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12-week or 24-week test for HCV RNA
May 4, 2003

Dear Dr. Dieterich,

First, I would like to thank you for the time you take to answer questions and for the hope you give to people. I have HCV with genotype 1. I have been on combination therapy with Peginterferon and Ribavirin for 18 weeks now. At 12 weeks my doctor ordered a test for HCV RNA. Unfortunately, It took a month and a half for the result to come to his office. Yesterday he called me and suggested to stop therapy because HCV RNA was still positive at 12 weeks (it dropped thought from 2.5 million to 600,000). As far as I understand NIH recommendation is to assess HCV RNA at 24 weeks. I am at 18 weeks now and just 6 weeks away from 24-week deadline. My questions are:

1. Should I continue for just 6 more weeks and then check HCV RNA again? 2. What are the chances in my situation of having negative HCV RNA at 24 weeks? 3. If HCV RNA is negative at 24 weeks, what are the chances that virus will come back after a year of treatment? 4. If the treatment doesnt work, should I try Pegasys and how long should be the vacation?

Thanks a lot for your help.

Response from Dr. Dieterich

I would definitely complete the 24 weeks now because that gives you the benefits of decreased chances of cirrhosis, liver cancer and better survival. If it is still positive then, I would stop for a while and re try with Pegasys in 3-6 months when you have recovered. Good luck! DTD



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