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HCV Treatment Length
Jan 11, 2009

I'm HIV coinfected/undetectactble, Tcells @120 (after typical interferon drop)....geno 2b, cleared @12 wks test.... Dr. says he wants to keep me on treatment for 36 wks "maybe 12 wks after that" ... I thought geno 2 could go for less treatment time.... I can't stand the side effects (fatigue, cloudy thinking, headaches, joint pain, etc., etc.)WBC 2.0 K/UL; RCC 3.59 M/UL; hemoglobin 11.9 GM/DL; platelet count 129 CD3+CD4+% 21 steady) When should I get procrit ... can't he reduce the meds ....600 rbavirin, 135 microls. peg interferon? Thank you.

Response from Dr. McGovern

Excellent question.

HCV genotype 2 is typically treated for 24 weeks in patients who are HIV negative. There is even some data to suggest that shorter courses may be effective in patients with rapid virologic suppression at four weeks.

There is a little bit of data that suggests that HCV genotype 2 can be treated for six months in HIV/HCV coinfected patients as well - IF they have a non-detectable viral load (HCV RNA) at four weeks. It appears that this was not checked in you so we will not know if you can "short-course" your therapy.

Procrit is usually offered when your hemoglobin is less than 10 mg/dL.

As for the meds...it appears that they have already been reduced - perhaps for side effects or for laboratories??? It is hard for me to say. I am assuming you mean 600 mg of ribavirin a day. If you are getting 600 mg ribavirin twice a day - YES, you can have a dose adjustment to 400 mg twice daily for genotype 2 disease.

I try not to reduce dosing of medications until a non-detectable viral load is achieved. Use of growth factors can help with laboratory problems although, uncommonly, symptoms can be severe enough to drive a dose reduction.

Best of luck to you - hope you have a great outcome. You deserve it!



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