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Why won't he begin treatment?
Mar 7, 2008

I have been positive with HIV for 21 years and 3 years ago I was told I have Hep C Geno Type 1. I asked the doctor about how we should proceed. First he did an MRI and it was unremarkable, then there was the lumbar puncture and it showed no scaring or fatty tissue. One year later there was a ultra sound which also came back as unremarkable. My viral load for Hep C was 90 million. HIV is under control at 50 which has concerned them, and my t-cells are at 336 I asked about treatment and the doctor didn't seem to think it was time. When would be the time for me to begin treatment? I don't want to wait until my liver is compromised so I am stuck and need some wisdom here.

Response from Dr. McGovern

I assume that you had a liver biopsy (not a lumbar puncture) which showed no scarring or fatty tissue.

When I have patients with no scarring whatsoever, I tend not to treat, particularly in patients with high viral load genotype 1 infection.

However, I continue to follow them. A repeat biopsy in two years would be my preference to be certain that the disease is not progressing. This is a short enough interval, that if you were developing liver disease, you would certainly catch it soon.

It is good news that your liver health is excellent. I am hoping that we will have some new drugs in the future.

Best regards



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