When to stop treatment????

[Mimi4141]

Hello again!  I just wanted to thank everyone for being here.  The information we have gained has been so helpful!!!

Today the doctor (he was coving for a regular GI) was telling my husband he should think about stopping treatment.  He is stage 4 cirrhosis, Hep C 1b.  Pre treatment viral load was 2 million, 12-week viral load 275, 19 week viral load 59, all done with the Hepamax.  The doctor said that since he did not clear at 12 weeks his chances were less than 5% for the medication to work. He is on pegasys 180 mg + ribavirin 1200mg a day.  

I do know that it was not good that he was undetectable at week 12, but I did not know that his chances were that bad.  The doctor did not seem very positive about his response to treatment and stated that he was not a very good candidate for treatment from the start due his platelet count.  However, his platelets were within normal limits the last lab draw.

Does any one have any information on what he should do?  He has gotten very sick, but is a fighter and refused to stop treatment.  The doctor said that he would not test the viral load again until week 48.  I thought that after someone reaches undetectable the treatment would continue for another 26-28 weeks, or something like that.  

Any suggestions or input would be greatly appreciated.

Airborne's wife

[tulsatime]

I always say they will take me out of this world
"kicking and screaming" I am fighting till the end!

[Fisheress]

Hey nyg, just noticed you were looking for Beagle dog......well I had promised him a nice personal walk by me in celebration.  Today he is at the beagle spa (been out chasing wabbits and getting dirty) getting all cleaned up for our walk today.

I am sure he will chime in when he is done, maybe after spa and before walk.

Later,
Fisheress

[Dale_Ray]

Snookmiester's answer is my understanding, as explained to me by my doctor. At 24 weeks if he were UND then tack 36 weeks on it. Everyone is different though and even if he is pulled from this treatment keep watching for the new stuff. We heppers are becoming such a burden to the health care system that they are going to have to cure us or shot us. Good luck to your family in getting through this thing. Dale

[cuteus]

just remember that 36 wks from undetectable is a suggestion not based on any factual studies, it is a medical guess. If you can tolerate longer tx, don't stop at 36 wks, especially if stage 4. I would go at least 48 wks from clearing.

[jmjm530]

My doctor suggested the same 48 weeks beyond clearing and no doubt would have let me go even longer had I wanted. As a stage 4 -- depending on how well you're tolerating tx, general health, etc, -- it's certainly something to consider. But in any event, you really need that week 24 test to see how well the drugs are taking. Hopefully, your regular GI will be more amenable than the doctor filling in. If not, you might want to seek an outside consult with a liver specialist (hepatologist) who may have more experience in treating slower responders with more liver damage. All the best.

-- Jim

[NYgirl]

That "sounds" like a good answer but my doctor says that in order to really do it RIGHT you have to do 72 instead of 48 (like Cuteus did and I will do).  It's NOT just add 36 on as we mostly believe. For example he said there is NO such thing as a '60 week' course of treatment.

He said that there is no such thing as adding a few random extra weeks, that PROTOCOLS have been established and the medical field doesn't take it lightly...and shouldn't just 'guess' and add on weeks.  This is the reason he is sending me to Dr. Jacobson for a second opinion to make SURE I should do the extra time.  It's a LOT to have to go to 72 instead of 48.  

(And I have to pay cash for Dr. J $600 for the one visit...but it will be worth it for HIS opinion you know? I'll wait and submiit out of network knowing that no matter what he says at least I've done the MOST possible to make sure I am not going to 72 for no reason).

Some people won't agree with him but he's an awesome doctor who wants me to have EVERY chance at beating this thing, and as a 1A and 1B my chances STINK...so I will do what I have to.