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Pegylataed or Combo treatment?
Jun 15, 2000

Hello Dr.....thank you for your answer to my question (Drug Combo Choice...May 26). My last blood tests (march 3) show VL 208 and CD4 589 for HIV! The hepC vl showed 296,774 (i'm in the middle of stage 3 fibrosis and never been on any hiv meds). My dr definitely wants me to treat the hepC again (i only lasted 2 1/2 months, but definitely was responding) but am on a break now. He says now that he wants me to wait for the pegylated form of interferon to come out, but doesn't know if the ribavirin will be able to be used with it (legalities). If the ribavirin will not be able to be used with it would the standard combo treatment be better? I know the pegylated has higher success rates, but will using it without ribavirn be almost as good as the combo? Also, do you think i should wait for the pegylated? I would really like to treat the hepC before i start any hiv meds and hopefully become hepC undetectable. thanks, robert (vroom)

Response from Dr. Dieterich

Dear Robert,

Your biopsy is fairly serious and I would not recommend waiting too long for pegylated. While you are waiting it might be a good idea to treat the HIV, the more CD4 cells you have, the more likely you are to be able to clear the hepatitis C! It is not clear if the pegylated interferons will be approved with ribavirin or not (probably not) however, there is probably some way to combine the two. Peg alone is about as effective as combo given 3 times per week. Good luck! DTD



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