Aa
What if Tx does not work???
I have Hep C Genotype 2b and my viral load is 2.9 Million is that high? I will be getting my 4th shot tomorrow. I will be on tx for 24 weeks. I was just wondering if treament always works with people who have my genotype. I am wondering if it is possible that my body won't respond to treatment. I know my chances are good, but I just want to know if anyone has ever not responded to TX with genotype 2b. I also wanted to know what the liklyhood of " Relapse" is with my genotype. Dose is only happen when you have type 1? Is their anything I can do to prevent relapse? Do people always clear with genotype 2b?
Sorry to go off thread....please see my next post....'2b, week 7, withholding dose's"
Jessica.....type 2b is already in your favor to SVR. stop borrowing trouble and worry for yourself. "What if's" are nothing but needless worries! (most of the time). Get the 4 week labs and take your meds EVERY day. Be sure to post about RVR or not when you know. Will take a lot off of your mind when you know.
LL
Jessica.....type 2b is already in your favor to SVR. stop borrowing trouble and worry for yourself. "What if's" are nothing but needless worries! (most of the time). Get the 4 week labs and take your meds EVERY day. Be sure to post about RVR or not when you know. Will take a lot off of your mind when you know.
LL
If you have a high viral load, HCV is active. It doesn't just decide to go dormant again. If you ignore it you will most likely get very ill as the attacks your liver and it develops cirrhosis. You will most likely have to look at a liver transplant down the line, which is a pretty ugly proposition. Bottom line, without treatment, life is going to suck.
Treatment is not something to look forward to either. For me, it was hell! I am Genotype 1a stage 2 and due to my body weight, I was maxing out dosages which didn't make things any easier. I served in the Marine Corps and this goes above and beyond anything I did in the field. I finished treatment in June of this year and am not feeling right. I don't know if I have sustained SVR yet.
If it didn't work, there are a number of trials for new treatments that become available fairly soon and I will have to give that a try.
I know this is not a rosy picture. It's my experience and I think the same for many people. You have a support group here and you are by no means the Lone Ranger.
My recommendations...............CHOOSE LIFE!
Treatment is not something to look forward to either. For me, it was hell! I am Genotype 1a stage 2 and due to my body weight, I was maxing out dosages which didn't make things any easier. I served in the Marine Corps and this goes above and beyond anything I did in the field. I finished treatment in June of this year and am not feeling right. I don't know if I have sustained SVR yet.
If it didn't work, there are a number of trials for new treatments that become available fairly soon and I will have to give that a try.
I know this is not a rosy picture. It's my experience and I think the same for many people. You have a support group here and you are by no means the Lone Ranger.
My recommendations...............CHOOSE LIFE!
If tx does not work, you will wait, live as healthy as possible and try again at a later date. There are many here who have txed more than once. The first thing you need to do though, is to find out if the tx is working for you now. Get the viral load tested again.
My viral load was 11 million so I can say, for me, the viral load had nothing to do with my bodies ability to clear the virus. I'm still clear 7 months post, did 16 weeks of tx (genotype 2).
I was very vocal about asking for a pcr to determine my viral load. I switched drs when my first dr's nurse said that they wouldn't test my viral load again till week 12. I was tested by the second dr immediately, I think she was trying to impress me or something because I was never given that much help again.
Long story short, get tested--like the others said--the day before your 5th shot or the morning of your shot.
Good luck and stay strong. Tx is rough and sometimes coming here can feel like a beating!
Bug
My viral load was 11 million so I can say, for me, the viral load had nothing to do with my bodies ability to clear the virus. I'm still clear 7 months post, did 16 weeks of tx (genotype 2).
I was very vocal about asking for a pcr to determine my viral load. I switched drs when my first dr's nurse said that they wouldn't test my viral load again till week 12. I was tested by the second dr immediately, I think she was trying to impress me or something because I was never given that much help again.
Long story short, get tested--like the others said--the day before your 5th shot or the morning of your shot.
Good luck and stay strong. Tx is rough and sometimes coming here can feel like a beating!
Bug
As a 2b, I worried like you that the virus wouldn't be cleared. Then, adverse reactions forced me to quit after only 13 weeks of tx. However, the virus was UND in my blood after just 4 weeks, so there was some chance of success. Needless to say, I was holding my breath with anticipation and fear. Last week I went to the hep doc to learn the results of the six months post tx blood tests and was happy to learn I was SVR.
Make sure to be tested a week after your 4th shot, which will be next week. If you're UND then, you probably don't have to worry very much. Of course, there are always exceptions. But if you lose the **** shoot, there are many newer and better meds coming down the line that will probably cure most people. Good luck and good health.
Make sure to be tested a week after your 4th shot, which will be next week. If you're UND then, you probably don't have to worry very much. Of course, there are always exceptions. But if you lose the **** shoot, there are many newer and better meds coming down the line that will probably cure most people. Good luck and good health.
If treatment doesn't work, you will keep going on just like everybody else.
I think one of the most important things to remember while treating is to always take your meds ON TIME. Don't miss any doses and drink lots of water.
Good luck! I hope you clear. I think most people with 2b do.
I think one of the most important things to remember while treating is to always take your meds ON TIME. Don't miss any doses and drink lots of water.
Good luck! I hope you clear. I think most people with 2b do.
One of the most important things someone told me when I was treating was just take things one day at a time and don't project into the future. Riba sometimes causes us to have irrational fears and worry. No one knows what will happen tomorrow, personally or globally. We just have to do our best and leave all results to the Lord because they are never in our hands. Just cross each bridge as it comes to you. Martin Luther King Jr. said, "Just because you can't see the top of the staircase doesn't mean you can't climb. Just take one step at a time."
Sweetie...tx IS working until you have definitive proof it isn't. You'll deal with that IF it ever comes to that and here's hoping it doesn't and that we'll be having an SVR celebration for you too. In the meantime...some good advice coming your way and some excellent support for you here. Control the things you CAN control, like taking your meds on time and all that...and the rest will take care of itself. I wish you serenity to accept the things you cannot change, courage to change the things you can and wisdom to know the difference. (I admit, that last sentence is not my own original thought but borrowed from someone called Serenity Prayer, whoever that is. :)
Hang in there.
Trish
Hang in there.
Trish
I think the greatest motivator for taking all your meds on time (following the doctor's orders) is because you only want to do this once, you don't want to relapse and have to do it all over again.
My doctor's office never called to see how I am doing during 51 weeks of tx. They know I will call them if I have any problem. They are extremely busy; they have lots of patients.
Imagine an hcv world where there are one million patients who have geno type 2 and the success rate for the entire population is about 80%. 200,000 people will not be successful. Odds and percentage are indicators and maybe predictors. In the end, the 200,000 are real live people - individuals. Numbers are great, until you relapse. And if I were one of them, there would be nothing that would separate me from the aggressive pursuit of a cure. That includes shoveling in all the meds when I least want to. The doctor, nurse, NP or PA are not the primary watchguards of a patient's health, progress and follow-up. That's the patient's job to the exclusion of anyone else. Want to get cured? Get serious first. Even then nothing is assured.
Is that wrong? When should i get tested? What is RVR?????????
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RVR is Rapid viral Response meaning that you are "Undetected" as far as the virus being in your blood. Read the post that Mike posted above and discuss that with your doc or print it out.
As I mentioned in order to see if you are 'responding rapidly' RVR, you NEED to get a blood test AFTER your 4th shot - as close to your 5th shot as you can...meaning the day BEFORE your 5th shot OR the day OF. For instance if you inject Friday nights,,, get your blood test Thurs (day before) or Friday morn or afternoon,,then that night you will inject the 5th shot.
The results of that blood test will show results of what "4 injections" have done.
This is VERY IMPORTANT. Because lets say you are NOT clear at 4th shot, you will NOT be considered a RVR and your tx plan maybe should be extended IMO. Well I know thats what I would do at least.
Hind sight is alot different. As I said, my VL was high and I would now tell people that I would insist on longer tx if they start with a viral load as high as mine...or double dosing interferon early on.
Try to read as much as you can on forum and insist on things at the doctors office.
Many of us had weekly blood tests just to see how quickly we were responding. In my case it didn't pay off cause I fell into the percent that relapse, but it still something that every doc should do. Weekly blood tests IMO are important for the doctors to do, but if you can get the one I mentioned, that would be good too. INSIST.
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RVR is Rapid viral Response meaning that you are "Undetected" as far as the virus being in your blood. Read the post that Mike posted above and discuss that with your doc or print it out.
As I mentioned in order to see if you are 'responding rapidly' RVR, you NEED to get a blood test AFTER your 4th shot - as close to your 5th shot as you can...meaning the day BEFORE your 5th shot OR the day OF. For instance if you inject Friday nights,,, get your blood test Thurs (day before) or Friday morn or afternoon,,then that night you will inject the 5th shot.
The results of that blood test will show results of what "4 injections" have done.
This is VERY IMPORTANT. Because lets say you are NOT clear at 4th shot, you will NOT be considered a RVR and your tx plan maybe should be extended IMO. Well I know thats what I would do at least.
Hind sight is alot different. As I said, my VL was high and I would now tell people that I would insist on longer tx if they start with a viral load as high as mine...or double dosing interferon early on.
Try to read as much as you can on forum and insist on things at the doctors office.
Many of us had weekly blood tests just to see how quickly we were responding. In my case it didn't pay off cause I fell into the percent that relapse, but it still something that every doc should do. Weekly blood tests IMO are important for the doctors to do, but if you can get the one I mentioned, that would be good too. INSIST.
I Have had only 1 blood test since Tx and that was the day before I started Tx. I have not even spoke to my doctor. I can't believe they have not even called me to see how I am doing. They can call a million times to make sure your going to be there on time, but they cant call and ask how your doing.So no I have not had another blood test. I was going to wait untill I hear from my doctor.
I assumed I wouldent need to go back their for at least 3 months to get the next blood test.
Is that wrong? When should i get tested? What is RVR?????????
I assumed I wouldent need to go back their for at least 3 months to get the next blood test.
Is that wrong? When should i get tested? What is RVR?????????
Lots of geno 2s who have been VERY serious about their medications and protocols have failed treatment.-
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Yeah, I fall into that group. I NEVER missed one pill. My last shot though, I didn't continue the riba for 7 days - just 4 days - but of course that wouldn't be why I didn't remain UND.
My VL was at one time 10 million, but base line was 8 million. IMO, 24 weeks is NOT long enough for someone with a VL as high as mine.
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Yeah, I fall into that group. I NEVER missed one pill. My last shot though, I didn't continue the riba for 7 days - just 4 days - but of course that wouldn't be why I didn't remain UND.
My VL was at one time 10 million, but base line was 8 million. IMO, 24 weeks is NOT long enough for someone with a VL as high as mine.
Lots of geno 2s who have been VERY serious about their medications and protocols have failed treatment. You really need to get much more serious about it all if you intend to make it. Some of the bigwig docs are now starting 2s off at 48 weeks from what I hear, just like geno1.
I am a 2b who was RVR, but I relapsed about 8 weeks post tx. My VL was very high thou and that MAY have played a part. Most people with 2b usually do clear tho, so try not to worry. You have greater odds of clearing than not clearing.
Good luck.
Good luck.
I will be getting my 4th shot tomorrow.
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Do you know if you are UND yet? If you haven't had a PCR as of yet - make sure you get one BEFORE (the day before or day of) your 5th shot which will show if you are RVR.
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Do you know if you are UND yet? If you haven't had a PCR as of yet - make sure you get one BEFORE (the day before or day of) your 5th shot which will show if you are RVR.
People with 2b who don't forget to take their meds have a good chance of clearing!
Missing doses of ribavirin particularly during the first 12 weeks after starting therapy is worse in reducing liklihood of achieving SVR.
http://www.natap.org/2005/EASL/easl_5.htm
Missing doses of ribavirin particularly during the first 12 weeks after starting therapy is worse in reducing liklihood of achieving SVR.
http://www.natap.org/2005/EASL/easl_5.htm
Summary of Clinical Implications
* A patient must respond virologically and achieve undetectable HCV RNA (< 50 IU/mL) to achieve an SVR.
* Patients who do not respond virologically cannot achieve an SVR by continuing the same treatment for a longer period of time.
* Patterns of virologic response and nonresponse be recognized by assessing HCV RNA at monthly intervals until the HCV RNA has become undetectable or a nonresponse pattern has been defined (Week 24).
* Up to 90% of patients with RVR achieve SVR if they remain on treatment for 48 weeks for HCV genotype 1 infections and 24 weeks for HCV genotype 2 and 3 infections.
* Rates of SVR in patients with genotype 1 infection who achieve an RVR do not appear to be affected by reduction of ribavirin dose.
* The initial management strategy for patients with RVR who develop adverse events should be to consider reduction of the doses of ribavirin and/or peginterferon alfa so that these patients can hopefully complete the recommended duration of therapy.
* It is important to continue to monitor HCV RNA through Week 24 even if the patient does not achieve undetectable HCV RNA during that time to allow for identification of partial virologic response.
* It has been hypothesized that some patients with a partial treatment response may achieve undetectable HCV RNA if switched to or retreated with a more intensive peginterferon alfa regimen.
* Patients who do not achieve an EVR will not achieve undetectable HCV RNA with continued treatment and are defined as having a null response. This is an indication for stopping treatment.
* An important reason for viral breakthrough may be missing doses of peginterferon alfa and/or ribavirin.
* Patients fail to achieve SVR for several different reasons. All but one of these factors, null response, can potentially be overcome during retreatment.
* Only those patients who have a known and correctable reason for their previous treatment failure should be considered for retreatment.
* The outcomes of retreatment may be maximized by improving education and awareness about adverse effects of peginterferon alfa and ribavirin, having a stronger commitment to therapy, or seeking care from a more experienced and/or attentive treatment provider.
Clinical Care Options site
* A patient must respond virologically and achieve undetectable HCV RNA (< 50 IU/mL) to achieve an SVR.
* Patients who do not respond virologically cannot achieve an SVR by continuing the same treatment for a longer period of time.
* Patterns of virologic response and nonresponse be recognized by assessing HCV RNA at monthly intervals until the HCV RNA has become undetectable or a nonresponse pattern has been defined (Week 24).
* Up to 90% of patients with RVR achieve SVR if they remain on treatment for 48 weeks for HCV genotype 1 infections and 24 weeks for HCV genotype 2 and 3 infections.
* Rates of SVR in patients with genotype 1 infection who achieve an RVR do not appear to be affected by reduction of ribavirin dose.
* The initial management strategy for patients with RVR who develop adverse events should be to consider reduction of the doses of ribavirin and/or peginterferon alfa so that these patients can hopefully complete the recommended duration of therapy.
* It is important to continue to monitor HCV RNA through Week 24 even if the patient does not achieve undetectable HCV RNA during that time to allow for identification of partial virologic response.
* It has been hypothesized that some patients with a partial treatment response may achieve undetectable HCV RNA if switched to or retreated with a more intensive peginterferon alfa regimen.
* Patients who do not achieve an EVR will not achieve undetectable HCV RNA with continued treatment and are defined as having a null response. This is an indication for stopping treatment.
* An important reason for viral breakthrough may be missing doses of peginterferon alfa and/or ribavirin.
* Patients fail to achieve SVR for several different reasons. All but one of these factors, null response, can potentially be overcome during retreatment.
* Only those patients who have a known and correctable reason for their previous treatment failure should be considered for retreatment.
* The outcomes of retreatment may be maximized by improving education and awareness about adverse effects of peginterferon alfa and ribavirin, having a stronger commitment to therapy, or seeking care from a more experienced and/or attentive treatment provider.
Clinical Care Options site
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