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Hep C Discussion Forum -> On Treatment -> Confusion About Treatment Duration for Relapsers?
Post Info TOPIC: Confusion About Treatment Duration for Relapsers?
kiwi


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RE: Confusion About Treatment Duration for Relapsers?
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im in week 27 of 48. nice to not feel so alone in the 48 week slog. and man, it feels like a slog sometimes eh.. ah well. onwards..



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kiwi. genotype 1. started pegasus and riba on 10 nov. VL 17.6 million. (4 weeks VL 1368)  week 15 UNDETECTED... :)
kr


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I am on week 31 also - are you on triple therapy still or just PR



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mallani


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I am a 69 yo cirrhotic, geno 1b, diagnosed in 1990, biosy 2000 Grade 3-4, fibroscan 2006 showed cirrhosis. Early portal hypertension, splenomegaly but no varices as yet. Liver carcinoma is the biggest worry for us, as long as we have virus in our blood. Get an SVR and the risk of liver cancer drops long a stone.  I was a responder in 2000, but my PCR became +ve after 6 months.

I've got my EVR after 4 weeks on Victrelis, and will definitely be in for the full 48 weeks. With cirrhotics there are more places for the virus to hide. So even with the Sx, I am not going to miss this chance!!!!



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Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
TazKat


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i am now on week 31. interferon& riba kickin my ass right about now.. have a chipped tooth down in the gum. so will problay have to stop when that sucker starts giving me fits... cry



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TazKat Genotype 1A null responder x 3 riba & iterferon twice, relapsed from Incivek 2012 with only 12 weeks left to do. stage 4 mild cirrhosis 4/25/2014/ started sovaldi riba & interferon.. finished treatment 7/17/14  results 7/25  cleared..

 

 
Sunrise747


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Sounds like 48 weeks is the way to go!



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Geno 1B Relapser 2001. Started Incivek 12-16-11. 57 yr old male.  Last biopsy 2000 -stage 3 fibrosis. UND Wk4, 12, 18, 26.  Did 34 weeks.  Still UND at 12-wks post.
Sed3


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I just found out I'm now on the 48 week program. Does it suck? Yes. But what is the choice? And I feel a lot better now that I'm off incivik.

If you had cancer and the doctor said you may benefit from longer treatment, you'd sign right up, and so would I.

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Type 1B - Unknown for 30 years, diagnosed September 2011, started treatment February 2012

8 weeks Incivik - stopped early due to rash.

Continuing Pegasys and Ribavirin until January 2013 - 48 weeks

Undetectable from week 4 --> present
Sunrise747


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Thanks All!  I appreciate the good advice and encouragement.



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Geno 1B Relapser 2001. Started Incivek 12-16-11. 57 yr old male.  Last biopsy 2000 -stage 3 fibrosis. UND Wk4, 12, 18, 26.  Did 34 weeks.  Still UND at 12-wks post.
Sailboatbend


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i am a partial responder with bridging fibrosis consistent with cirrhosis. Geno 1A I am in week 32 doing 48 weeks as Incivik says to do. I was undetected week, 2, 12, 18, 24 and am still undetected and would never think of stopping. i didn't come this far to stop now. At the end no one will tell me I didn't go all the way.

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LanaiSurferGirl


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There are still some unknowns with this treatment and not everyone is the same.  I would play it safe if I were you and extend my treatment.  Try to "chunk" it into small time frames like this:  don't look at it like an extra 24 weeks of treatment....take it one month at a time and do your best to get through it.  I am extending mine an extra 12 weeks and it is hard as I will finish 24 weeks in a few days.  I am not excited about it either but am taking it a little at a time. :)  Good luck!!



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geno 1a, mother & brother also hep c +...mom got a blood transfusion and passed it along.  Started tx with incivik 11/23/11 and brother started 2/8/2012.  Both of us und. at 4,8,12 and me at 24.  I am going 36 wks and brother is going 48 weeks.
Steve-o


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Not yet a Relapser, but started 24 week TX in Dec 2010.

On a routine visit in April 2011 was diagnosed with Cirrhosis( And subsequently with Varices) and the Hospital extended my TX to 48 weeks, I was so close to the "Finish" line tooyawn

They did this to give me a better chance of acheiving SVR, I was already UND at the time.

I finished the 48 weeks in Nov 2011 and as yet have still not recieved results of my SVR blood test 10 days ago.

The proof of the Pudding will be in the eating, I'll have custard with mine if I acheive SVR, a big slice of humble pie if not.

"Don't worry, be Happy"

Steve.



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Steve
davesf


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"Treatment-naïve patients with cirrhosis who have eRVR may benefit from a total treatment duration of 48 weeks"

Hmmm, I'm assuming that relapsers are always at an equal or greater treatment standard than naive patients. So a relapser with cirrhosis may benefit (equally or more) from a total treatment of 48 weeks.

The question is whether anyone has been able to qualify how much the additional benefit is worth. I know how you feel; I'm anxiously awaiting my 12 week labs to see whether I'll be doing 24 or 48 weeks.

If you can't quantify the benefit, I'd ask the input of people on this forum who have had to go the extra distance. There are some who are even on on 36 weeks. I'm not sure what the protocol is for 12 extra weeks vs. 24. I think you need their help for the mental barrier of going the extra distance. (How are you going to feel if you don't do it and end up relapsing?)

If you absolutely can't buy into the extra 24 weeks, perhaps your goal becomes 6/12/18 or just as long as possible. You already know this treatment is all about 1 day and 1 week at a time.

All the Best, Dave

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All Done Poisoning the Dragon that Used to Poison Me

Genotype 1b  Incivek Combo
Sunrise747


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With only three weeks to go, my doc called Friday to suggest I consider extending my treatment to a total of 48 weeks because she assumes I have cirrhosis since I was graded stage four fibrosis in 2001.  Arrrgh!   Not sure what she is basing this recommendation on but I am disinclined to take her up on her offer.  Here's what the Incivek dosing guide says for treatment naïve patients:

Treatment-naïve patients with cirrhosis who have eRVR may benefit from a total treatment duration of 48 weeks

However for relapsers it simply says:

Patients with undetectable HCV RNA at Weeks 4 and 12 (eRVR) can complete their total treatment duration in 24 weeks

So, my question is, what is the recommended treatment duration for relapsers with cirrhosis?  Best I can tell the guidelines make no specific recommendation for this subgroup of patients as they do for treatment naïve patients.  Thus I assume the recommended duration is 24 weeks.



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Geno 1B Relapser 2001. Started Incivek 12-16-11. 57 yr old male.  Last biopsy 2000 -stage 3 fibrosis. UND Wk4, 12, 18, 26.  Did 34 weeks.  Still UND at 12-wks post.
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