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Please Answer this one: Hep C and no hope!!
Jun 19, 2004

Dr. Mc Govern:

My father completed a pegintron and rebetol for a yr without any success. His VL at the end ot the treatment was 60,000. He took a 6 mons break and by the end of this 6th month break, his vl reached 300,000. He then re-started treatment with Pegsys and rebetol. His liver enzymes were normal but his vl is still high of, 240,000.

His liver biopsy indicates the following:

Chronic Heptatis with moderate activity grade II and focally bridging firbrosis stage III. His genetype is: 4.

Should he go with a maintenance therapy? what options do we have now or in the near treatment?

Response from Dr. McGovern

Although I don't know how long your father has been on Pegasys, it appears that he is not having a viral load response. However, the fact that his liver enzymes are now normal indicates that he is having a "biochemical response".

Whether he should go on "maintenance therapy" or not is unclear. The study that should answer that question is still ongoing. One study called "HALT-C" is using low dose Pegasys alone for 3 and 1/2 years in one group of patients and no treatment in the other group to see if low dose treatment can decrease the risk of decompensated liver disease or risk of liver cancer.

I would have a discussion with your physician about what should be done next since we don't have the answers just yet.

Dr. McGovern

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