Jun 5, 2007
Certainly I don't recommend this to anyone, but fortunately it worked out for me. With the comination of side effects from my pegasys/ribavirin plus my CD4 being suppressed even further while on the regimen (230 -> 100), I threw in the towel early. I had 37 injections, and then four doses of ribavirin after that before I sent up the white flag. Luckily, it was enough for me--my seven month viral load lab is still undetectable. But my question is: why isn't there more study of 36 weeks? What's so special about 24 and 48 (and I guess in some patients, I've even heard of 72). As brutal as the experience can be for some, not to mention the expense, I'm just curious why something in-between is never contemplated. In retrospect, I'm thrilled I bailed and didn't put myself through that additional 11 3/4 weeks; so at least, perhaps I can be a test case for 36 weeks! My AST and ALT have also normalized, and my CD4 has now risen back to 205.
Response from Dr. McGovern
I am quite thrilled to read about your response. But you are right in advocating that not everyone should do this.
Patients with HIV/HCV coinfection have somewhat lower response rates to Pegylated interferon and Ribavirin therapy than patients with HCV alone. However, it does lead to a sustained viral response in about 60 percent of people with a low viral load at baseline who have genotype 1 infection. PEG/RBV also leads to a sustained virologic response in about 65 percent of people with genotypes 2 or 3.
I suspect your great response to only 36 weeks of therapy is related to having either a low viral load to start or having a favorable genotype.
Another thing I would bet on is that your virus was suppressed early on in therapy. In patients with HCV alone, we are learning that 36 weeks of non-detectable virus while on therapy seems to be associated with the best outcomes.
Congratulations! 36 is your new lucky number.
Also talk to your physician about the prevention of HCV.
Is IVF Possible?
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