Dear Dr., I am a hemophilac, HCV + HIV coinfected, 36 years old. I have been on HIV meds for 8 years.(mostly on Stocrin+Combivir) VL < 50, CD4 range 270-700. I have tried peginterferon (180) once a week + ribavirin for 52 weeks, starting from 1,600,000 and going down until ending with 200,000 (no eradication) I then started with peginterferon (135) twice a week + ribavirin, for onother year, only to see my PCR climb steadily back up to 3,000,000. I do not not what I can do with my HCV now, as it seems that the current treatment is'nt working for me. any suggestions? Why did the PCR first drop on 180, and then climb back up on 270? thank you.

This is a tough one. You are a real trooper to take so much interferon too! At the moment there are basically two options. First would be to use higher dose peg for the first 12 weeks then drop down to normal levels. For example 360 of Pegasys or 3.0 mcg/kg of Pegintron for 12 weeks, plus ribavirin. Or you can use daily Infergen alfacon n otherwise known as consensus interferon with ribavirin. If you are not responding in 12-24 weeks with either of these, then I would stop at 24 weeks. Good luck! DTD