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Avatar universal

Will this work afraid of research

I've had Hep C for a long time, biopsy in 2006 said precirrosis scaring. The last test show AST 124, ALT 212, I will be starting treatment prescribed: Ribapack ribavirin tablet 400 mg & Ribavirin tablet 600mg dose pack # 56 tablets per month, and peginterferon alfa-2b inj kit 120 Mcg/0.5ml. My qustion is some of the research that I've read was not promising. Do you think this will work? has anybody had this exact prescription?
12 Responses
163305 tn?1333668571
What kind of doctor prescribed this for you, a GI, hepatologist or your GP ?
Avatar universal
Hi..

What  HCV genotype do you have ?

Will
Avatar universal
type3
Avatar universal
GI
Avatar universal
The modality for geno type 3 is the drug combo Interferon /Ribavirin as you have been prescribes

The efficacy is approx. 75 % and usually treated for 24 weeks ,however may be longer .depending   on early resonse..
Below I have linked a very recent article that will give you  lots of information  on Geno type 3 along with certain predictors of success of treatment of such including futer modalities

Good luck and welcome ..

Will

http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02715.x/full


163305 tn?1333668571
Many people with geno 3 do this treatment and a great deal do indeed clear the virus.
Good luck.
I would like to note that since you had the beginning of cirrhosis in 2006, you might want to consider switching to a hepatologist. As liver specialists they have more training than a GI in dealing with liver disease.
Having said that, many patients do treatment with a GI and have no problems.

Good luck~
Avatar universal
Thank you for the website and your words of encouragement
Avatar universal
Will see the GI 8/16 for utrasound b-4 starting tx and thank you for your anwser i was wondering what the diffrence between hepatologist & GI
446474 tn?1446347682
A "biopsy in 2006" is obsolete. Therefore it is no indicator of the current stage your liver disease. A biopsy should be performed ever 3-5 years to accurately assess the stage of liver disease. Biopsy results are listed in the biopsy report by stage of fibrosis.

The fibrosis score is also assigned a number from 0-4:
• 0 = no scarring
• 1 = minimal scarring
• 2 = scarring has occurred and extends outside
         the areas in the liver that contains blood vessels
• 3=bridging fibrosis is spreading and
connecting to other areas that contain fibrosis
• 4=cirrhosis or advanced scarring of the liver

You should have a biopsy performed before starting treatment, as genotype 3 patients with cirrhosis have lower rates of response to treatment and lower rates of cure (SVR). Treating beyond 24 weeks may be beneficial in cirrhotics.

Note: IF your biopsy indicates you have cirrhosis, you should be under the care a hepatologist. A GI is not qualified to manage hepatitis C treatment in cirrhotics and doesn't have the resources that you may need to successfully complete your treatment.

"Patients with genotype 2 and 3 infections who fail to achieve an RVR (mostly patients with HCV genotype 3 infection with high viral loads and bridging fibrosis or cirrhosis) have poor SVR rates with 24 weeks of therapy and may benefit from longer duration of treatment, but this has not been prospectively evaluated"  - AASLD Diagnosis, Management, and Treatment of Hepatitis C: 2009

Also the term "precirrosis scaring" is an oxymoron. As cirrhosis IS "scaring of the liver".
"Cirrhosis is extensive scarring (fibrosis) in the liver caused by long-term damage. This damage is caused by inflammation, which is a normal response to some injuries like chronic viral infection or chronic alcoholism. The liver repairs the damaged areas by replacing them with scar tissue, which is a process similar to the way a scar develops after a cut on your arm or leg. Just as the scar tissue on your arm is different from the surrounding skin, the fibrosis in the liver is different from the surrounding healthy liver tissue. Unfortunately, since scar tissue can't function as normal hepatocytes, too much scar tissue interferes with essential liver functions."

Good luck with your treatment.
Hector
548668 tn?1394187222
I had G3A with bridging fibrosis  (note that an ultrasound will only pick up severe cirrhosis, and not clearly, but may pick up an enlarged portal vein or other areas that can be affected by cirrhosis).   I did manage SVR with lots of researching this site (and other sites) to get the best information as to how I could assist my body to get through... i.e. eating easily digestible proteins, juicing beetroot/celery/carrot and freezing, staying away from sugar and fats,  eating lots of small meals daily instead of few large ones, and staying well hydrated during treatment.

Pivotal to getting a chance of success is obtaining RVR (rapid viral response) in week 4 of the treatment (make sure they test for your viral load on week 4).   I went from having a 50/50 chance to having a 75% chance after the 4th week PCR test;  those without cirrhosis had 80-90% chance as G3's.

A hepatologist is a specialist who would be more researched on liver disease, and in particular HVC and treatments.   My specialist chose to treat more 'aggressively' with a higher dose of riba, but a lot will also depend on your blood tests (get copies of all of your blood tests) which can sometimes give an indication of progression (ALT and AST give the level of 'inflammation' rather than level of disease;  bilirubin, albumin, alkaline phosphotase and platelets may give a corresponding picture.
Avatar universal
my progression (212ALT and 124 and for the cirrhosis lets say • 2 = scarring has occurred and extends outside is this the correct treatment=: Ribapack ribavirin tablet 400 mg & Ribavirin tablet 600mg dose pack # 56 tablets per month, and peginterferon alfa-2b inj kit 120 Mcg/0.5ml.
        
Avatar universal
why peginterferon alfa-2b inj kit 120 Mcg/0.5ml- why not alfa-2a ?
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