Nov 21, 2004
Hello, first, I wanna to apologise because I am disturbing you and my English is very bad and I hope that you can understeand me. My name is Ivy, 29yrs, from Croatia, Europe. I am HCV positive, genotype 3A. I didnt get interferon therapy yet. I was diagnosed 1 year ago. Last year in tha May 2003 viral load was 300 000 IU/ml, alt 108, ast 52. After that in the June 2004 ast was 28, alt 34. Now I am cofused because one of my specialists here in Croatia told me that if my blood test results are not 3 times higher then they must be, I dont have to start therapy (Pegasys, Ribavarin) because of contraindications. Other specialists said to me that I have to start therapy and that I would have better results if my blood tests are lower as they are now. What is the true? Do I have to start therapy now or is it really better to wait until my blood test results gonna be higher?! I have new results from today ast: 46, alt 74, ggt 10, Fe 28.6, crp 5.0, UIBC, BIL 13.4 I am waiting to get HCV quantitative results next week. I forget to tell you that I have made liver biopsy in november 2003 and results was:
Bridging necrosis : 0 piecemeal necrosis: 2 portal inflammation: 3 focal necrosis: 2 = 7/18
fibrosis stage = 2/6
Please, let me know what would you do ? Start therapy or wait? Thank you , Ivy
Response from Dr. McGovern
Based on your liver biopsy which shows stage 2 fibrosis and moderate inflammation, I would treat you.
You have an excellent chance of responding also with genotype 2 infection and relatively low viral load!
You would only need 6 months of treatment. In matter of fact, at a recent liver research meeting, patients with genotype 3 infection and low viral load were usually cured by as little as 4 months of treatment. So if you are having a lot of side effects, this will be important to remember.
I would not base my decision to treat you or not based on the level of your ALT or AST. Even with normal liver function tests, I would treat you based on your biopsy.
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