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Avatar universal

fishdics consults-interesting

OK, everyone in the area of Albuquerque, Dr. Arora is the real mccoy.  I put 11 years of labwork into a spreadsheet, my list of questions, and this is the skinny.  Just to update those that don't remember, baseline 2,890,000 12 week was 38,700. His resident said "thats close enough", and I was thinking HUH UH< I have read the literature...  Dr. came in with two students, and said. You failed to achieve a 2 log drop.  If you continue the current course, you have a 5% or less chance of SVR.  However, it may be that you are not a true nonresponder, because your hemoglobin has remained virtually unchanged, which tells me you are one of less than 5% of patients that hypermetabolize ribavarin. ( he has conducted 17 clinical trials with ribavarin)  Essentially, you are on monotherapy.  Options: increase ribavarin, 6 weeks at 1400, then up to 1600 for another 6 weeks, redo the PCR.  If you are undetectible at the 12 week, you have a 65% chance of SVR.  If you fail to hit undetectible, then stop the treatment.  If I am undetecitible, my 48 weeks starts today.  If I stop, and  start again in 6 months, you start out with the same odds as this time (I wondered about that).  He also said that he has a VX-950 trial coming up for....... nonresponders.  You have to have failed to achieve a 2 log drop, and failed to hit undetectible at 24 weeks.  Starts in 6 months or a year.  So trip was well worth it.  Cops came and hauled the crazy uncle off while I was gone, man, I'm a making progress.  Thanks for all your well wishes, I could feel the vibes...
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Avatar universal
anyone  remembers one of the presentations at the FCO AASLD conference that dealt with using Procrit at the onset of tx, which yielded higher SVR rates?  How would anyone in a study like the one mentioned, know of hypermetabolization of Riba if Procrit is used from the begining? I guess none of the subjects experienced that situation, given the high SVR results. I can't believe how complicated this treatment can be!
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Avatar universal
My mom told me a story when she was little she got a piece of glass in her hand well it kept moving deeper into her skin and was getting infected really bad infected , my great grandma put the salve on her infection and within 2 days it had pulled the glass right out of her hand and she was healed, must be good stuff.......
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Avatar universal
I believe it takes about approx 2-weeks for a change in riba dosage to reflect itself in a change of hemoglobin levels. So, personally I'd ask for a hemoglobin test in another two weeks -- and if the hemoglobin hasn't moved downward much, I'd speak to him about upping the dosage even more so you don't have a repeat of last time,  and see what he says. Anyway, I'm calling it a night. Have a great weekend and glad you found someone who is knowledgeable and will work out of the box with you.

-- Jim
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sounds like yu got some answers,hope this does the trick and you lose the vrus like the crazy ol uncle...Goodluck
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Avatar universal
No doubt fishdoc , the 1st rd the riba wasn't dosed high enough. From the post I've seen, others whose hmg dropped from base , got anemic , seemed to have the best results. In other words , the more redblood it's killin, the more hcv goin down too. How close is  that clinical study the new consult mentioned?
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Avatar universal
hey how ya doing, up late aren't we?
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