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to treat or not to treat! 2 biopsies
Oct 22, 2002

I have hep C. Have had most likely for at least 30 years. I am 56 year old female who stopped drinking 20 years ago. had 1 biopsy 2 years ago, stage 2-3 fibrosis, stage 2 on activity. Had 2nd biopsy 2 years later, showed no progression and inflamatioon had subsided some,probably because of Vit. E (800mg a day) plus milk thistle, alfa lopiac acid, selenium etc. Anyway have chosen not to treat. Am genotype 4. Am I nuts? Doctor wants to wait to see via Nov. Liver conference what's on the horizon regarding newer meds. Your view please.

Response from Dr. Frascino

Hello,

Are you co-infected with HIV as well? Co-infection presents additional treatment challenges. Are you nuts? Well, I'm not a psychiatrist, but you don't seem nuts to me. Should you treat genotype 4 hepatitis C? Well typically HCV genotypes 1 and 4 are associated with the worst responses to treatment. However, there was an interesting medical report at the International AIDS Conference in Brazil this past summer presented by Christian Perronne. This French group showed that treatment of hepatitis C with pegylated interferon (IFN) alpha-2b plus ribavirin was associated with impressive response rates in co-infected patients, including those with genotypes 1 and 4. Side effects (leukopenia, anemia, etc.) remain a significant problem. Luckily, we have medications to help combat the side effects. Procrit, for instance, is extremely effective in treating the anemia associated with HCV combination therapy.

Hope that helps. The decision to treat or not is certainly yours to make. If you decide to treat, I'd suggest the newer pegylated interferon. Also, it's comforting to know the success rates of therapy for your genotype are improving.

Good luck.

Dr. Bob


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