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Hepatitis C - Do I need a treatment?
Jul 26, 2009

Hello Doctor Barbara!

In November 2008 I detected virus in my blood. My doctor recommended me to wait for 6 month until my enemy decrease to normal level ( Had an excessive alcohol intake which caused ALT elevation to 1000) .My genotype is 1. Now after 6 month of diet and no alcohol at all ALT -30 AST -22 (which is normal).. All other blood analyses is normal as well. RNA positive with load 1078 kl/U. My doctor assures me that by liver is absolutely well and I do not need a treatment right now. He says you are a carrier and there is no risk to your liver. He says you can live a normal long life but with some restrictions (no alcohol and other toxic stuff) I want to believe to this but still a bit afraid . there are many "what if" questions... What would be your reccomendations? What to do in this case ?

Ideally I would just ged rid of it..but doctor says response in my case could be very very low ...

Thanks in advance for you answer.

Response from Dr. McGovern

Your story demonstrates that alcohol can cause significant injury to the liver. Congratulations on your abstinence. You have made great progress as noted by the normalization of your ALT test.

As for your hepatitis C - Your viral load is so low that I would want to follow it again to see if it continues to be present. If yes, my guess is that you could have complete clearance of your infection with a short duration of treatment despite having genotype 1 infection.

As for how much liver damage you have, that would be best assessed with a biopsy or perhaps with at least some serum fibrosis marker (a blood test) for starts. A normal ALT does not mean you don't have liver disease. You may have damage from past alcohol use,especially if it went on for years. It will be hard to determine what additional role HCV is playing but I would still want to stage your liver disease. If you have cirrhosis, I would also want to follow you with an ultrasound every six months and an AFP by blood testing.

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