Aa
it's not really that complicated
SVR is considered a cure. Treatment with interferon and rivaviron is the only way to get this. Period.
That was my point, NYGIRL. Thanks. I meant, without hep meds, you aren't going to get of the virus.
Thank God that modern medicine is progressing and new important drugs are being added IN to the equation of riba and peg sometimes......but it's all the same concept being that without the hepmeds you just ain't going to get magic SVR (unless you spontaneously clear and we all know how often that doesn't happen and won't happen to someone who is chronic like most of us when we do find out).
good health.
What is the best way to attain or maintain that? I am 55 and in good health with low damage staging. Yes, I could treat, but I may be able to limit my collateral liver damage through some diet and lifestyle modifications while I WAIT. This isn't proclaiming a cure; it's only about attempting to mitigate damages while monitoring ones progression. My take on it is that IF I can wait things out for a few years I will have a far better chance of treating once successfully and for a far shorter period. Since chemotherapy is not without it's own danger and potential damages one must weigh out the risks and rewards.
For me it is far more complicated than the presented premise.
Think about 9-12 trains leaving Topeka at various speeds. ; ) (and differing departure dates)
One might be represented by going to the local doctor and doing TX today.
Another might be going further out of town and getting a great hepatologist as Jim suggested and doing TX TODAY, possibly with some *tweaking* of treatment convention.
Still yet another might be doing TX but adding Alinia to the mix
or getting onto a trial such as Boceprevir or Telaprevir.
All of these methods might yield different outcomes, mid course response rates, side effects, treatment lengths and ultimate outcomes. One also cannot also simply determine "success" by whether one attains an SVR or not. Many people suffer some short term, long term and in some cases permanent sides from TX.
Some of the "other trains leaving Topeka" but further in the future........
The ability to take an approved drug such as Telaprevir or Boceprevir and have the ability to treat with more flexibility than current trials allow; that may mean dose increases, pre-dosing with SOC, a "surge" at the beginning of TX, combining with Alinia or other drugs that may reduce IR that are just being evaluated now.
...... or a future trial in which protease inhibitors might be combined with polymerase inhibitors.
.........or any of the vast number of drugs in trials right now.
....... or use of the Chron-vac inoculation which is showing great promise in greatly reducing viral load. We may soon be able to rid ourselves of the virus without doing chemotherapy, or lowering our viral load such that a much shorter course is possible.
So many trains that one can catch....... and the passengers are all different, too. Some MUST travel today, some can wait to catch their train. Some who wait may wish that they had left earlier. Some who leave today may end up wishing that they waited. We all progress at differing rates based on genetics, lifestyle factors, age, sex, etc. We will all experience differing extra-hepatic issues if we don't treat just as surely as we will end up with differing side effects from SOC if we DO treat.
For me the calculus of the equation; when to treat, what to treat with per each individual case is more complicated than many people consider.
I am still in the process of waiting.
I just passed on an opportunity to get into a trial using Telaprevir on treatment naives. I had a 100% chance of getting triple therapy. I still ask myself; why would I pass that up for free? It seems like a no-brainer.
Here's why I waited. We may have only one pass on the protease inhibitor train. It is theorized that resistance will occur if the treatment is unsuccessful. I chose to wait (since I have some leeway in time) knowing that I will be able to treat with greater odds of clearing in the future as well as a shorter treatment time.
It was a hard choice; it may not have even been the RIGHT choice, but just when does one know for certain what to do in the treatment equation?
Best wishes and happy new year......
Willy
What is the best way to attain or maintain that? I am 55 and in good health with low damage staging. Yes, I could treat, but I may be able to limit my collateral liver damage through some diet and lifestyle modifications while I WAIT. This isn't proclaiming a cure; it's only about attempting to mitigate damages while monitoring ones progression. My take on it is that IF I can wait things out for a few years I will have a far better chance of treating once successfully and for a far shorter period. Since chemotherapy is not without it's own danger and potential damages one must weigh out the risks and rewards.
For me it is far more complicated than the presented premise.
Think about 9-12 trains leaving Topeka at various speeds. ; ) (and differing departure dates)
One might be represented by going to the local doctor and doing TX today.
Another might be going further out of town and getting a great hepatologist as Jim suggested and doing TX TODAY, possibly with some *tweaking* of treatment convention.
Still yet another might be doing TX but adding Alinia to the mix
or getting onto a trial such as Boceprevir or Telaprevir.
All of these methods might yield different outcomes, mid course response rates, side effects, treatment lengths and ultimate outcomes. One also cannot also simply determine "success" by whether one attains an SVR or not. Many people suffer some short term, long term and in some cases permanent sides from TX.
Some of the "other trains leaving Topeka" but further in the future........
The ability to take an approved drug such as Telaprevir or Boceprevir and have the ability to treat with more flexibility than current trials allow; that may mean dose increases, pre-dosing with SOC, a "surge" at the beginning of TX, combining with Alinia or other drugs that may reduce IR that are just being evaluated now.
...... or a future trial in which protease inhibitors might be combined with polymerase inhibitors.
.........or any of the vast number of drugs in trials right now.
....... or use of the Chron-vac inoculation which is showing great promise in greatly reducing viral load. We may soon be able to rid ourselves of the virus without doing chemotherapy, or lowering our viral load such that a much shorter course is possible.
So many trains that one can catch....... and the passengers are all different, too. Some MUST travel today, some can wait to catch their train. Some who wait may wish that they had left earlier. Some who leave today may end up wishing that they waited. We all progress at differing rates based on genetics, lifestyle factors, age, sex, etc. We will all experience differing extra-hepatic issues if we don't treat just as surely as we will end up with differing side effects from SOC if we DO treat.
For me the calculus of the equation; when to treat, what to treat with per each individual case is more complicated than many people consider.
I am still in the process of waiting.
I just passed on an opportunity to get into a trial using Telaprevir on treatment naives. I had a 100% chance of getting triple therapy. I still ask myself; why would I pass that up for free? It seems like a no-brainer.
Here's why I waited. We may have only one pass on the protease inhibitor train. It is theorized that resistance will occur if the treatment is unsuccessful. I chose to wait (since I have some leeway in time) knowing that I will be able to treat with greater odds of clearing in the future as well as a shorter treatment time.
It was a hard choice; it may not have even been the RIGHT choice, but just when does one know for certain what to do in the treatment equation?
Best wishes and happy new year......
Willy
It's not that simple.
Enrolling in a PI trial is a reasonable option for many, so that would be three drugs.
Further, many are adding Alinia to SOC per some very promising studies.
Then there are the stain studies and pre-dosing with IR drugs where indicated.
Best bet is to hook yourself up with the best liver specialist (hepatologist) you can find and then ice the cake with a stack of studies you can go over together -- as even the best hepatologists are someitmes reluctant to go too far out of the box without a strong indication from the patient that they are amenable.
-- Jim
Enrolling in a PI trial is a reasonable option for many, so that would be three drugs.
Further, many are adding Alinia to SOC per some very promising studies.
Then there are the stain studies and pre-dosing with IR drugs where indicated.
Best bet is to hook yourself up with the best liver specialist (hepatologist) you can find and then ice the cake with a stack of studies you can go over together -- as even the best hepatologists are someitmes reluctant to go too far out of the box without a strong indication from the patient that they are amenable.
-- Jim
I just keep seeing people post about other "routes" for treatment. Aside from the "trials" drugs that are showing a lot of promise, the only established way to rid the virus is with interferon and riba. There should be a sticky on the top of this forum that says that in bold.
...hmm, maybe the meds are just making me irritable. Grrrr.
...hmm, maybe the meds are just making me irritable. Grrrr.
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