|I don't want to die
Mar 26, 2007
I'm a 43 year old female who lives in Sydney Australia. I have been on methadone since 1986 (2ml/10mg) and I haven't touched heroin in 16 yrs and no other drugs.I was infected with hep B when I was 18 yrs old(1981); my blood tests indicate positive to anti-HBc and that I am immune to hep B. I first learnt I was hep C pos in 1990/91 through regular screening because of being on methadone. In '91 my platelet count was 123 /nl, neutrophils 1.6 /nl,AST 136,ALT 187. I developed Hypoglycemia in 1996 and vitiligo(my ANA & DNA were neg.I have a normal prothrombin ratio and normal immunoglobulin with no evidence of polyclonal hypogammaglobulinaemia.) in 2000. By 2004 my enzymes were, AST 73, ALT 76, GGT 43 and my bloods WBC 3.1, Neutrophil 1.8 and platelets 86. My bone marrow results were essentially normal(megakaryocytes normal to mildly increased). I went to be assessed for interferon therapy in May 2005 - I have genotype 1b and my RNA Quantitive is 1.29E6, my WBC and neutophils were normal,platelets 93. I had an ultrasound(liver and spleen appeared normal) and then a CT scan(I am in the process to obtain a copy of results but I think my specialist said serosis) I didn't go through with interferon because I have angina caused by spasm of the arteries and thrombo'(I didn't want a heart attack or any spontaneous bleeding. I saw my methadone doctor on Monday to get the results of my latest liver function test, the first since 2005. My platelets are now 59 and he said he was concerned about my life span. I'm scared to go on interferon because of the side effects. With my history do you think I have major liver damage and is my prognosis poor? Please, what do you suggest? Do I have to 'bite the bullet' and have interferon, I've been trying to hang out for something new?
Response from Dr. McGovern
It sounds like you may have cirrhosis, which is advanced liver disease. I would see a liver specialist and get an alfa feto protein, a prothrombin time, and discuss whether you should go on interferon. Patients may consider interferon if they have compensated cirrhosis. Your physician will need to determine that.
I would also get vaccinated against hepatitis A and avoid alcohol.
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