JENNETIC....IMPORTANT...and OPEN THREAD

[ringading]

sorry for the new thread....but it was VERY IMPORTANT...

JENNETIC...please go back and read my post under your 'addictions and treatment' comment, i read your reply this morning and am a little worried that maybe you mis-understood and thought that 'street herion' was okay with treatment....while it is VERY POSSIBLE and IS DONE to treat for hep c WITH active addiction, i just want to be clear that it is IMPARATIVE your fiance seek out methodone in conjunction with his doctor and treatment....I DO NOT ADVOCATE 'street junk, (herion) in conjuntion with treatment as there are sooo many unknowns in street herion and it is far safer if he is unable to stop, THATS FINE, he should not be shamed for that....BUT that his doc MUST be involved and monitor the situation with methodone as part of a Harm Reduction Statagy. if you need more info, for you and his doctor, please leave me your e-mail and i can send off tons of it for you  remember....everyone has the right to be afraid and to deal with thier feelings and emotions and cope in whatever way nessisary, until they no longer need to....when shame or dis-approval is brought apon one...they may have even a more difficult time with getting and seeking help....wishing you both all the best and loads of sucess with this....he is very fortunate to have your suport...both you and he are very brave and i admire you both....you WILL get through this...
kimberley

[Med Help]

It is IMPERATIVE that your fiance tell his doctor that he is using heroin!!!!  PLEASE make sure that your fiance does this BEFORE beginning the PEG-interferon treatments!!!

There is a VERY high Hep C re-infection rate among intravenous drug users.  Why go through PEG-interferon treatments, if your fiance plans to continue sharing needles?  By sharing needles, he is setting himself up for almost certain re-infection.

MED HELP INTERNATIONAL

[willing]

here's the stuff I couldn't find yesterday:
- the Schering REBETOL <a href="http://www.spfiles.com/pirebetol.pdf">medication guide</a> and
- the 2002 NIH HepC treatment <a href="http://consensus.nih.gov/cons/116/hepatitis_c_consensus.pdf">consensus conference</a> statement.

so rebetol=copegus=ribavirin=1-beta-D-ribofuranosyl-1,2, 4-triazole-3-carboxamide, it's exactly the same drug. The Schering dosing recommendation guideline doesn't differentiate genotype but this seems outdated: the consensus treatment recommendation is pretty explicit:
<em>Similarly, a reduced ribavirin dosage
of 800 mg daily appeared to be adequate for patients with
genotypes 2 and 3, but the higher, standard dosage of 1000
to 1200 mg daily yielded better response rates in patients
with genotype 1. Thus, 24 weeks of treatment and an 800
mg dose of ribavirin appears to be sufficient for persons with
genotypes 2 and 3, while patients with genotype 1 need 48
weeks of treatment and standard doses of ribavirin.</em>

and these recommendations have been confimed in various studies (eg here's one on <a href="http://www.hivandhepatitis.com/2003icr/38easl/docs/032103b.html">relapse rates</a> that found increased riba or tx-time don't have much impact on relapse odds if you're a 2/3). All the best.

[ringading]

wow, thanks....made for some fascinating reading,( not quite done yet ) i was espeacialy interested in the results and reports coming out of the NIH Consensus Conference....however...i would argue that there is far too much emphasis spl? put on transmission rates being in IDUs'....of course there rates are very high in this particular group...90% i believe,( definately on the decline with easier access to needle distribution ) but my question being....HOW does that account for the immense number of people infected that have not been IDU, 'main stream population', or 'middle america' as well as the staggering numbers of veterans infected....i would argue, that IDU was NOT the largest mode of transmission before 1992, but that perhaps we must also consider that the majority of North Americans between 40 and 54 yrs olds were subject to mass innoculations through public/private school systems....for TB and polio....just a thought for debate.....
thanks again so much for all the trouble you have gone to to make dosing more understandable Willing..
there are stats included in the NIH peice that i have been unable to receive from the WHO as of yet...so thanks!
cheers
kimmy

[MajNeni]

G.I.P.A. has written in an earlier post (or several) that in the early part of tx, the Pegylated Interferon plays the key part (in killing off the virus); the Ribavirin is "more important" later.  So lower riba in the early weeks of tx may not make too much difference.  
In any case, you'll have to go forward from where you are now.  The past can not be changed, so don't spend too much of your precious energy and volatile emotions on it.  When is your first PCR, did you already get the 12-week?  Good luck!
Maj Neni

[LvdByGod]

IT IS VERY IMPORTANT to realize that different drugs can ruin  our chances of clearing the virus. please read these articles below.
most drs want to wait 6 months after clean and sobor before starting the treatment for hcv. one of the reasons for this is that they will have a better chance of clearing with the drugs out of thier systems.  my dr. made me wait to do treatment and i had bridging fibrosis so there is time to do the right thing. You cant make him do this but, at least you can use tough love and discourage him (not enable him) to harm himself. these GI's know alot about this disease and they can determin the best course of treatment for both problems.so that the best outcome can happen.
http://www.hepatitisneighborhood.com/content/in_the_news/archive_1527.aspx

http://www.hepatitisneighborhood.com/content/understanding_hepatitis/treating_hepatitisc_1389.aspx


i pray he will listen to you and others who love him and take this seriously, and when he does this treatment that he would go all the way and hit the virus with full strength of the treatment. very concerned, sandi

[jennetic]

Hi,
Thanks for posting all this info. I am really horribly confused and don't know what to do, so this information is extremely helpful. It's really nice to know that you all cared enough to respond!!!!!!

My guy was clean for 8 years, but has now fallen back into the pit. It didn't take long for him to really sink down. I think he's going to have to go inpatient to detox- he is a complete mess.

I am consulting with a psychiatrist who is experienced in treating Hep C and HIV, and hopefully will get some direction there. I don't think his insurance will pay for inpatient, Hep C treatment, and methadone.  I was trying to talk to him about going the methadone route, but the new research pointed out here is making me think otherwise.

Originally, I did think that the research found that heroin use wouldn't interfere with the action of the treatment medication. However, after reading this thread and now having to live with an active addict, it's clear that he won't get through treatment until he takes care of the addiction. I thought that regardless I would stick with him through treatment, but I don't think that's possible if he doesn't deal with the addiction.

Right now, the best I am hoping for is that he goes inpatient to detox and is able to stay clean. He'll probably have to wait six months, then start treatment. The specialist originally said that he should have started treatment YESTERDAY, that his liver is awfully far gone, and that his time is running out.

Thanks so much for posting this!!!! I, too, hope he takes this very seriously. Right now his only concern is warding off withdrawal- he can't really think too much about treatment. It's such a sad and depressing situation. Thanks for your concern!!!

Jenn

[jennetic]

Hi Kimberly and TB,

I re-read my previous thread, and posted the below there and here:

My fiance is definately physically addicted. He kicked this habit eight years ago, but he's returned to it in the face of this illness and losing his job, and probably getting engaged as well. Too much for him.

I am extremely worried for him. He is a mess- he won't do methadone, he wants to kick, but only lasts a few hours into withdrawal. He says that he's not sharing needles but he is definately shooting up.

If you have ANY advice, please post it here, or email me at: ***@**** .

Many thanks,

Jenn

PS. Med-help: thanks for your concern! I am talking to a specialist off the record before I talk with his doctor, namely because I'm afraid his insurance will refuse to pay for the Hep C treatment if they learn that he's actively using. This whole thing is a huge mess!!!!!

[LvdByGod]

you are on the right track by seeking advise on this. this is a very serious issue. we will be praying for you and your boyfriend. your therapist should know how to guide both of you in this area.
you may want to reread the above site i listed. i don't think they are saying that methadone interfers with treatment. please re read. also there must be way for someone to go into rehab with out insurance and money. perhaps you can repost this question up above to get others imput. there are many people on here who have experience with kicking the drugs. perhaps they can get you some info on treatment programs and insurance coverage. the problem with posting down here is that very few people go down this far on the list of posts on a daily bases. please post up above on a new question or new thread.

you guys will be in my prayers. he just needs to reach out for help. there is help out there i know that. sandi