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Avatar universal

Overview of 1st appt. After diagnosis

I wanted to first thank all of you that have traveled this journey before me and been so willing to share. I met with a Hepatologist at Duke in NC. They explained about the disease and after a thorough medical history evaluation he believes I have had this disease around 35 years. He felt I would be a good candidate for treatment. He proceeded to talk about the upcoming test needed:

Blood test completed today
Hep A/B shot completed today
Ultrasound scheduled for Friday
Colonoscopy

He didn't mention biopsy..so I asked.....he said since I was otherwise healthy (only elevated AST and ALT) that I could start treatment without it. I told him I would feel better knowing what condition my liver was in and he said that would be fine...he understood that I would want to know. He gave me an overview of the triple therapy with Telaprevir and I asked him if that was the only treatment they did...he said they also do invicek, but that the other is shorter duration. OK...he also said if they determine the liver damage is 0 to minimal that I could wait for a study.

So...I have an option on jugular or side biopsy.....does anyone have feedback on the differences?

Why would he automatically think Telaprevir without knowing genotype??  I am worried about eating so much fat!!! He said how much fat do you eat today....uh ...not that much!! I might look like it...but I don't. (LOL)

Anything else I am missing that you guys have been through and are willing to share would be appreciated.

Thanks

Vann
5 Responses
Avatar universal
I thought Incivek and telaprivir were the same drug/pharma man. You are walking the same steps I did 3-4 weeks ago and the biopsy, while not the most pleasant thing, was painless for me-I didnt realize that the MD had finished. I healed in a week-no problems. I had a side biopsy w/MD using the ultrasound. Duke is an excellent medical center, but if you don't feel totally comfortable,get tested and see if you could be reffered for a 2nd opinion. I am stage0,gr.3 and will begin 4 week lead in this Fri.,  after 4 weeks we will be adding Victrellis .
223152 tn?1346981971
incivek and telaprevir are the same thing.  Telaprevir was the name used during the testing but when it hit the market it became Incivek. You are right that he cannot use it if you are genotype 2 or 3.  I think you will just have to wait for the results on all your tests.

The other PI (new drug) is Victrelis - which, before it hit the market was called boceprevir.

I think you are smart for requesting a biopsy.  You really can't make an informed decision without it.  I think a lot of doctors feel that as long as you are willing to treat, they can dispense with the biopsy.  The colonoscopy, by the way, is how they make their money (gastroenterologists) and has nothing to do with Hep C.  He is just telling you that you need this based on age, probably.  It is probably a good idea (I had one) but not necessary to treat.

I am really surprised that he asked you about the jugular biopsy.  Most people don't get that  -- they get the needle core biopsy - the side biopsy.  The jugular is thru the vein and used for patients they feel might have a bleeding problem. They are fine but if it were me I would get the one thru the abdominal wall.

frijole
1669790 tn?1333666195
Since close to 75% of the people in the US have genotype 1, this might be why your doctor is leaning on the treatment protocol with the triple treatment.  Of course, you'll need to determine genotype to decide the propor course.  

The following is the distribution in the US:
HCV genotype 1: 73.3% genotype 2: 11.9% genotype 3: 11.6% genotypes 4, 5, or 6: 3.3%.

http://www.hivandhepatitis.com/2010_conference/icaac/docs/1001_a.html
1735424 tn?1357437158
All correct info. Dr is generalizing and that's cool. You are in the early stages. My family history has colon issues and I had colonoscopy. Clean and thats one less thing to be concerned about for 5 yrs. I belueve that the toxicity on the liver in conunction w the colon doing a ton of work makes a colonoscopy a wise idea.  Duke is amazing. GO FOR IT. Side biopsy the way to go, minimal pain, a bit long to get back to normal 5-7 days good to go. Clear concise real results. My dr used ultrasound plus needle and took 2 samples. Late stage 2 early stage 3 fibrosis.
You are knowlegeable and instinctive. Get genotyped, get a new RNA, VL, get an IL28b gene test if you are genotupe 1 a or 1 b  and keep us posted!
Stay the course and live!!    Blessings.
Avatar universal
Thanks for the many responses!! Indy531-- You are right and my mistake...invicek and Telaprevir are the same. Thanks Frijole for the clarification:-).  So much to learn.

Flcyclist- I think you are right that he was basing it on statistics and of course will wait for actual results. Lifenet62 - Thanks as well

I will definitely opt for the side biopsy. I will also keep you posted as the results roll in and thanks again!!!

Vann

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