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Hep C treatment caused disease progression??
Jan 8, 2005

I came off hep c treatment six months ago and have a durable response. Success! Problem: pre-treatment, my numbers were VL - 8000, and CD4s - 800 for five years, no meds. Post- treatment my VL - 50,000 and CD4s - 450. That's the average from three tests (Dec, Mar, Jun). My percentages are the same.

So I lost 350 CD4s in ONE YEAR. What's up with that? I was caught in primary stage hep c, with jaundice and chose aggressive treatment, even though I may have fought it off without treatment. Now I'm thinking I'd have been better off not treating if this is what happens - especially since hep c isn't all that bad for you for many, many years!

I can't see how this is normal disease progression since my numbers are holding steady now. The loss of CD4s happened in one fell swoop post hep c therapy.

Advice?

The only other possibility is loss of Hep G (GBV-C) from the interferon, which may have been helping me. What do you think?

If treatment messed up my bone marrow or something, is there anything I can do to help build it back up?

Thanks! Dave

Response from Dr. Holodniy

Sorry this got lost. We don't have as much experience with treating HCV in HIV infected patients who are not on treatment. So it is hard to know how common or to what level CD4 counts decreases might be with interferon treatment. CD4 count decreases have been shown to occur with HCV treatment in coinfected people. Reports indicate that levels usually do come back up to baseline levels sometime after treatment. I suspect more than your CD4 count decreased, given that your percentage stayed the same. I would guess your white blood cell (WBC) and total lymphocyte counts decreased as well, probably as a result of the interferon. I would love to hear what the followup counts look like now 6 months later.



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