alpha-1 antitrypsan

I am about to start tx and my Nurse said I would be 'challenging' because I've got alpha-1 antitrypsin.  An x-ray showed I have no emphasema but I do get a little breathless at times and do not look forward to ribaviron sides.  In NZ,  we do not have the opportunity of having bloods done until the second week (after the second shot), and PCR is not done until end of treatment.  I'm a 3A with low viral load, portoportal bridging and Stge 2:2 fibrosis, and a non-responder to mono-therapy in 1994; bloods normal except alt and ast platelets 188 neutrophils 2.7.  I'm really anxious about the ribavirin and don't feel very well supported.  Should I go to my GP and get my alpha-1 levels checked, and would alpha-1 be a valid argument for (a) getting bloods done in the first week (b) getting a PCR at 4 weeks.   Many thanks for your input;  I should've started tx yesterday, and have put it off for a week.  I also see a Naturopath and take supplements; he said not to take folic acid during tx, should I continue with alpha lipoic acid?  I read something quite horrific about interstitial pneumonitis induced by tx.

[Douglas Dieterich, MD]

I think that is a good idea and I would also get pulmonary function testing. I am not worried about the ribavirin issues, but interferon can make pulmonary fibrosis much worse. Be a good idea to get baseline pulmonary function testing. Good luck! DTD