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Lupus & HCV TX
Sep 9, 2007

Hello Dr. McG, I was diagnosed with HIV infection in 1991, with HCV in 1997, Lupus in 2001, and Autoimmune hep in 2002. I am currently on Viracept, and Viread for HIV, and Predisdone for Lupus. My current HIV lab work is VL undectable, CD4 is 600 with 18% ratio. I am not currently aware of my HCV viral load and it never interested me since I have been told for so many years that I can not be treated for my Geno-2 HCV. In 2001, I was hospitalized for liver toxicity/liver failure resulting from HIV regimen (Viramum, Zerit, & HIVID). A little over 4 years ago I had a liver biospy which indicated that I had fibrosis/stage 3. A month ago, my doctor informed me that he has treated a few patients with had either Lupus, autoimmune, or RA (all considered autoimmune conditions) and most patients did well - some also wiped out their autoimmune disease as well with HCV treatment (pegyasay & copegus). I would like to ask you two questions, my first question is "have you ever treated someone with similar health issues as me?" and "what is your opinion on this treatment plan if you have not experience treatment treating some with such?" I have noticed that you response to all your reader at the end with encouragement...I will appreciate one myself. I also like to thank you for your wonderful work. Sincerely, M-ruby

Response from Dr. McGovern

I have shyed away from treating HCV in a patient with lupus because of concerns regarding flares. I can understand though that your physician is justifiably concerned however, about the degree of fibrosis in your liver. Although new medications are being developed, it looks like for now most are being combined with interferon based therapy.

You can have an open discussion with your physician about the risks and benefits and decide with him as to the best way to proceed. It is a very difficult question. If you do decide to proceed, you will need very careful monitoring, as I am sure your physician is planning.

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