Starting HCV treatment 9 years post liver transplant

[secondround02]

Anyone that can share similar sinario, would be cool I will be receiving the meds this week. Im wondering about the posibility of it working , looking for positive feedback.

[mikesimon]

Your history pretty much mirrors mine except that though they suspected a cancerous lesion it turned out that my liver was clean.

Yes red blood cell count and hemoglobin can be adversely affected by the treatment drugs - ribavirin primarily but interferon can also play a role. Many doctors prescribe erythropoietin - Procrit or Epogen - to boost red blood cell production and improve the hemoglobin level. Hemolytic anemia (drug induced anemia) is a frequent side effect of treatment and some doctors would rather prescribe an erythropoietin than reduce dose(s) of the treatment drugs.

Briefly: I treated three times. I treated for 53 weeks, 52 weeks and my third was for 73 weeks. I believe that I was under-dosed the first two treatments and specifically my ribavirin dose was inadequate. The third time it was weight based and I was clear by week 12 and just extended because I was desperate to achieve SVR.

Keep us informed and don't hesitate to ask any questions. There are a lot of smart people here who are compassionate as well. Treatment can be a hard road and it's very helpful to have support.

Good luck,
Mike

[secondround02]

Thanks for your response, The reason the decison to do the treatment now is that there was never a reason or opertunity as I have now. I was first diagnosed with non a/b hep back in 89/90 when they havent yet labeled it at that time I was very concerned however no solutions. Life goes on always to work and regular lifestyle maby some fatigue , the way it is, then out of the blue at a Dr exam the bloodwork had issues ao on to ct scan and there it was , a tumor,in my liver go to another Dr and said ,this is now 2001, nothing to do I will make you as comfortable as i can I give you maby 6months to maby year. That didnt set well and off to another oppinion and this Dr saw the scan and shot it to the UWMC and next week in the transplant services for workup for transplant, what a whirlwind that was, next thing after all the workup and prepwork required I was on the list. Sept 01 so on the 6th while working at the local aircraft co. I received my page. The 7th  I wake up with a new liver. Since, there has been no real treatment offered or reason  to because all is going great, of course still have HCV and now agressavly affecting new liver , In 08 biopsy showed level4 and ciroses ,,now some concern. At my anual check up at the UW this year they said good results with treatment at least better to try than not.so here we go. Im not sure about all of the bloodwork lingo yet however sure to learn, I guess the red blood count becomes an issue possibly and will need another drug for that. I hope my insurance has good coverage for all of this.              
   Its never been presented with such positive and its monotered closely to check for rejection, my biggest fear, Thats why I decided to treat now.
      Thanks again,
      Jerry R

[mikesimon]

I started treatment just a couple of months after my transplant in 2000. The bottom line is that I achieved SVR in 2004 but it took me a while.

Tolerability is a major problem for transplant recipients which partly explains the rather low percentage of SVRs in that population. Often the doses (pegylated interferon and ribavirin) are suboptimal because the doctors are attempting to lessen the side effects which I believe also contributes to a lower SVR rate. I think the overall SVR odds are between 25% and 34% across all genotypes depending on which study you look at.

May  ask you why you've decided to treat now?

Good luck,
Mike