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36 or 48 wk PegInterferon?
Mar 31, 2009

I am HIV/HVC/HBV ... HIV and HVB undetectable on 2 yrs. of Atripla. I sarted w/ a high viral load of HVC (9 million), but I had genotype 2b, at wk 4, my vl was down to 1045, at wk 4 my heptalogist knocked me down from 1200 mg of Ribavirin (I'm 206 lbs, 52 yrs. old m) to 600mg, and the standard PegInterferon dose (180) to 90 for 2 wks, then told me stop all treatment, because he was nervous about my CD4 counts (baseline 190) 100 then, but percentages were always 25%. My HIV dr. had a fit and referred me to another heptalogist who resumed treatment at original dosage of PegInterferon, but 800 mg Ribavirin. I tested negative on the most sensetive HVC viral load test at wk 12, again at wk 16, wk 20, and wk 24. Like that other recent inquirer, my heptalogist says I have to make it to 36 wks, and we might go for 48. I hate the HVC treatment, but I really want an SVR more than anything. (I had chemo in first half of 2007 for AIDS-related NHL, so w/ that and PegInterferon, I've been immuno-suppressed for awhile. Do you have a recommendation about treatment length? Thank you!!

Response from Dr. McGovern

Since you were first tested at 12 weeks, I don't know if you had early clearance. Without that information, I would have to suggest 48 weeks of treatment for the "best bet". However, extrapolating from your first set of numbers (where your viral load was 1045 at week 4) you probably have cleared at 6 to 8 weeks. If that is the case, then you may do just fine with a total of 40-42 weeks, which still would be something to consider if you are having trouble tolerating the treatment.

I agree with your HIV doctor that your CD4 percentage is the leading reassuring factor. We always expect CD4 absolute counts to drop.

Best wishes for a successful outcome!

Genotype Percentages in US/World HVC populations
Hepatitis C

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