CJ, as you've probably found, there's not a wealth of information out there
dealing with extended re-treatment of relapsers since the pegylated IFNs
became the standard-of-care. Indeed, I really haven't found any good studies
that were structurally conceived to determine how much, for instance, a 72
week course of peg-IFN & riba improves outcomes.

That said, there is a definite inverse correlation between degree of fibrosis
and SVR using the 48 week regimen for tx-naive responders, and there is plenty
of *conjecture* that a longer regimen could improve SVR rates in that group.

Positive support for "extended therapy" is historic and ongoing: from the
original studies using Pegasys & Ribavirin that had 24 week treatment g1 arms,
through current trials with alternative interferons, or additive drugs such
protease inhibitors, all show the benefit of longer treatment durations over
shorter.

Obviously, there's a "tail of the dragon" in the curve, so the degree of
improvement approaches zero at some point, but there are a few studies on
tx-naive g1s showing increased SVR with 72 weeks on standard therapy in the
low double-digit range, so the zero-point is out beyond 72 weeks.

Dr. Ben Cecil is an advocate for "individualized treatment" that includes
extended regimens. It appears that his basic g1 responder-relapser
retreatment game plan is to do frequent viral load testing, and add 48 weeks
to the point of first undetectable status. He also likes to vary the amount of
Peg to get the patient on a good VL-fall curve. I think those are good
strategies, while recognizing that it isn't going to be a cakewalk.

Correct me if I'm remembering this wrong (there's been a lot of folks that
passed through here since you did therapy ;-) but you really didn't have a lot
of early viral load testing - so you're not really sure when you went
undetectable, but you know you were undetectable by week 24? If you actually
went undetectable much earlier than 24 weeks, you might not be facing a whole
72 weeks.

Which Peg did you do the first time: Pegasys or Peg-Intron? Would you be
repeating the same Peg - or switching?

fwiw, I'll keep looking for anything that might help.

Cheers

/greyhackles

On Sep 5, 5:45 pm, "Cactus Jammies" <cactusjamm...@retinal.circus.orb>
wrote:

Hi cactus,
As i have posted before and you might remember.After 72 week treatment
of infergen i finally cleared at week4.dr told me i had a 95% of SVR.
week #8 still clear.Dr said 98%.she will retest at the 6 month point
which is december.she is optimistic but after 3 treatments i am still
nervous..........
pegasys didnt work for me,genotype 1a stage 3-4 in 2004.
but when i tried infergen for the full 72 weeks with 4 weeks of
pegasys mixed in at the end of treatment it might have worked.
Infergen is hell i am not going to lie to you.It was the worst time in
my life at the end of treatment number 3.It was tough.
If you are near cirihoisis you might have to do whatever possible.For
me i realized after that treatment i am done regardless of the
outcome.
Best wishes i am pulling for you....................

John