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Medical Forum / Diseases and Disorders / Hepatitis / May 2008

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Russian - 23 May 2008 08:02 GMT
I got to zero in treatment within 3 (or 4) months as I recall, and I
stayed at zerio to the end.

2 months after treatement, I had 400 IU HEP  C
4 months after treatment, I had 3.2 million IU
8 months arter treatent, I now show 1.5 million IU

I'm glad, but how can it go down by half?  My own immune system?

My ALTS went down from the high 200's to normal during treatment.

They are back up, but just above normal, not back anyhwere near to
pre-treatment levels.
TX-012 - 23 May 2008 16:10 GMT
> I got to zero in treatment within 3 (or 4) months as I recall, and I
> stayed at zerio to the end.
[quoted text clipped - 9 lines]
> They are back up, but just above normal, not back anyhwere near to
> pre-treatment levels.

Those are sad numbers. I also got to zero in about the same time frame
you did. I still have 7+ months to go (I'm doing 72 weeks)...

I have no idea why the variance. Perhaps your own immune system,
perhaps a testing artifact...

What were your numbers before treatment? Are you trying to get into a
trial for one of the new meds, and/or perhaps try Infergen combo
therapy+fluvastatin?

Fluvastatin piece (crappy, but...): http://tinyurl.com/3vjrfp

Infergen:

http://hepatitisdoctor.com/infergen.htm

http://www.infergen.com/1-For_Consumers/index.html

Lastly---not to blame the victim or anything like that, but as I very
much want my treatment to work, is there anything you feel you could
have done "better" while on treatment that might have improved the
outcome?
greyhackles - 23 May 2008 17:25 GMT
>I got to zero in treatment within 3 (or 4) months as I recall, and I
>stayed at zerio to the end.
[quoted text clipped - 9 lines]
>They are back up, but just above normal, not back anyhwere near to
>pre-treatment levels.

Hi, Rusky. Sorry to read about this.

Chronic HCV patients are host to a raging battle between immune system and
viral reproduction. Because the virus can change its coding to help avoid
recognition, it always holds the highest trump card. So, when its numbers
decline under immune system pressure, it uses mutation to regain its numbers
again, and once the virus gains the upper hand, it usually returns to its
"natural" coding, at which point the immune system starts winning. Repeat
indefinitely.

Thus viral load tests over time can produce highly varied results. I have read
that in untreated folks there can be a variability in viral load measurements
far exceeding 1 log. Indeed, pre-treatment, my VL over two measurements 6
months apart was 541K and 7M, using the same quantitative test.

That latter number scared me right into treatment, as one can imagine, even
while my bcld explained it wasn't an unusual occurrence, in light of the
mutation ability of the virus.

That viral mutation capability is a major cause of on-treatment viral
"breakthrough" - a phenomenon which has been significantly reduced by the
addition of Ribavirin to the Interferon, and the shift towards weight-based
dosing.

What we all hope for is a better set of combo drugs with higher success rates.
And hopefully something will be approved in a couple of years. In the mean
time, if you are considering re-treatment, switching to another Interferon and
extending treatment duration based on response rate is probably the way to go
- similar to the philosophy espoused by Dr. Ben Cecil and others. You may
simply have needed to stay on-tx for a few more months instead of following
the current standard of care for your genotype...

Cheers - and hang in there.

/greyhackles
Russian - 25 May 2008 20:45 GMT
Thanks for the info.

I like to think that when the immune system is (however temporarily)
winning, it's better for my liver.  I think the ALT levels show that.

When I first decided (after several years of holding off) to do
treatment, the doctors told me that even if it didn't work, it might put
my disease status back 5 years ("buy you 5 years" as they put it) until
another treatment comes out.

A week after I stopped treatment, the hep doc waffled about going 72
weeks, but I didn't get a clear message from him on that.

I hear your recommendation - but I'm hoping to try it with Telepravir in
the fall.

Although I originally had planned that if it didn't work I would wait at
least 3-5 years for the Next Big Thing, now I'm thinking that it might
be best to attack it now while it's been knocked down a bit.
 
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