Hello TX

Well beeing undetectable at 5 months of tx you might benefit from 72
weeks tx, I would say that beeing undetectable for 12 months puts you
in pole position. How are you doing?

Cheers

/H

Current protocol recommends a viral load test 12 weeks of tx, and if it
doesn't result in a 2-log drop then tx is usually discontinued or extended
beyond the initial duration because the odds of SVR aren't great. Without
knowing your baseline and 12-week results, it's impossible to guess whether
or not the 72 weeks might be advantageous. However, it does sound like your
doc is well educated on hep c research, so good for him or her-- a lot of
them don't bother.

Sorry I haven't got links handy for you, but you can probably find lots if
you spend some time googling.

I don't know if there is much research out there for extended
treatments with very late viral response.  There was a group member
with Geno 3 who was not undetectable at 12 weeks and extended his
treatment from 24 to 48 weeks and it worked.  But that was genotype 3.
One thing I wondered about was whether you were at full dosage
throughout that early period.  There is this though
http://www.ncbi.nlm.nih.gov/pubmed/16618403   "CONCLUSIONS: Extended
treatment duration generally is not recommended in HCV type 1
infection and should be reserved only for patients with slow virologic
response defined as HCV-RNA positive at week 12 but negative at week
24."

I'm not a doctor but... My thoughts are that the late response is a
bad predictor for success stopping at the conventional treatment
length because you didn't meet conventional treatment guidelines.  I
am optimistic about the fact that you did eventually obtain the
undetectable response before 24 weeks and wondered whether switching
interferon types or a weight based dosage would have been more
effective for you as mentioned at http://hepatitisdoctor.com/ and
other places.  

I don't know what kind of shape your liver is in but if it was pretty
bad that might swing my thoughts more towards extended treatment
sounds like a good option.  The longer treatment would be a longer
rest for your liver so that might be good in itself.  However, the
sooner you get off treatment the better with regard to avoiding
complications from the treatment.  Has it been pretty mild for you to
date?

You're only about  half way through conventional treamtent it looks
like and some doctors would have stopped treatment at week 12.  I
don't really have the data to say much about that and don't know what
the factors were that went into the decision to keep going. Whatever
choice you make I'd be interested in hearing the outcome and wish you
the best of luck.

Don