Thanks.
I'm a bit nervous about it all. Guess that is why I am on this computer at this hour of the morning!
Jean
How hard will it be to clear 1b?
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Geno 1 is the prevalent type in North America. It is also probably the most difficult to cure. For this reason treatments for geno 1 are typically 48 weeks or sometimes 72 weeks (and occasionally more). And the chances of clearing are less than for most other types. But geno 1 is the most common here, so you're with a lot of company!
The difficulties experienced during treatment vary between individuals. If you treat I hope your road is a relatively easy one, and most of all that it results in SVR.
There are also options to standard TX mainly in the form of study trials for newly developed treatments. Some of these offer some hope for a less arduous treatment path and greater SVR rates now in studies and in the future as more is learned.
Best to you,
Brent
Hi. Basically the chances are about 50% that you will clear the virus. Depending on a number of factors in addition to genotype. See last section below.
(I'm genotype 1 on my 7th week of Peg/Copegus with compensated cirrhosis and a beginning viral load of 6.2 million. Infected by the virus as best I can tell 38 years ago).
I wish you well!
For more details see this portion of the doc "A Guide to Understanding Hepatitis C" from www.hcvadvocate.org.
The Standard of care: Pegylated Interferon plus Ribavirin
The combination of pegylated interferon plus ribavirin is now considered the standard of care for treating HCV. There are currently two different pegylated interferon/ribavirin combinations that have been approved by the FDA: Schering’s Peg-Intron plus Rebetol brand ribavirin, and Roche’s Pegasys plus Copegus brand ribavirin.
Schering’s Peg-Intron plus Rebetol:
SVR for Peg-Intron plus Rebetol combination therapy is 41% for genotype 1, and 82% for genotypes 2 through 6. Peg-Intron is a reconstituted powder that is dosed according to a person's weight.
Roche’s Pegasys plus Copegus:
SVR for Pegasys plus Copegus combination therapy is 44-51% for genotype 1, and 70-82% for genotypes 2 through 6. Pegasys is a ready-made solution that is dosed at 180µg regardless of a person's weight. The FDA has also approved Pegasys for treatment of chronic hepatitis B and Pegasys plus Copegus for the treatment of people with HIV and hepatitis C coinfection.
Treatment Duration and Medications
The standard duration for treatment of chronic hepatitis C is 48 weeks for genotype 1, and 24 weeks for genotypes 2 and 3. Pegylated interferon is given once a week as an injection right under the skin. The ribavirin dose is given at 1000/1200 mg/day (depending on a person's weight) for genotype 1 and 800 mg/day for genotypes 2 and 3. Ribavirin is taken orally twice a day with food (breakfast and dinner).
Predicting Response to HCV Treatment
Treatment with interferon or interferon plus ribavirin is more likely to clear HCV if a person has a genotype other than 1, a low HCV viral load (less than two million copies), has been infected with HCV for a shorter time, has mild to moderate disease, is female, and is of a younger age. After twelve weeks of antiviral treatment, a 2-log drop in viral load or elimination of virus predicts a successful response at the end of treatment. These guidelines may be used to help tailor treatment or to stop treatment that is not working. However, these are guidelines only. Some doctors believe that therapy should be continued because some people still respond to therapy or experience improved liver health even if viral load does not decrease by the suggested amount.
Hope this helps.
Cheers!
HectorSF