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Duration of treatment with Pegasus and Copegus
Dec 19, 2004

My husband is HIV pos (undetectable)and was on 48-week treatment for Hep C with Pegintron and Rebetol. Was off for three months, the Hep C came back, and his doctor put him on Pegasus alone. After five months on maintenance, he convinced his doctor to put him on Copegus also. My question is how long do you retreat using both Pegasus and Copegus. His doctor thinks 24 weeks, not 48 weeks since he was already on treatment for a year. However, he had a three month break. I'm a bit confused. How long should he be on Copegus with the shot the second time around? Could you please respond and let us know. Thank you very much.

Response from Dr. McGovern

It is excellent that your husband did attain viral suppression the first time around, since most likely his liver did get a histologic benefit - ie, the liver probably looks healthier under the microscope than it did before treatment.

When your husband was put on Pegasys alone, this was for "maintenance therapy." The idea here is that perhaps keeping a patient on low dose maintenance is healthier for the liver. However, keep in mind that this is not yet proven since we are still waiting for the results of studies. However, on a case by case basis many experts are doing this if the patient has severe liver disease.

A second trial of Pegasys and Copegus may not work any better than the first unfortunately. Some studies like "SLAM-C" are looking at whether longer treatment may be helpful but again, we do not know if this will work any better.

Over the next year or two more and more information will be coming out in this regard so stay tuned.

Dr. McGovern



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