short course tx and riba question/ other posts too!

[amommy]

Hi All, any insight on this is greatly appreciated.  I am geno 2, and cleared by week 4.  I have been on 800 riba eventhough that is NOT weight based for me, i'd be up to 1000.  Anyway, prior to starting tx, I asked to do weight based riba especially if I was going to do short course of tx.  Doc said it wasn't necessary.  Now, I talked to my NP today and he said well, I have talked to the doctor, and if you are going to do short course tx, then I think you should up your riba until the end to decrease odds of relapse.  Does anyone know of any articles about short course of tx and riba dosing?  I am a little bit afraid since the riba has been wreaking havoc with me the past few weeks, but I can definitely handle it if it increases chances of SVR.  I don't know why this is throwing me for a loop. In a way, i'm kind of just mad because this is what I asked for from the beginning and NOW they are telling me it is a good idea.  ARGHH.  
As far as length of tx, here is my very unscientific decision.  I will get my 12 week pcr, which I will not get the results of until about 14 weeks.  At that point I figure I might as well finish out my current batch of meds, which would bring me to 16 weeks.  I feel more comfortable with 16 than I do with 12 and I am optimistic that in my case, 24 is not necessary. I realize this may seem like crazy logic to some of you, but ummm I blame brain fog!  
So, any ideas about whether upping the riba from now until the end makes sense?  
Thanks so much for all of your support and insight!

[jmjm530]

Well, asking me whether to up the riba is like asking NY Girl if if it's OK to up the ice cream :)

But seriously, weight-based riba intuitively makes more sense to me on a short course, but you might want to research out how the short-course study did it. For a brief overview:
http://www.medpagetoday.com/tbindex1.cfm?tbid=1240

Also, keep two other things in mind. First, non-detectible at week 4 was I believe by a very sensitive PCR that went down to at least 50 IU/ml. Make sure your PCR was at least that sensitive so you're not comparing Breyers to Hagen Daz.  And second, I believe the 12-week short course study was for Peg Intron. If I remember correctly, the shorter-course studies for Pegasys were for 16 or 18 weeks, not 12.  

Also, in spite of your early response, if it turns out that you were significantly underdosed with the riba for the first 12 weeks, a conservative approach might be to up the riba and go the full 24-week course. Same thing if you have moderate or significant liver damage.

Good luck. BTW all we geno 1's are very jealous you have these kinds of decisions :)

-- Jim

[FlGuy]

If it was me I would call it a day at 16. As I recall you are youngish, had no bx and little kid(s). The no bx is the wild card here. Being young with other meds on the horizon, even if you don't get svr now, gives you options.