my post.

What I meant was that there is no reason for me to try to understand your contradicting interpretations when I can read what Schiffman says himself. I do not find this Schiffman paper relevant at all in the discussion of extended tx for super late responders. I cannot see that he even touches this subject.

But I have read every word you have written in this thread. Too bad you will not do that for me.

[jmjm530]

Zazza: I actually will not waste my time trying to understand your interpretations.
-------------------------
Then I will not waste my time reading the rest of your post :) Have a nice weekend.

[zazza]

Just so you know, I have read every post in this thread, but one of your posts and Smaug's last post were written when I was writing mine, so I did not see them until afterwards.

"Are you suggesting that Shiffman is saying that if you aren't UND by week 24 that you will never be UND? I think he's clearly talking about sustaining an UND status to SVR."

I cannot see how this statement fits with your later posts. That is why I am asking if you changed your mind. I actually will not waste my time trying to understand your interpretations.

Have you read my post?! I am saying f!ck the Schiffman paper and let's concentrate on discussing the studies that actually are looking at extended tx for super late responders.

I am not at all disregarding stopping at week 24 if detectable. This has always been my recommendation (knowing very well I am a layman) to all detectable at this time. But I find this new study interesting. Maybe there is something such as a group of super late responders who would benefit from extending tx beyond 72 weeks. In my mind this is worth looking at. And of course I am being as critical as always when looking at a study, as you ought to have noticed if you read my post above.

Smaug had already decided to go 72 weeks before he saw the Arase study. I understand that he tolerates tx well. So why should he not indulge in this study, talk to Dr Dietrich, find out all he can and figure out if what he finds has any impact on how long he wants to tx.

My own experience is that tx was tolerable all through my 72 weeks. The worst part was between week 5 and 16, so a long tx does not scare me. I am now 4 months post, and completely back to normal. I know all are not as blessed in this way as I, but this is my reality. I hope Smaug will be as lucky as me in this regard.