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Double dose peg
Jun 6, 2005

Hi Dr. D I am in the process of considering tx. Never treated before, known since 97'. Per biopsy 97' (grade 1 stage 2), and again in 03' (grade 1 stage 2). Load, just under 2 mil (1.8). Geno 1a. I have several questions: the first is relating to your response to the following post dated 4.25.05:

I have had hep c for about 35 years. I am female who is 58 years old. I am between stage 2& 3 on fibrosis. I had a biopsy 4 years ago which showed this and another biopsy 2 years after the first, which showed no progression.I am grade 2, geno 4a. I do get colds and sinus problems quite often, but I work full time, and really do not tire like so many others. I am scared though of the future in regards to the hep C and could really use some reassurance. I did not respond to Pegasys and Rebetol. My alpha feta proteins are very low as is my viral load which is under one million. My ast is 65 and my alt is 92. I am scared though. Do you think I have enough time before things get worse, to wait for a new treatment; and realistically do you think one will come out in time? Your prognosses for me please! Thank You. S.I.

There will not be a new drug approved for HCV until at least 2007 if not later. It would not be unreasonable to try again now with either standare therapy, double dose peg plus ribavirin or daily infergen. With genotyp 4 you have a good chance of responding! Good luck! DTD

My questions are as follows: 1. is a double-dose something I could consider?

2. which drug; pegasys or peg-intro has the better response rate / do u prescribe... I have been offered both.

3. Finally, do u see patience. I live rather close to the city.

Response from Dr. Dieterich

If you have not been treated before, then double dose may not be necessary. I only know of data on double dose Pegasys, so while I use both Peg Intron and Pegasys, so far I have only used double dose Pegasys. Sure I would be happy to see you at Mt Sinai. Office number is 212 241 7270 for appts. Think positively! DTD



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