To interferon or NOT to Interferon

I am embarking on treatment, have been asked to get an eye test, warned of the side affects and am doing well on Milk Thistle and daily habit change.  Do I take the risk of depleting what good immune system i have for the chance of possible altercations in my system.  Many things have changed in my original diagnosis that i am afriad to put a man made drug in my system and alter my obvious good health.  This was a freak finding and certianly not symptomatic, so i am scared

[Bill1954]

The primary factor for this decision is the degree of liver fibrosis or cirrhosis we might have. Have you had a recent biopsy to help with this assessment?

You mentioned ‘depleting a good immune system”; for the most part, any impairment of immune response is temporary, and returns within weeks of completion of treatment. Interferon modulates the immune response, in the hopes that it sill destroy the HCV virus.

These drugs are strong; no doubt about it. We’re told that only around 5% of HCV patients will eventually succumb to the disease; if you have limited progression at this juncture, a good case could be made to delay/postpone until other management techniques become available. On the other hand, treatment seems to be more efficacious in younger patients; as we age, our immune response becomes weaker. Additionally, we seem to be more responsive to the current meds with minimal liver damage.

Your doctor should help you weigh these decisions; he has your health profile, and should be equipped to evaluate you and walk you through these choices.

What is your doc’s position on this subject? What are his/her thoughts?

Best to you whatever you choose—

Bill

[teabefree]

Ever since 94, two weeks after delivery, my knees were getting tapped every day, no one coudl explain, just rheumatoid arthritis, then i pursued other avenues and foudn i had 9.5 titer lyme, then further testing showed i had the antibody for Hep C, so montioring every year until most recently they decided to do a depper test for teh actual virus, since my liver levels were high and then noted the viral load, etc.  That was Jan/09, so i went on line, ordered milk thistle, quit drinking alcohol altogether as well as coffee, refused any medicines for headaches and cut my alt and ast in half.  IN a Cat scan they foudn all these spots (hemangiomas) on teh right and left lobe, and foudn it impossible to biopsy for fear i would bleed out, they have been stable through follow up ultrasounds.  Two weeks ago, i go to do a full body scan since it had been almost a year and the spots were undetectable, odd, but good.  Not that I was a big smoker, jsut with a drink or stress, but i decided to drop that habit a week or so prior to the catscan and possibly that is why or the milk thistle, but for some reason they disappeared and my only conclusion would be the cigarettes since they are the number one cause for blood vessel constraints...I have genotype 1, predicted medicine for 11 months, but i am more in fear of long term side affects.  I am assuming if my body chemistry is healthy it will restore itself, even if the medicine depletes all my good cells as well as bad.  I was suggested to get B12 shots to avoid fatigue, is there any other preventive measures to make this treatment smooth in my chaotic world?  Where can i see statistics, side affects of others in the world?  You are so kind to reply yesterday adn I see you are doing better.  My liver is smooth and the right size at this time and i am not supposedly affected, but many are urging me to take care of it now.  I know there are new drugs to come to life and i would rather wait, but then again, you see so many new drugs evetually causing worse side affects.  New isn't always better.  Thanks for you help.

[Bill1954]

I think you might reconsider deleting coffee and analgesics for headaches, etc; most of these, including moderate acetaminophen use, are fine. There are no specific dietary constraints for HCV; unless perhaps you are cirrhotic. Even then, this is usually limited to salt and some animal protein intake.

Hemangiomas are relatively common, and don’t normally require intervention unless they cause pain or biliary blockage, I believe. They shouldn’t be a factor in your HCV management.

I’m unfamiliar with vitamin B-12 injections regarding fatigue; discuss this with your primary care physician.

If you want to year more about patient reported long term side effects, this is an excellent place. Another source for HCV education is Janis and Friends website; I’ll link you to their ‘newly diagnosed’ page. Additionally, make sure to review the section ‘other HCV information’, located in the right-hand margin of their homepage:

http://janis7hepc.com/have_you_been_just_diagnosed.htm

Another factor in this equation is your support status; do you have friends or family that can help if you don’t feel well during treatment? How about work, insurance, children… These issues need to be weighed and considered prior to committing to long term antiviral therapy.

Thanks for the good words and thoughts; yes, I successfully completed treatment over a year ago, and all is well now.

Take care, and good luck—

Bill

[newleaf09]

Interferon activates a part of the immune system that is required to eradicate the virus.  While removing interferon from the treament is a goal of researchers, I think it will be a very long time before they find a replacement that will do the job as well.  The new drugs are protease inhibitors added to the interferon and ribivirin which is an antiviral drug that enhances the activity of the interferon.  The protease inhibitors interfere with viral reproduction, so are adding another weapon to destroy the virus.  They are still in testing but will be on the market in the next few years.  They work so well with the interferon and ribivirin that they offer the possibility of reducing the treatment time to 7 mos. instead of the standard 11 month course of treatment.  It's true that interferon can destroy some white blood cells that assist the immune system, but there are drugs which can be used to cause the bone marrow to produce extra white blood cells so that the treatment is less dangerous.  Long term effects of interferon are more common in  patients that are on the drug for longer than 11 mos.

Seek your doctor's advice about beginning treatment or waiting for the protease inhibitors to reach the market.  A liver biopsy, if your doctor approves, is the best decision making tool to advise of the necessity of embarking on threatment at all.  Hepatits C is an insidious disease that can do great damage with no symptoms.  It's good to be aware and proactive.  Good luck.

[Ironpony]

Someone please tell me how to report this guy...he is pulling up old threads now. and scaring everyone on current threads.