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Urgent request-Maintenance therapy post treatment for Hep C
May 4, 2005

Dr. Dieterich, I am nearing completion of 18 months therapy with pegasys and copegus for treatment of HCV genotype 1A. this is my third course of therapy in 5 years. initial pretreatment liver biopsy showed very minimal indication of disease and liver enzymes have always been normal. i always respond well with an early drop to undetectable levels of virus. the first 2 courses of therapy lasted 12 months each and were with peg intron and ribaviron. my doctor has asked me to consider long term maintenance therapy with pegasys when the current acute therapy is completed. i am concerned about the ongoing side effects as i am a nurse and need to continue to work. if ongoing maintenance therapy is needed what would the dose be and would it still have the associated side effects my current dose of 180mg has? I am also interested to know if there are any published studies or literature indicating the effectiveness of a maintenance regimen as i am concerned that my insurance will not cover maintenance therapy without evidence of its effectiveness.

Response from Dr. Dieterich

I think I recognize this question! Same answer as in my office! The data is really good for maintenance peg interferon. Some of the data was presented again at the European Liver meeting last month in Paris. It is usually only used in people with bad biopsies, that is stage 3 or 4 out of 4, so it does not sound like it it would be good for you. 18 months of treatment should do it, if you were undetectable by about 12 weeks or so. This sounds really promising! I think you have got it now! Good luck! DTD

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