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Efficacy of Second Round of HCV Treatment for Co-infected Patient
Jan 1, 2005

I am an HIV/HCV co-infected patient. From October 2002 through March 2003, I was on a Peg-Intron/Ribavirin combination with an ALT range of 427 at the beginning to 138 at the, an AST range of 174 to 146, and an HCV viral load of 21, 700,000 and ending at 40,000,000. My doctor stopped the interferon/ribavirin treatment. My liver biopsy, after treatment, showed that I was at Stage 1. Since stopping treatment, my most recent viral load has dropped to 1,921,420, and my ALT/AST is 257/176.

I am now considering the pros and cons of going onto a PegaSys/Ribavirin treatment regimen. What are the success rates (either anecdotal or via a study) of clearing HCV by undergoing a second course of treatment in co-infected patients? Is there a difference in success rates between Peg-Intron and PegaSys?

Response from Dr. McGovern

I would advise that the chance of responding to a different interferon preparation would be very low. However, it is fortunate that your liver biopsy shows mild disease so I would simply wait until better therapies come along. I would also get a repeat biopsy in about 3 years after the first to confirm that the liver disease is stable. I would also limit any alcohol intake to little or none.

If you liver biopsy shows progression, you may want to discuss the role of "maintenance" interferon therapy, although the benefits of this is unknown.

A study called SLAM C may help shed some light on longer treatment courses. This study is now ongoing.

Dr. McGovern



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