Re: 3 weeks post treatment  

Group: alt.support.hepatitis-c Date: Sun, Mar 4, 2007, 12:44am (CST+1)
From: greyhackles@NOSPAMyahoo.com (greyhackles)
On Sun, 04 Mar 2007 04:51:11 GMT, "Cactus Jammies"
<cactusjammies@imitation.univ.net> wrote:
On Mar 3, 6:20 pm, greyhackles <greyhack...@NOSPAMyahoo.com> wrote:
I find it more than curious that your doctor said "You were clear at six
months too, that's good". Hell, son, if you *weren't* clear by 6 months,
you'd
have likely been taken off therapy as a "non-responder"! That's
"good"?!?
Cheers - and good luck. And be sure to tune in here to let us know you
got
your SVR!
/greyhackles
Well, I was just reporting what he said. I was actually clear at 12
weeks but that wasnt the qualitative test. Maybe he was just trying to
make me feel good. It is rather curious isnt it?
Hey Grey,
I don't know if things are crossed in front of my eyes, but when I
treated a year a half ago (and then relapsed) my two log drop at the 12
week pcr test was enough to keep the tx going for the 48 weeks. I was
not pcr tested at week 24, which seemed to cause some discussion in this
group. I did get a clear (negative) pcr at the end of 48 but the 6 month
post tx test clipped my free wings for me. positive. no svr. In the
current practice, I understand that the tx continues for 48 weeks after
the two log drop, and if there is no svr after week 24, then treatment
is ceased as unlikely to provide the svr. or is this changing again? (I
guess it depends, there is now some flexibility in the subjective side
of treatment)
other things going against me ... I was more than 20 lbs over the weight
based dosage level my Rx was for (the orange box, the biggest IFN and
Rba doses), and I was diagnosed with a fatty liver (steatosis) during my
initial (only) biopsy. stage 3 level 3, 3 years ago pre-tx.
Anon, read "The Patient From Hell" by Schneider, if you have the time.
cactus jammies ============
Clearly there are different strategies with different doctors (and
likely with their different patients). A g1 who tests clear at 12 weeks
may reasonably not get another PCR until EoTX - unless (s)he is
insistent - or doesn't have a problem adding a check mark to test orders
(eg: elmo ;-)
Another g1 who just makes the 2 log drop in 12 weeks may get checked at
24 weeks and if still positive could reasonably have treatment
discontinued (that's pretty common, especially if the insurance
companies are in the game. For g1s it is pretty darned unlikely to
obtain a durable SVR with the standard 48 week regimen if the virus is
still ticking after 24 weeks.
And then there is the g1 patient who makes the 2 log drop at 12 weeks
but doesn't get tested again until EoTX - which I reckon is what caused
many of us to get cranky with your doctor ;-)
Some docs are now moving toward extending treatment for slow responders
- they take the first undetectable test result date and add 48 weeks. I
think that could boost the overall g1 SVR rate by 5% or so - I don't
think it will provide much more dramatic results than that.
Anyway....the doctor's line just sounded weird - and more so after
learning the OP was undetectable at week 12! I wonder if he was thinking
of someone else at the time ;-)
Cheers
/greyhackles  
////////////////
I remember the look on my NP's face when she noticed there were pcr
results when she hadn't ordered the test.  ahahahahahaha!!  I told her
she must have ordered the pcr....why else would there be results?  And
then I suggested she might have been having brain fog.  We both got a
chuckle.  After I went undetectable and had no reason to check the pcr
box anymore, I fessed up to her that I was responsible for her bouts of
brain fog.  She also sh.t a brick when I told her I'd been doing
Infergen and Peg together for a few weeks.  She said she'd suspected
something was up when my labs dropped into the toilet so fast, but
couldn't put a finger on it.  

I don't have any proof for it (other than it worked for me), but I
strongly believe in the strategy of 'shock and awe' early in tx for
relapsers, rather than extended tx duration.  Fire all the bombs and
missiles you can tolerate at the nasty virus early on til it's
undetectable, then cruise to the finish line.  The idea is to get
undetectable as fast as you can, certainly sooner than the 12 week
standard for 2-log drop.  My impression is that if you graphed your
progress, that the curve toward undetectable would be a steep one.  And
it's that steep curve that actually kills the virus, rather than a
slower response that allows the virus to hide and continue replicating,
even with a 2 log drop by week 12.  That's my take on all of this.
elmo  

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