non rvr

[santaclaus]

hi all. as some of you know ive startedtreatment 8wks ago and am 3a, i done a viral test at 4 wks and got results when i meet doc 2day. i started with a vl of jus over 5.9m. my 4wk vl was jus over 1.1m. im on 180 peg and 800riba per day and i way 90kg, i have asked doc wat happens next as its not the vl he was looking 4 and said he`ll decide wat course of action 2 take hen he gets my 12wk vl. he said he might add a futher 16wks to my 26wks but depending on my vl.
if he`s not happy with vl he`l stop treatment.
i have tried 2 get him 2 entertain the opion off upping my riba but he`s not budging.
so if any 1 out there had same experiance or any1 can tell me what they think my chances of svr are.
thanx santa

[Facta_non_verba]

I agree with everyone else about the weight-based ribavirin. The problem with upping your dose is that you will likely become anemic. Here in the States some docs don't offer rescue drugs like they should, but some countries have "health care for all," but they come with a "well almost" clause. Does Ireland's system offer drugs like Procrit and Neupogen?

I could picture a scenario where your doc doesn't know that you've upped your ribavirin dose, you become anemic and he stops your treatment. Gotta think about that. On the other hand, if you don't become undetectable by a certain time, you'll have to stop anyway because it's unlikely your doc will off extended treatment.

Jeff
Facta non Verba

[copyman]

i would go off label and add aliana to the combo drugs along with upping the riba. If your doc was up to date with the latest protocol he would increase the riba ASAP !!! Tell him you want to be treated as individual not as a "outdated" protocol. If he will not do it then find a new doc. In the meantime I would up the riba on your own to at least 1000mg. Best of luck

[epiphiny]

Here is a link to the previous discussion you started on this topic, there is some pretty good info in there.

http://www.medhelp.org/posts/show/639343

Also a link that jmjm has already posted for you:

http://www.****.***

I'm sorry I don't have any more time to do more searches for studies for you as I'm at work but the info is out there if you search for it.  

I really think you would be better finding another Doc who is up with new protocols.  All the printed material (such as the insert your Doctor quoted from) are still based on old studies, it takes time for the new info to make it to print and filter down.

Go for it, Santa, it's your health, your life, YOU have to fight for it!

Epi.

[santaclaus]

when i said 2 him bout upping ribba he checked the leaflet from inside of the roche box and sais that i was on the max, dont make sence 2 me.
he is head of hepatoligy unit in beaumont hos in dublin, even goes by the name of prof murray???
i might try ringin roche ireland and see if they would be willing to up dose and get onto this fool.
im really upset by this clown, so if any1 has links to sites with oproval so i can be armed wiyh this info for him.

if i was able 2 get my hands on some extra riba would u think it wise 2 up it myself?

thanx all 4 answers

[Marcia2202]

I'm a 3a and weighed 58 kg when I started treatment, am now down to 55. I am on 800mg of riba and did not RVR4 either. Even though 800mg IS weight based for me. I find it very curious that they still treat the old way at your hospital in Ireland. The protocol has long changed to weight based for g3's. I would print out some studies from the internet and show to your doctor and push him to up your dose. I believe he is really jeopardizing your chance of SVR.

Good luck to you.

Hugs, Marcia

[epiphiny]

I'm a Geno3a, 77kgs and I'm on 1200 Riba per day.  This is my 2nd TX, I am UND.

On my first TX I was only on 800 Riba per day and just as you are describing now I had NO sides and NO Viral Response.

I agree with everyone else here -  it would seem that your Doc is working off the old protocols for G3 rather than the newer weight based dosing protocols.

You could arm yourself with some studies to present to your Doc, there are plenty around.  Or you could spend the time finding a new specialist...

Given that the idea is to get to UND as soon as possible you could always up the dose yourself while you look for a new guy.  Depends on how many meds you have in hand...

Of course I am not a doctor, this is just my opinion. You would be much better served to find a new Doctor, even if you have to pay for your first consult.  Get the best guy you can find - the AASLD web site has list of specialists in all areas.

Oh, I've just seen that you are in Ireland, don't know where you would access specialists list there.  You could check out the UK Hep C Forum, there are some good people over there with knowledge of the system on your side of the world.

hepcukforum dot org

Epi :)