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Ask the Experts about Hepatitis and HIV Coinfection
Hep C
Aug 20, 2008
Hi, i have Hep-C from the last 5 years, my genotype is 3. I was on treatment of Interferon Alpha:3MIU and ribavirn for 9 months but my ALT was never go to normal. In June,08 i have visited my doctor after 2 years with my latest ALT which was 97 and Ultrasound which is negetive. As per my doctor he told me that there is nothing wrong till now he suggest me Siliver and Hepamerz Syrup and told me to come again after 6 months with fresh ultrasound. If he thinks he will put me on treatment again but that time on Pegasys not Interferon Alpha. What you think what should i do now, i have had never do biopsy.
thanks
Response from Dr. McGovern
I would certainly favor treatment since you have a relatively easy to treat genotype. Patients with genotype 3 tend to have overall higher sustained virologic responses to treatment than genotype 1 for example.
Yes I would certainly favor Pegasys over standard interferon. It is much more effective. I would also dose you with Ribavirin by mouth for combination therapy to prevent relapse.
Your liver function tests do not help me make any decisions regarding your case.
I would also say that I don't feel strongly about a liver biopsy.
I do suggest a baseline virus level (HCV RNA) and measuring it just before your fifth shot and your 13th shot of pegasys in order to measure your 4 and 12 week response to treatment. If you have no detectable virus at 4 weeks and you are having severe side effects, you may be able to stop after 16 weeks. Otherwise I would treat for at least 6 months.
If your virus is declining (by two logs) but is still detectable at 12 weeks you will probably need a longer course of therapy.
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