I AM THINKING ABOUT NOT DOING TREATMENT FOR HCV,I AM ON ATRIPLA FOR HIV. CD4 460, VL UNDETECTABLE,QUESTION IS:WHATS THE "AVERAGE" LIFE SPAN WITH NO HCV TREATMENT? TESTED POS. 2005

There is no "average life span" since some patients never develop disease, some progress very slowly, and others progress rapidly. So frankly, it only matters what your individual disease progression is.

In cases like yours, where you are reluctant to get treatment, I usually still like to get a liver biopsy so we can both be comfortable that delaying therapy is a good decision. Also it is best to get a "baseline" for comparison for the future to see how you are progressing even if you have mild disease right now.

If you do not want a liver biopsy at all, consider a blood test for fibrosis assessment. These tests are not as well tested in HIV/HCV infected patients as in those with HCV alone, but there is mounting information that a test that is quite mild or quite severe is usually accurate. The testing in the middle - ie for moderate disease isn't as good.

In the meantime, keep your alcohol drinking to a minimum. Keep taking your HIV meds as well as you are to keep your CD4 counts high and your HIV viral load as low as possible.

Make certain you are immunized against hepatitis A and B.

The other thing I would consider is trying therapy for 12 weeks to see your viral response and to see if you are having symptoms. I have had patients who walked the AIDS marathon on interferon they were feeling so well. Not everyone has a lot of symptoms. Again, it only matters what you will be experiencing - not the experience of your friends or relatives.

Hope this is helpful.