Resistant Hepatitis C
May 9, 2010
Hello Dr. McGovern,
In September 2008 I was diagnosed with Hepatitis C genotype 1 B. Blood test showed the value for Hepatitis C Virus RRNA, QL, NUCLEIC ACID PROBE of 3,950,000 IU/ml and RRNA, QL, NUCLEIC ACID PROBE 6.60 LOG IU/ml.
Rx plan consisted of Peg Intron 150 mcg week SC. Ribavirin 2 capsules, 200 Mg BID. Initially I showed a significant drop in viral load until I hit a plateau in June 2009. At that time my doctor increased Ribavirin to 5 capsules totaling 1,000 mg a day also continuing the same dose of the Peg Intron. In July I saw a new doctor who increased the Ribavirin to 3 capsules twice a day or 1200 mg and kept the same dose of Peg Intron.
I reached a non-detectable virus level from November 2009 through February 2010 and continued these dosages until May 5. However, my May 2010 tests showed a viral load of 21,254 with a log of 4.33.
Consequently, my doctor has stopped treatment. Can you provide any information for new or experimental treatments available?
Response from Dr. McGovern
Because of the dosing changes, I would suspect that either you may have gained weight during therapy or the initial dose was not high enough for genotype 1. We usually dose ribavirin about 13 mg/kg for that infection.
I think you will be an excellent candidate for the new drugs that are coming down the pike because you did respond transiently to PEG/RBV. We expect a new protease inhibitor probably by 2011 so stay tuned! The new drug is telaprevir and will hopefully be reviewed by regulatory agencies in the coming months. In combination with PEG/RBV, telaprevir leads to a sustained virologic response in the majority of patients, particularly those who did have some response in the past to PEG/RBV.
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