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What Now?
May 29, 2009

My husband is coinfected, HIV (UNDETECTABLE for 11 years) HCV, has been through two rounds of treatment with Peg Intron, then Pegasus, both times went undetectable then relapsed after three months of stopping. However, he recently went back on Infergen. The virus became undetectable after 8-12 weeks, remained that way for 5-6 months, now his doctor says the HCV is back. He said it might have been a 'breakthrough'. My husband recently had a colonoscopy during treatment and needed to do a barrium enema. He was sick for a week with this, vomiting, etc. Could this be one of the reasons the virus returned so soon? His doctor wants to leave him on Infergen for another month or two, he says the test might have been a false-positive. PLEASE Please, tell me where he goes from here? Does his liver just get worse? Do you think this might have bought him some time to try other medications coming down the pipeline? Is there a chance he can go undetectable again if he continues the Infergen? I know these are a lot of questions, please try to answer them for me. Am very worried about everything. Thank you, doctor.

Response from Dr. McGovern

I suspect that your husband simply needs a better regimen. Fortunately, it does appear that new agents are at hand. Studies of telaprevir have gone very well and it will be considered by the FDA in the next year or so. Hopefully we will be able to start prescribing the drug in 2011.

To answer your other question - has the therapy helped his liver at all? I would answer "yes" due to the fact that he had a lot of time spent with an undetectable virus.

Furthermore, there are more and more studies suggesting that suppression of HIV is also good for the liver. The benefit of this may be that suppressing HIV also leads to suppression of other cytokines (hormones) that cause of lot of inflammation in the body.



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