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Hepatitis and HIV CoinfectionHepatitis and HIV Coinfection
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cirrhosis and interferon
Jul 25, 2004

dear Doctor¡ I am a 41 female on haart for the last 7 years , 2 years ago i was diagnose with cirrhosis due to hepatitis c, I went on pegasys+ riv for 7 months i did have a 2 logs reduction but didnt have svr i had to stop due to thrombocitopenia, i had a partial splenic embolization where they reduce the size of the spleen 65% and began therapy one month later again with pegasys and riv, after 12 weeks of therapy i hardly have one log reduction before i restarted therapymu vl was of 90 million copies, i would like your opinion if is worthwhile taking inter + riv I have no side efects at all but as my insurance company doesn' t cover the treatment i am paying it myself and its extremely exensive, should i continue??? Also i would like to ask you if smoking a couple of marihuana cigarretes a day can have any efects on my liver as this gives me some relax and also i eat much better. thanks for your cooperation and God Bless You

Response from Dr. McGovern

Although you have not been cured of your hepatitis C, it is still encouraging that your viral load did decline. Your "partial response" to interferon hopefully also led to some improvement of your liver. Many patients who do not get any decline of the virus itself, still have improvement of their biopsy as demonstrated in clinical studies such as "APRICOT" and "ACTG 1571".

Whether you should continue or not is obviously an important question. The rationale to continue would be to keep your liver as healthy as possible, but this approach has not been proven yet. Also interferon is quite expensive. I would speak to your physician to see if there is a site near you for the "SLAM C" trial which is specifically designed for patients with HIV/HCV who have not have a successful response to treatment for their Hepatitis C. Since I don't know all the details of your case, I am not sure if you are a treatment candidate, but it would certainly be worth checking into. Best of luck to you, Dr. McGovern

Divergent subtypes
Hep A, B & C

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