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Date Posted: 19:11:34 05/08/02 Wed
Author: Junobear
Author Host/IP: 216-220-251-198.midmaine.com / 216.220.251.198
Subject: I'm a 2 too.
In reply to: Chopper John 's message, "Question regarding length of tx" on 13:08:20 05/08/02 Wed

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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Replies:

[> 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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