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Medical Forum / Diseases and Disorders / Hepatitis / May 2006

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Negative at 8 weeks

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Susan - 26 May 2006 22:44 GMT
I just got back from Lexington for my 12 week check up and am negative
at 8 weeks.  I am taking 4 more weeks just to be on the safe side and
then go back in 7 months from today to make sure blood work is still
negative!!
dortski - 27 May 2006 00:45 GMT
> I just got back from Lexington for my 12 week check up and am negative
> at 8 weeks.  I am taking 4 more weeks just to be on the safe side and
> then go back in 7 months from today to make sure blood work is still
> negative!!

Isn't it amazing how those positive test results can make you feel? When I
got my 12 results that showed <10 I walked out of the doctors office and
called my momma crying with tears of joy. I hope this news gives you new
strength to beat that dragon! Thanks for letting us know!

All the best....dort
elmoemerson@webtv.net - 27 May 2006 02:18 GMT
16 weeks of treatment?  You sure you want to do that?
elmo

http://community.webtv.net/elmoemerson/DocElmosHepFile

http://community.webtv.net/elmoemerson/TheFamilyAlbum
Susan - 28 May 2006 02:10 GMT
Yes, my doctor and I both feel that I can stop at 16 weeks of treatment
and will still be cleared.  If I was already cleared at 8 weeks - there
should be no problem.  Besides, I am having such a hard time with the
treatments - psycologically - I think it is a good idea.
Burke Gilman - 28 May 2006 03:36 GMT
I concur that a efficacious variable-treatment is an option you are
fortunate to have, considering the sides you are suffering.

In my own case, my PA told me she thinks it likely I will be a
candidate for variable-treatment, based on results she anticipates for
my 4-week labs, but I replied that I will opt for standard treatment
anyway because my sides are not too bad and because I understand that
my chances of attaining SVR will be significantly improved if I go the
full 24 weeks.

(I have HCV G3, started Tx with VL = 57000, and will see the results of
my 4-week PCR this coming Tuesday.)

Best wishes,

BG in Seattle

I don't know what my situation will be just yet. I find out what my
4-week PCR turned up when I go into see my doc this coming Tuesday. I'm
into my 9th week now, and by a fluke of scheduling problems I'll not be
seeing what my VL was after the first month until I'm actually well
into the third month. Anyway, like I said, I'm lookng at going the full
24 weeks because I'm not having too hard of time with sides and because
I think the chances for SVR are better.
Burke Gilman - 28 May 2006 03:43 GMT
(Edit this: The last paragraph in my last post is editting debris that
was unitentionally included.)

--BG
Burke Gilman - 28 May 2006 01:38 GMT
Susan,

Standard-treatment for genotype 2 and genotype 3 patients is 24 weeks.
A recent study concluded that G2 and G3 patients who have undectable VL
at 4 weeks can do just as well with a "variable-treatment" duration of
only 12 weeks.

But for a G3 patient now presented with the option of
variable-treatment, the following highlight taken from that study is
pertainent:

"In patients with genotype 3 with a 4-week response, response rates at
24 weeks after treatment were 77% in the variable-duration group vs
100% in the standard-duration group."

Source: http://www.medscape.com/viewarticle/507068

BG in Seattle
Paul - 28 May 2006 08:06 GMT
On 26 May 2006 14:44:21 -0700, "Susan" <zimaky@tgtel.com>, in message
ID <1148679861.395776.283280@g10g2000cwb.googlegroups.com>, in the
newsgroup alt.support.hepatitis-c wrote:

>I just got back from Lexington for my 12 week check up and am negative
>at 8 weeks.  I am taking 4 more weeks just to be on the safe side and
>then go back in 7 months from today to make sure blood work is still
>negative!!

Sounds a bit risky to me unless there is some reason you really cannot
cope with doing 24 weeks (I assume you must have geno 2 or 3).
I can't honestly recall where I saw it but I did read something about
a study that showed there being a  higher relapse rate for shorter tx
(though I can't recall how much higher).
Were you tested for the virus 4 weeks into tx?  The shorter tx models
have usually relied on testing after 4 weeks.  Relying on an 8 week
test could prove flawed if you didn't have a 4 week test.  I say this
because it's possible that your virus could have been detectable until
week 7 without you knowing it.

If your sides are really bad, why not set your stall out for 16 weeks
(though possibly risky), and take it a week at a time after that and
do it as long as you can cope with it?
Burke Gilman - 28 May 2006 11:56 GMT
> On 26 May 2006 14:44:21 -0700, "Susan" <zimaky@tgtel.com>, in message
> ID <1148679861.395776.283280@g10g2000cwb.googlegroups.com>, in the
[quoted text clipped - 19 lines]
> (though possibly risky), and take it a week at a time after that and
> do it as long as you can cope with it?

Paul,

As mentioned previously in this thread, you can read about the study
here: http://www.medscape.com/viewarticle/507068

As mentioned by Susan in an older thread, she has genotype 3.

And as stated previously in this thread, as well as in the in the study
that found variable-duration treatment is sometimes prudent for G2 and
G3 patients, 77% of G3s who were put on variable treatment attained
SVR, while of the G3 variable-treatment candidates who were put on
standard treatment, a full 100% attained SVR.

Despite the remarkable 100% SVR outcome for G3 patients who showed no
VL at 4 weeks AND who went the standard 24 weeks of Tx, only 66% of the
the G3s overall attained SVR. Therefore, it seems risky indeed for any
G3 candidate for variable Tx to opt for early discontinuance of Tx,
especially without benefit of the telltale predictor provided by a PCR
test at 4 weeks.

(Because an 8-week PCR doesn't figure into the landmark study, I too
see that figure in Susan's case as somewhat irrelevent.)

Again, details on the study are available here:
http://www.medscape.com/viewarticle/507068

BG
Paul - 28 May 2006 17:31 GMT
On 28 May 2006 03:56:41 -0700, "Burke Gilman"
<burkegilman@moxmail.net>, in message ID
<1148813801.329096.82090@j55g2000cwa.googlegroups.com>, in the
newsgroup alt.support.hepatitis-c wrote:

>Paul,
>
[quoted text clipped - 21 lines]
>Again, details on the study are available here:
>http://www.medscape.com/viewarticle/507068

Thanks for that.  For some reason best known to my news server, it
looks like not all the posts in this thread have shown up.
As for posts in older threads, well I have so much to remember at the
moment, it would be difficult for me to recall the details of what
people have written.
In fact, I'm so far behind with my non-internet life, I think I need
to take a break for a while.  I find that this internet stuff can be a
great way of not sorting out some of my real life issues.
So, from tomorrow, I may not be posting for a couple of weeks or so.
I'm just going to use the computer for my work for a while
(spreadsheets, databases) and the only time I will connect to the net
is to upload files for backups and to upload a website that I've
started to form.
Burke Gilman - 28 May 2006 12:43 GMT
> On 26 May 2006 14:44:21 -0700, "Susan" <zimaky@tgtel.com>, in message
> ID <1148679861.395776.283280@g10g2000cwb.googlegroups.com>, in the
[quoted text clipped - 19 lines]
> (though possibly risky), and take it a week at a time after that and
> do it as long as you can cope with it?

Here's a study that compares 16-week Tx with 24-week Tx:

"24 Weeks of Peginterferon alfa-2a Plus Ribavirin More Effective Than
16 Weeks in Patients With HCV Genotype 2 or 3"
http://clinicaloptions.com/hepatitis/conference%20coverage/vienna%202006/capsule
s/734.aspx

greyhackles - 30 May 2006 03:59 GMT
>I just got back from Lexington for my 12 week check up and am negative
>at 8 weeks.  I am taking 4 more weeks just to be on the safe side and
>then go back in 7 months from today to make sure blood work is still
>negative!!

-  g3, f3, vl at start of tx = 6,180,000
-  you were running a fever at week 7
-  tested clear @ wk8
-  no mention of a wk 4 vl test

A few months ago you were wondering if your "3/4 destroyed" liver could be
healed via therapy. You are now facing a near slam-dunk if you go the
distance.

Without an undetectable test result at week 4 - using a test *at least* as
sensitive as 10 IU/ml - you're out there on thin ice without favorable study
data to support you if stop therapy at 16 weeks.

It's pretty much down to that question: did your doctor do a high-quality
viral load test after the fourth week on therapy and was the result
undetectable?

If no to either question, you'd do better to up your anti-Ds, buckle your chin
strap, and hold on for the full 24 weeks.

Regret sucks. Go for the slam dunk! :-)

/greyhackles
 
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