need to take informed dicission

[tehmina]

hi,
my mother was diagnosed hep c  5 year ago.biosy showed grade 2 inflamation and stage 1 fibrosis.she took peg interferon fro 12 month 2yr ago  for genotype 1b.initially she got response after 6 month but on complition of treatment she was again reactive.now drs advice her for peg interferon for another 12 month.i heard about new treatment like telaperavir,and some one telling me about infergin or concensu.what should i do what will you recommend?.which injection are best for her and most effective for her disease?..b/c last treatment she took she developed lots of side effects.so now she made her mind after lots of councelling.so we want the best injection and which have good response.
kindley give me your expert opinion.
thanks.
tehmina

[tehmina]

THANK YOU VERY MUCH FOR YOUR TIME AND PRECIOUS SUGEESTION.I HOPEFULLY WILL WAIT FOR THE NEW DRUG.

[copyman]

Telaprevir is not meant to be added later in therapy.  It is best utilized when given with peg & riba at the beginning of treatment. It works because it kills the virus quickly the first 12 weeks then discontinued. At that point the peg & riba can continue to suppress the virus for the remaining 12 or 36 weeks, hopefully  enough to achieve SVR (cure).

[tehmina]

thank you very much for your replies.
i discussed this matter to her doctor.but he is telling that we should start theraply now with pag and ribavirin b/c virus will continu to damage her liver.and when new treatment will come then we will add on it.so in this way we can an not cure the disease but at least we will have control on it.

[Bill1954]

Hi Tehmina,

I see you have several posts in here going now. The most efficient way to communicate in here is to try for one post; you can add comments by typing a reply into the dialogue box below, then clicking the green ‘post comment’ button.

In another thread, you mentioned your mother’s viral load is ’25 lac’; this translates to 2.5 million (2,500,000) I believe. I assume the lab is using IU/mL for a unit measure?

Viral load is less important than genotype, which is the important predictor for treatment success. I commented in another thread about Infergen therapy; I’ll repost here:
~~~~~~~~~~~
Infergen/Consensus interferon is a possibility; although her odds of success are thought to be less than 32%, assuming her fibrosis is F1-F3:   [Thanks Trish…]

“Patients achieving the greatest reduction in baseline viral load with peg-IFN/RBV therapy, especially in patients demonstrating > 1-log drop with initial therapy
Patients with fibrosis scores of F0 to F3 at baseline demonstrated SVRs of 7.8% in the 9 mcg arm and 13.1% in the 15 mcg arm
Patients maintaining full dose of INFERGEN/RBV therapy had SVRs of 7% and 17% for the 9 mcg and 15 mcg arms respectively
Patients demonstrating partial response (>2-log drop) with previous treatment and low fibrosis scores F0-F3 had SVRs of 10.7% and 31.6% for the 9 mcg and 15 mcg arms”

http://www.ncbi.nlm.nih.gov/pubmed/19291790?dopt=Abstract
~~~~~~~~~~~

You also received comments from others in the previous thread; here it is again in case you lost your way:

http://www.medhelp.org/posts/Hepatitis-C/need-help-to-take-decision-regarding-hep-c-treatment/show/1418446?personal_page_id=1931608#post_6466616

I agree with others that Vertex Pharmaceutical’s ‘Telaprevir’ offers her best chance to clear the virus; it will hopefully be available in the U.S. sometime next year. You should discuss this with your mother’s doctor; he might have insight as to when it will be available in your country.

Good luck to you and your family,

--Bill

[copyman]

There is no way for us to know how much your mother may have progressed with the fibrosis. Although it is typically a slow moving disease it can progress quickly in some, especially if someone drink alcohol, has a poor diet, etc.

Perhaps her doctor is making a decision for her to treat sooner because of signs she has progressed, i.e. physical exams, blood markers, etc.

Personally I would want to wait for the new drugs next year if I had minimal liver fibrosis. I would at least be seen by a Hepatologist (liver specialist) for an evaluation before proceeding.

best of luck to you and your mom

[Trinity4]

Hi techmina,

Your mother had mild fibrosis as 5 years ago.  I doubt her condition has changed much since then and she has time to wait for Telaprevir which is expected to be released mid 2011. Actually, she could wait even longer if circumstance were not desirable at that time. Even though she responded to pegylated interferon and ribavirin another round may again prove ineffective. Her best chance of obtaining a sustained virological response is treating again with triple therapy which consists of Telaprevir, pegylated interferon and ribavirin.  There is a 75% chance of SVR with triple therapy as opposed to a 45% with the current standard of care.  Because she relapsed her treatment duration with triple therapy will most likely be 48 weeks.  

That is my opinion

Trinity

[tehmina]

trying to post in doctor forum,,,,,,,,,,,,