Please Note: Due to volume considerations, not all questions can be answered. Questions most likely to be answered will be those of general interest to a broad group of visitors to this forum. Questions pertaining to a specific case; requests for diagnosis, medical advice, or second opinion; or requests for opinions about untested alternative therapies will generally not be answered.
The participation of Dr. McGovern in this
Forum is made possible in part by an independent educational grant
from Roche Laboratories.
Ask the Experts about Hepatitis and HIV Coinfection
Can You Please Answer
Aug 20, 2008
Hi, this is the second time I'm asking this question, this is very important and I would really appreciate an answer. My husband is coinfected with HIV (Undetectable) and Hep C. He's been through treatment twice for Hep C, the first time with Peg-Intron & Riba (11 months),the second time with Pegasus & Riba (7 months) Had to stop early due to heart bypass surgery. He's been off Hep C treatment about 5-6 years now. Just saw his Hep C doctor and he wants to put him back on treatment, his liver numbers are very high. He's going to do Infergen, 3x a week. My question to you is, is this a wise or safe option? Can he get back on treatment if he's taking heart medication? And if he can do Infergen, and he relapses,could this buy him some time to try new therapies that are in the pipeline? Can you please take the time to answer these questions. I'm worried and scared. Thank you.
Response from Dr. McGovern
You have asked excellent questions. I am not the best person to give advice since your husband's case is quite complicated and I am sure there are details that are guiding your doctors in their decisions, which I don't know.
I will tell you a critical piece of information that is needed. If your husband had a non-detectable viral load on Pegasys and Ribavirin, but his therapy was prematurely stopped due to the heart surgery, I would simply favor going back on that therapy. If he has genotype 1 infection, I would also be certain that his ribavirin dose is optimized.
The cardiologist on your husband's case should be in agreement to proceed. If your husband has not had problems tolerating ribavirin in the past (eg, no severe anemia) this should be a good sign to proceed.
The hope is for a sustained virologic response. And yes, even if he relapsed after treatment, most studies have shown that interferon does cause improvement in the liver health. However, this improvement is mainly sustained by cure - not temporary suppression.
The other important issue is that being on HIV medications is also important for his liver health. A recent study showed that fibrosis of the liver slowed down in patients who have suppression of HIV.
I hope this is helpful to you.
Please remember that this forum is designed for educational purposes only, and experts are not engaged through this
forum in rendering legal or medical advice or professional services. Experts appearing on this page are independent and are solely responsible
for editing and fact-checking their material. Neither The Body nor any sponsor is the publisher or speaker of posted visitors' questions or the experts' material.
Questions and messages posted to this forum are not statements of advice, opinion, or information of The Body, Body Health Resources Corporation or any sponsor of this
forum. While neither The Body nor Body Health Resources Corporation regularly reviews posted content, we reserve the right to delete, move, or
edit postings if we deem it appropriate under the circumstances. Visitors submitting questions remain solely responsible for the content of their
messages.
Information provided by experts is general only and should not be used for diagnosing or treating a health problem or a disease, or relied upon as
legal or other professional advice. This information is not a substitute for professional advice or care. If you have or suspect you may have a
health or legal problem, you should consult your own health care provider or your attorney.
