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Treatment for HCV with hemochromotosis
Feb 24, 2002

I have HVC and also have hemochromotosis. My hemotolagist is defuring a phlebotomany until treatment is addressed for my HVC. The idea being the the phlebotamany might dilute the interferon/cobination effectivesness. At present I am on the list for peg-intron / rebetol. (Some people don't know that some of these drugs they are needing are on a waiting list that you have to go through before you can get your prescription from Schering.) My Latest lab results are: Ferritin 709 ng/ml AST 121 U/L ALT 169 U/L Iron 246 uq/dl iron binding 389 uq/dl Saturation 63.5 Hematocrit 47.1 RNA Viral Load 526,045 IU/ML Fatty Liver from ultra sound DNA 02827 Homozygous Normal DNA H63d (ABN) Heterozygous Liver Biopsy Chronic active hepatitis c inflammatory grade 2 fibrosis stage 0-1 1+ periportal hepatocelluar CT Abdominal Scan multiple low density lesions in the liver possible cyst less than 1 cm A single lession less than 1 cm in the left kidney. My first question is should I address the HVC or hemochromoatois first. One doctor says that doing a phlebotame wil dilute the peg-intron. The next question is should I wait for the Pegays.

Response from Dr. Fried

I usually treat hemochromatosis (iron overload) first by performing phlebotomy (removing units of blood until the ferritin is low normal but avoiding anemia). Although still controversial, iron overload may adversely affect response to HCV treatment. Since treating HCV is never an emergency, this can be done after the iron overload has been corrected. By the way, if you have true genetic hemochromatosis, your family members should be screened. Check with your doctor about the best method.

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