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when to start hepC treatment
Jul 30, 2014

I am co infected with both hiv and hepC since I was diagnosed in august 1997. My last absolute CD4 count by Flow cytometry was 552 cells and CD4% 19 as of may 2nd/2014 and viral load < 150 not detected by plasma HIV-1 RNA PCR(Quantitative) VIRAL LOAD method. I am presently on a triple second line drug regime for hiv namely ritonavir,atazonavir,tenofovir and am strictly adhering to this regime. As per my HIV C it is genotype 3 and my HCV Quantitive viral loads have been changing from 242,152 copies/ml on april 15th 2009 and alphafeto protein 3.83 ng/mL to 518,163 IU/ml and alphafeto protein to 6.97 ng/mL on march 19th 2013 and my last count was 1,38,280 IU/mL as on may 9th 2014.My doctor said that as of now taking interferon treatment can be postponed due to unwanted side effects and my HCV viral loads which aren't too high. A fibroscan of my liver showed liver with uniform echopattern with no evidence of focal or diffuse pathology and the intra and extra hepatic biliary passages are not dilated. Portal vein is normal but ARFI values are mildly raised suggestive of early fibrotic changes. This scan was done on march 19 2013 and I am due to a scan soon. My life style is strictly no to alcohol and smoking.My query is can I wait for a year or so as my doctor says that oral tablets called sofusabivir is round the corner and though they are expensive today in a year's time the price is expected to come down for certain cases from where I am taking treatment in India and the manufacturing company of sofusabivir has already had a meeting here and the price was agreed to come down by a year so only for selected cases taking treatment here. Please I need some advice.

Response from Dr. Taylor

It sounds as though you can wait for hep C treatment without interferon. Talk with your doctor about your platelet count(ask if above 160), albumin, PT blood tests too. Check in with your doctor every 6 months as scarring of the liver for people with both HIV and hep C can progress more rapidly than for people with hep C alone.

Remember that the level of hep C virus in the blood does not correlate with wellness or illness and does not predict scarring in the liver.

It is wonderful that your HIV is under such good control and that you do not use alcohol or smoke. All best to you.



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