I would not automatically agree with Claudine, or wait until the biopsy,
although I agree with the basic idea behind it. The reasons I do not
fully agree are that, as of right now, the peg treatment has not
received full approval, and there is a chance, however small, it may not
Additionally, it appears that the peg treatment may only be used for
those that have failed previous treatments, but that is still not known.
Also, if it does, your insurance company may not agree that it is an
accepted treatment. Also, it has a failure rate the same as all other
There are pros and cons about taking or not taking treatment, no matter
what your genotype is. While the 1a and 1bs are the least responsive to
the combo, if you are one of the ones that does respond, then who cares
what the statistics say. If you do not, you may have bought yourself
time by trying the other therapy, or you could get quasi-species that
might increase your viral count.
The only positive aspect of that, is that you then qualify for high
induction interferon, similar to the idea behind the peg. Also, if you
wait, the virus may do nothing, or, if it is destructive, it may be
increasing in it's liver destruction while you wait. If you take the
combo, it may hold everything in check, or, place you into remission, or
whatever. The treatment is not pleasant, but, the long term consequences
of liver disease are worse.
Just like some have not been able to tolerate the combo therapy due to
their blood tests, you may not also be able to tolerate the peg, if you
qualify. These are all tough decisions, and none of us can predict the
future. Claudine has been an excellent source of information for this
list, and we have all seen and felt different opinions.
I have one patient that took the interferon only many years back. He had
every risk factor possible to get the disease including IV drugs,
snorting of coke, blood transfusions, heavy drinking, etc. But, his
viral loads are still undectable, and his liver functions are normal.
So, go figure.
Medically, there are no absolute rights or wrong until you try and find
out for yourself. Find out as much as you can, and then you have to take
your best guess. My wife finishes her combo in 1 week. She has had an
undetectable viral load since week 1. It has been rough on both of us,
her as the patient of the disease and treatment, and me as her spouse
that has tried to comfort, support, and keep my own worries to myself,
as well as handle the lack of being able to make any plans for the last
year because I do not know how she'll feel, mood swings, etc. But, if it
works, all of it will have been worth this year of hell. If not, at
least we tried and we'll take the next step as it comes.
Good luck in whatever you decide and keep us informed. Marty