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Aug 6, 2005

HIV pos. (undetectable) and went through Hep C treatment twice with peg intron and then pegasus. Negative on treatment but relapse when stopped. Due to heart surgery, I had to stop pegasus and ribavirin 10 months into treatment. Five months later, Hep C is back and still not on any peg. My HIV doctor doesn't feel I need to start treatment again until my numbers start climbing since treatment is very rough on my system. I have to go for a biopsy. My question is, how long can I stay off treatment for Hep C before it does major damage and I'm also looking into Hep C natural extracts. I feel it's better than doing nothing for it. I know I have alot of questions, but confused at this time. Would low dose peg maintenance therapy be an option? Please point me toward a solution. Thank you.

Response from Dr. McGovern

First of all, it seems that you are certainly with the right physician who is being very aggressive in helping you treat your hepatitis C.

The courses of PEG which you have already taken have most likely already improved your liver health since you did have viral suppression during therapy.

Whether maintenance of PEG is a good idea is the million dollar question. Since we don't know the answer to this, it is something you will have to speak with your physician about, particularly if your repeat liver biopsy shows improvement since it demonstrates that PEG is beneficial to you personally. What could be considered is treatment again until you get down to a non-detectable viral load and then switch to low dose maintenance PEG thereafter. However, I need to point out that we do not know at the current time that this is the right way to do. Simply no data. However, low dose PEG is easy to tolerate.

Good luck! Dr. McGovern



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