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Re: Tatezi's anemia

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  • Mark Middle Mountain
    I read thru this and saved it. While it is primarily about retreatment, read thru and notice when I broke it out - that if you were undetectable at 20 weeks,
    Message 1 of 2 , Apr 11, 2004
      I read thru this and saved it. While it is primarily about retreatment, read
      thru and notice when I broke it out - that if you were undetectable at 20
      weeks, reducing ribavarin after that had no effect on eventual outcome.
      Seems you could drop back on the ribavarin which may help the anemia and not
      hurt outcome.


      Peginterferon Alfa-2a and ribavirin in patients with chronic
      hepatitis C who have failed prior treatment.

      Shiffman ML, Di Bisceglie AM, Lindsay KL, Morishima C, Wright EC,
      Everson GT, Lok AS, Morgan TR, Bonkovsky HL, Lee WM, Dienstag JL,
      Ghany MG, Goodman ZD, Everhart JE.

      Background & Aims: The most effective therapy currently available for
      treatment of chronic hepatitis C virus (HCV) is the combination of
      peginterferon and ribavirin. This study evaluated the effectiveness
      of this treatment in patients who were nonresponders to previous
      interferon-based therapy. Methods: The first 604 patients enrolled in
      the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis
      (HALT-C) Trial were evaluated. All were HCV RNA positive, previous
      nonresponders to interferon, with or without ribavirin, and had
      bridging fibrosis or cirrhosis on liver biopsy (Ishak fibrosis stage
      3-6). Patients were retreated with peginterferon alfa-2a 180
      microg/wk plus ribavirin 1000-1200 mg/day. Those with no detectable
      HCV RNA in serum at week 20 continued treatment for a total of 48
      weeks and were then followed for an additional 24 weeks.Results:
      Thirty-five percent of patients had no detectable HCV RNA in serum at
      treatment week 20, and 18% achieved sustained virologic response
      (SVR). Factors associated with an SVR included previous treatment
      with interferon monotherapy, infection with genotypes 2 or 3, a lower
      AST:ALT ratio, and absence of cirrhosis.

      ******* Reducing the dose of
      ribavirin from >/=80% to </=60% of the starting dose during the first
      20 weeks of treatment was associated with a decline in SVR from 21%
      to 11% (P </= 0.05). In contrast, reducing the dose of peginterferon
      or reducing ribavirin after week 20, when HCV RNA was already
      undetectable, did not significantly affect SVR.********

      Conclusions: Selected
      nonresponders to previous interferon-based therapy can achieve SVR
      following retreatment with peginterferon alfa-2a and ribavirin.

      PMID: 15057741 [PubMed - in process]
    • Tatezi
      It s reassuring to know that I m not comprimising my treatment by cutting back on the ribarvarinn, but at this point I want to be able to move and breathe at
      Message 2 of 2 , Apr 11, 2004
        It's reassuring to know that I'm not comprimising my treatment by cutting back on the ribarvarinn, but at this point I want to be able to move and breathe at the same time...It would also be nice to stay awake for more than a couple hours.

        Just have to get through tonight and then I can go for labs at County and get my appointment for week after this to be moved up to this week.

        Thanks for posting this...I'd forgotten about the Halt trials.

        Tatezi

        ----- Original Message -----
        From: Mark Middle Mountain
        To: GIWorld-Hepatitis@yahoogroups.com
        Sent: Sunday, April 11, 2004 1:02 PM
        Subject: [GIWorld-Hepatitis] Re: Tatezi's anemia


        I read thru this and saved it. While it is primarily about retreatment, read thru and notice when I broke it out - that if you were undetectable at 20 weeks, reducing ribavarin after that had no effect on eventual outcome. Seems you could drop back on the ribavarin which may help the anemia and not hurt outcome.


        Peginterferon Alfa-2a and ribavirin in patients with chronic
        hepatitis C who have failed prior treatment.



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