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Is treating HEP C early worth it?
Jun 28, 2004

I have been coinfected with HIV/HEP C since at least 1988. My HIV is stable, viral load undetectable, t cells currently 285. My Hep C has caused minimal scarring to my liver (Biopsied last month) but my hep c viral load is over 10 million copies. My HIV doc says it is up to the liver doc. The liver doc recommends treatment. I am hesitant because of the side effects. I should note here that I have Hep C genotype 2 which I am led to believe has a higher cure rate. I have been treated for depression for the last six years. I was one of the first people on AZT at the largest dose when it was first available then it was found to be better to reduce the dosage as the higher dosage wasn't safe. Then I was one of the first on the cocktail - saquinavir and it was later learned that saquinavir shouldn't have been given first. I don't want to suffer for six months, lose my hair, possibly have bone marrow transfusions, get suicidal - only to learn five years from now that I should have held off on treatment. Should I go for this when my liver only has minimal inflammation and little scarring or hold off and hope for the best? I would appreciate any input that would shed some light on this decision I need to make. My fear is that I have suffered side effects with every med I have been on. Even during the biopsy I broke out in hives because of whatever med they gave me during the procedure. I work as well and do not wish to lose this job but at the same time would hope for a cure from the Hep C as I have lost several friends to hep while their HIV was well under control. I guess I am just looking for another opinion here. I know that the decision is mine alone to make. Thank you for listening and for whatever light you may shed on this controversial subject of to treat or not to treat.

Response from Dr. Dieterich

Sound like a slam dunk to me! You have good HIV control, a good biopsy and a great genotype! You do however probably have to treat for 48 weeks. If you are getting treated for your depression now, then you have little to worry about. You can take the peg on Friday night and still work Monday to Friday. It will not be easy but this is a combo that has been used now for almost 5 years and there will not be any new drugs for at least 5 years and interferon will be needed for at least 10. You will never by any younger or stronger than you are now and you lose about 1% in response rates per year of age. There is no time like the present! Go for it! Good luck! DTD



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