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hepc relapse

I completed 1 year of peg and rabitol but relapsed after 1 month of stopping. Was put on conventional IFN and after another 6 months am HCV RNA negative. First time I became negative after 20 weeks and am genotype 3
9 Responses
Avatar universal
You are a geno 3 and, if I understand it correctly, were not undetectable even by week 12?

What do you mean with "conventional" interferon?

Are you treating with ribavirin as well?

How long are you planning to treat?

What country do you live in?

As a geno 3, you need to be undetectable preferably at week 4, but at the latest at week 12. If not undetectable until somewhere between week 5 and 12, you need to treat for 48 weeks to up your chances of SVR. If detectable at week 12, SOC (standard of care) for geno 3's is to stop treatment.

Please write more details of your treatment. The information you have given so far seems confusing.
Avatar universal
I see you already treated for a year, and then relapsed. What is your doctor's plan to prevent relapse this time? What has he done differently?
Avatar universal
I am from India. I have now  completed 72 weeks with a gap of 4 weeks after 48 weeks. I became positive again in those 4 weeks hence restarted. Conventional IFN is not peg but thrice weekly 3miu. I took initially peg but developed high levels of iron and ferritin so changed to standard, conventional IFN. My doctor wants to continue beyond 72 weeks as he says I am difficult to treat category may be "non responder"
Avatar universal
Conventional IFN has lower SVR ("cure") rates than pegylated interferon. I don't know if high levels of iron and ferritin are an accepted reason to change to conventional IFN. Maybe someone else on the forum knows about this? What dose of ribavirin are you on? Your doctor's strategy worries me. One does want a good treatment strategy to take interferon for such a long time.

Since you relapsed after the first 48 weeks, you will have to look at it as if you restarted a separate second round of treatment. If I understand you correctly, it then took you 6 months to become UND. This does not look good for the future.

What dose of pegylated interferon and ribavirin were you on the first time? If you were not underdosed, your slow response (week 20) the first treatment should by itself have indicated that you are a non-responder.

I just read that Telepravir, a protease inhibitor, is being tested in trial this year for genotype 2 and 3. Have you had a biopsy? If your liver is not that bad off, it might be better to wait for the new drugs hopefully approved in a couple of years.
Avatar universal
"What dose of pegylated interferon and ribavirin were you on the first time? If you were not underdosed, your slow response (week 20) the first treatment should by itself have indicated that you are a non-responder."

I guess since you have managed twice to reach undetectable although late in treatment, the question is if you should be called a "partial responder" instead of "non-responder".

A partial response would indicate greater chance of success with treatments in the future which include a protease inhibitor and/or a polymerase inhibitor.
Avatar universal
thanks. I took 1.5 mg/ kg peg and 800 mg ribaverin { I was 65 kg} in the initial treatment. Now in retreatment I am only on conventional IFN without ribaverine as my Dr said the latter caused hemolysis and raised iron levels which got deposited in my liver and further caused damage. My pretreatment biopsy was stage 3.I remained negative on treatment in the first year from 20 to 52 weeks.  The test was not done at 12 weeks as it was coming down slowly at 4 and 8 weeks------pretreatment 1835819 copies, 4 weeks---- 728775,  8 weeks -----4672. Stopped therapy after 52 weeks for 4 weeks and it reappeared at 528784 copies/ ml. according to WHO 1IU/ml is equal to 4 copies/ml
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