I had the same concerns when I read about the higher the riba the better to
kill the dragon. But for geno 2 and 3 it seems it's not as critical. I
completed 6 months of tx and post tx pcr was negative. I guess if my biopsy
results were up there stage and grade I would have insisted on a higher
dose. I will know in Oct. if I should have asked for a higher dose of riba.
It wouldn't hurt to ask your providers what they think.

Good luck....

dort

You are doing the classic Pegasys/Copegus regimen: the 180ug IFN is on the
high side of the weight-based 1.5ug/kg, while the 800mg Ribavirin is on the
low side given the preponderance of current data (at 90kg, at least 1000mg and
more likely 1200mg).

Intuitively, the higher dosage regimens *should* provide a commensurately
higher rate of SVR *if* the full regimen is maintained. In the real world,
there are forces working against that conclusion: drop-outs and dosage
reductions totally screw with the numbers, obviously; and then you have the
cases that would have obtained an SVR with the lower dose regimens anyway.

On the one hand, the largest WBD vs FD study conducted to date was so riddled
with serious problems that no solid conclusion can be drawn (I'm speaking of
WIN-R.  You can Google that study up pretty easily, every liver site has some
chunk of the data) but if forced one would have to conclude there was little
gain for any G-type with WBD over FD

On the other hand, numerous - much smaller, and presumably better managed
given the resulting data - studies indicate that for G1 with higher VLs there
is a significant increase in SVR with WBT vs FD, in the 5% or even better
range. The same studies tend to show less gain for G2 & G3, and all G-types
with low VL, however; the studies I reviewed showed a point or two improvement
- certainly noise level differences given the size of the cohorts used.

With all that said, were I starting tx, I would go with logic and intuition
and do WBD all the way, and *particularly* if the use of EPO/Procrit and/or
Neupogen was supported to manage any bloodwork issues that arose.
But, in your case, after 8 weeks on the 24 week plan, I expect any positive
value in upping the dosage now would be significantly reduced vs having
started at the higher dose from the jump.

Talk it over with your doc, he/she may allay any concerns you have. It's quite
possible your doc did the math and concluded you'd do just fine at 800mg.

Full disclosure: In my case (G1b, highish VL, F2-F3/A3, 100kg at start of tx)
I did 1400mg Riba on top of 150ug of Peg-2b, and I needed 35 weeks of EPO @60K
IU/week to make it through the full 48 weeks of tx. The mayhem proved
successful - at least to the 6 month post-therapy SVR test :-)

Cheers

/greyhackles