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Date Posted: 13:08:20 05/08/02 Wed
Author: Chopper John
Author Host/IP: NoHost / 158.11.98.188
Subject: Question regarding length of tx

Hi all. I'm new to your board, but not new to Hep C. Can anyone tell me the guidelines for discontinuing Peg Intron/Ribavirin if one is genotype 2 and has no detectable viral load after 24 weeks of tx. Everything "official" I've read indicates that I must continue tx for an additional 24 weeks, however I've seen/read on some other boards that w/ genotype 2, tx can be discontinued after 24 weeks if no detectable viral load exists because there are no additional benefits to be had from additional tx. Can anyone provide me w/ the "official" poop? I certainly don't want to continue this tx for 24 "extra" weeks if I don't have to, but then again, I don't want to minimize my chances for a sustained response because I got hyped on a pie-in-the-sky idea and quit tx "before the miracle happened" Thanks for your help.

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Replies:

[> Hi Chop -- Susie, 13:26:58 05/08/02 Wed (bgp425870bgs.union01.nj.comcast.net/68.36.197.75)

Go to our home page at www.hepcassoc.org and click on the Pegasys slide show. It talks about the fact that their is no added benefit to the extra 24 weeks for anyone who isn't genotype 1. I realize it is a study done with Pegasys and not PegIntron but everything I have heard and seen says 6 months for geno 2 and 3.

And welcome. Hope you'll stick around even though you're one of the lucky guys who cleared!


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[> [> Re: Hi Chop -- Chopper John, 13:59:20 05/08/02 Wed (NoHost/158.11.98.188)

Thanks Susie....I've got to admit that I've already read the info you pointed me toward...it heats me up a bit...but not a total warm - fuzzy (if you know what I mean). I suspect there may be significant differences between Pegysys and Peg Intron that may require (under the circimstances listed above) a continuance of the Peg Intron for the additional 24 weeks. I really wish I could find something definitive regarding Peg Intron as opposed to Pegysys. Anybody else got anymore info on this?


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[> [> [> Ok Chop -- Susie, 14:05:33 05/08/02 Wed (bgp425870bgs.union01.nj.comcast.net/68.36.197.75)

You can call Schering's patient care consultants and leave a voicemail message. They will call you back within 24 hours. They are the ones who will have the latest statistical information. The number is 1-800-782-2347, ext 6003.


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[> Welcome to the board Chopper John... -- terry, 16:29:18 05/08/02 Wed (sg73.merr.com/209.83.14.204)

and big CONGRATS on clearing!! Hopefully that call to Schering Susie suggested will give you the answer. Stop in again.


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[> Re: Question regarding length of tx -- sugarB, 18:58:19 05/08/02 Wed (08-061.067.popsite.net/64.24.188.61)

im 3a and clear at 6 mo , Ive decided to continue tx to hopefully produce histological responce for my liver and to hopefully fend off relaps , which would create the necessacity for another round of tx for the full 48 weeks , no way Im goeing that route if I can possibly fend it off.


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[> I'm a 2 too. -- Junobear, 19:11:34 05/08/02 Wed (216-220-251-198.midmaine.com/216.220.251.198)

I did 24 weeks of IntronA/Ribavirin combo in 98-99 before it was pegylated. I was a 2b/250,000 pre-treatment viral load/condition of liver unknown. I went undetected the second week of treatment [8/98] and have been undetected ever since. 24 weeks of a much less effective treatment than the PEG with Riba was long enough to do the trick for me.

Pit [another 2b] and AuntieD [a 3a] treated 24 weeks with the old combo in 98-99 and also remain in sustained response. AuntieD did not have a perfect profile [cirrhosis/high pre-treatment viral load] but 24 weeks was sufficient to do the trick for her, as well.

I also know of a couple of 2's who relapsed. There are no guarentees for any of us.

24 weeks is sufficient for MOST 2's and 3's. Here are a couple of other predicters of response:

1. Genotype 2 or 3 [This is the most reliable predicter and you have it]

2. Low or very low pre-treatment viral load [If you have this predicter in addition to Genotype you're a better candidate for 24 weeks than someone with a moderate to high pre-treatment viral load.]

3. Pre-treatment condition of the liver [The lower your biopsy score, the better candidate you are for sustained response after 24 weeks. Certain specialists are treating 2's and 3's with cirrhosis longer than the usual 24 weeks. This is an important possible exception to the rule.]

4. Sex [females have somewhat higher rates of sustained response than men, we think because of often being smaller. Large or fat persons seem to respond in greater numbers on a little higher dose].

5. Very early clearance of the virus [This is emerging as almost a better predicter than Genotype. Sustained response rates for those who clear the first two or three weeks of treatment are running 95-98%. Very early clears with 2 or 3 genotypes are excellent bets for 24 week sustained response.]

Factor your Genotype with a couple of the predictors above and make the decision that is best for you. The data is clear and has been clear since 98-99 when I had the same decision to make that 24 weeks is sufficient for MOST 2's and 3's and you may be torturing yourself for nothing enduring treatment for longer.

You can always 'split the difference' and treat another 6-12 weeks instead of 24 if you have cirrhosis or cleared the virus slow on treatment or had a high pre-treatment viral load [over 3,000,000] and want to be certain you don't end up having to do it over again.

There is no such thing as a sure thing for any of us and that is what makes this decision a hard one.

Let us know what you decide -- and welcome.


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[> Re: Question regarding length of tx -- Chopper John, 08:42:56 05/09/02 Thu (proxy2.monmouth.army.mil/134.80.1.57)

Thank you all so much for the excellent insights and info. You know I appreciate it!


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[> welcome chopper......... -- juice, 09:09:24 05/09/02 Thu (spider-tr063.proxy.aol.com/152.163.201.203)

it's always good to hear that some body has responded to tx. stick around, nice place to be with a bunch of great people.....frank


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