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Fear of Treatment
Jan 30, 2005

I am HIV+, drug naive as my T's avg the upper 500's and my viral load remaines around 17,000. I am co-infected with HCV, and after ultrasounds and biopsies, my liver doctors believes there is up to a 70% chance of eradicating the virus. My question(problem?) is this, from what I have read about the treatment, I am confused. At this point, my liver seems healthy and the side effects sound horrendous. I am inclined to forego the treatment, as it is my understanding that one does not overcome the side effects until the treatment is over, 24 or 48 weeks later. Can you tell me, is foregoing treatment a legitimate option.

Response from Dr. McGovern

You ask a very good question. There are several things to consider.

1. Is your disease minimal or mild? Deferring treatment could be an option. If it is moderate, or more severe, I would definitely proceed with treatment.

2. There is a laundry list of side effects, but quite frankly, I have had very few patients who stopped therapy due to this. Most of my patients have some mild side effects; we see our patients frequently so we can give other medications to counter those side effects. I have even had some patients with no side effects at all except for some mild fatigue.

3. You can proceed with treatment no matter what your liver biopsy results are and see how you tolerate the medications. You can stop at any time. You are not on HAART so there would be no drug interactions to consider.

4. You can proceed with treatment and base your decision on whether to continue for 48 weeks of treatment based on your 12 week viral load result. If it does not show a 2 log decline or a non-detectable viral load by then, then the chances of you responding are very low. You could stop at this point.

As you can probably tell, I think it is worth a try. Dr. McGovern



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