Aa
viral load going down slow
I need help. I am confused. After reading this forum for months now, i was understood that you needed a 2 log drop for treatment to be successful. I have been on treatment since August 8. my viral load was 650,000. After the first month 450,000. Month three 150,000. The doctor says stay on the treatment we will check you at 12 months. This medicine is hard on me. Am I wasting my time? I am a 50 year old female and they believe i have had this for 35 years from a blood transfusion. I have type 1b. Should I insist on checking sooner.
By your numbers, you are having a slow response to standard treatment.
Slow responders have a lower chance of clearing the virus in 48 weeks of treatment. SVR improves some for these people if they continue on for an extended treatment of 72 weeks. See below from 2005:
I'd question your doctor about blindly enduring 12 months of treatment without feedback.
Mike
________________________________________________________________________________________________
"To determine whether treatment extension might benefit patients, Dr. Berg of Charite Medical University, Berlin and colleagues compared 48 weeks of treatment with 72 weeks of treatment. The findings are published in the April issue of Gastroenterology.
Two hundred thirty subjects received pegylated-interferon-alfa-2a 180 mcg per week and ribavirin 800 mg per day for 48 weeks. Another group of 225 patients received the same regimen for 72 weeks. All of the subjects were treatment-naive.
In the 72-week group, treatment response was seen in 71% patients and a sustained virologic response at 24 weeks was seen in 53%. In the 48-week group, corresponding proportions were 63% and 54%.
Despite the lack of significant difference, patients who were still HCV-RNA positive at week 12 showed significantly higher sustained virologic response rates when treated for 72 rather than 48 weeks (29% versus 17%).
The team concludes that extended therapy should be reserved for patients "with slow virologic response defined as HCV-RNA positive at week 12 but negative at week 24."
These slow responders, continued Dr. Berg, "clearly benefit from extended treatment duration up to 72 weeks."
However, "it has to be kept in mind that even after extended treatment duration, slow virologic responders have a greater risk of relapse after stopping treatment...compared to the rapid responders."
Slow responders have a lower chance of clearing the virus in 48 weeks of treatment. SVR improves some for these people if they continue on for an extended treatment of 72 weeks. See below from 2005:
I'd question your doctor about blindly enduring 12 months of treatment without feedback.
Mike
________________________________________________________________________________________________
"To determine whether treatment extension might benefit patients, Dr. Berg of Charite Medical University, Berlin and colleagues compared 48 weeks of treatment with 72 weeks of treatment. The findings are published in the April issue of Gastroenterology.
Two hundred thirty subjects received pegylated-interferon-alfa-2a 180 mcg per week and ribavirin 800 mg per day for 48 weeks. Another group of 225 patients received the same regimen for 72 weeks. All of the subjects were treatment-naive.
In the 72-week group, treatment response was seen in 71% patients and a sustained virologic response at 24 weeks was seen in 53%. In the 48-week group, corresponding proportions were 63% and 54%.
Despite the lack of significant difference, patients who were still HCV-RNA positive at week 12 showed significantly higher sustained virologic response rates when treated for 72 rather than 48 weeks (29% versus 17%).
The team concludes that extended therapy should be reserved for patients "with slow virologic response defined as HCV-RNA positive at week 12 but negative at week 24."
These slow responders, continued Dr. Berg, "clearly benefit from extended treatment duration up to 72 weeks."
However, "it has to be kept in mind that even after extended treatment duration, slow virologic responders have a greater risk of relapse after stopping treatment...compared to the rapid responders."
I don't know the recommendations or SOC for 1B's but you haven't even reached a 1 log drop at week 12.
With 1A's the CW is that those who don't drop a minimum of 2 logs by week 12 should discontinue treatment.
Those who reach the 2 log drop but don't get UND are monitored for another 12 weeks and a dscision is made then about whether to continue.
There's a poster on forum, I believe his name is jboyhk, who seems to know a lot about 1B. You might try flagging him with your questions,
From what I understand, it looks like you are a very slow responder.
wyntre
With 1A's the CW is that those who don't drop a minimum of 2 logs by week 12 should discontinue treatment.
Those who reach the 2 log drop but don't get UND are monitored for another 12 weeks and a dscision is made then about whether to continue.
There's a poster on forum, I believe his name is jboyhk, who seems to know a lot about 1B. You might try flagging him with your questions,
From what I understand, it looks like you are a very slow responder.
wyntre
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