answers

[djbn13]

Just came back from appt with hepc doc.  If it wasn't for this place I wouldn't of had a clue what he was saying.  Wish one of you were there with me as it is.  Got an answer to my questions at last.  Hepc normally doesn't effect copd, but treatment does.  Especially the ribavarin.  He estimated that with my current heath status I would lose 30% more lung funtion since I only have 61% as it is it wouldn't be good. With my high virol count treatment would be 72 weeks which I couldn't do.  My best chance is wait until the new drugs come out that are suppose to cut treatment time in half with a 70% cure rate.  Back to waiting.  One thing he did say was that my ast and alt numbers are high but my alt number is lower than my ast(or was that the other way around)and that indicates no liver damage yet. He said it's the poor man's way of doing a biopsy. Anyone ever heard that?

[Diane12855]

You don't have to have cirrhosis to have liver damage. There is a big range between a healthy liver and cirrhosis.

[JennyPenny2009]

Just reread my post and it does sound  a bit confusing. Let me give an example.

If AST is 100 and ALT is 50 the ratio would be AST/ALT=2. That could mean cirrhosis. If ALT is 100 and AST is 50, the AST being lower than ALT would mean no cirrhosis.

[JennyPenny2009]

I have never heard a doctor talk about the ratio of ALT to AST in quite that way. However, when the ratio of AST/ALT is greater than 1, that often means cirrhosis is present. But it doesn't say anything about no liver damage if the ALT is greater than AST. It just holds somewhat true for cirrhosis.

[Javi1962]

I also have lung issues and that was my concern since I have difficulties breathing now, but my lung doctor cleared me to start tx when I am ready,and he will monitor me but said he did not see a problem.
you should probably consult with your lung doctor as well, he and the liver dr. will have to communicate during the treatment.

[Diane12855]

I agree.......... find another doctor.

I changed doctors and I'm soooooo glad I did. Find one that takes care of lots of hep c patients... preferably a hepatologist.

It's your health, you deserve the best you can get.

[Trinity4]

BTW, forgot to say now I'm really convinced you need to seek out another doctor.

Trinity

[Trinity4]

That rationale makes no sense dj.  You are a geno 1 and you need all the riba you can get to keep (weight based minimum) to keep the virus from replicating.  Reducing your riba dosage to 600 mg and extending the treatment does not halt the virus nor does it stop the virus from replicating.  Early virological response it crucial to SVR.  You have to hit this virus hard and fast.  Reducing riba will only jeopardize your chances of SVR and extending will not increase the odds of SVR.

Trinity

[djbn13]

I think the 72 weeks is because he would recommend 600mg. of riba and 180 mg of pegysys(sp). Lower dose-longer time? He said he would also put me on procrit(again not sure of sp) but it also comes with a black label warning for us copd people.

[Trinity4]

I've never heard that either Bill.  Ridiculous and dangerous for a physician to say that.

Find another doctor dj, yours doesn't know what he's talking about.

Trinity

[Bill1954]

I’m not sure I’ve ever heard that a high baseline viral load drives the decision to extend treatment to 72 weeks; this Tx extension is typically arrived at by how rapidly the patient responds to therapy. Conversely, a patient with very low viral load (<400,000 IU/mL) might be able to reduce treatment time to 24 weeks, if they also respond and become undetectable for virus at the 4 weeks juncture.

That said, yes; your best shot at doing this one time lies in waiting for the new drugs to be released; hopefully by this time next year.

There is some thought that having an AST score twice as high or more than ALT might signify cirrhosis or alcoholic liver disease; although a biopsy is of course the most accurate measure of fibrosis.

Some otherwise healthy patients in here have reported breathing difficulties while using interferon/ribavirin therapy; although certainly not all of us do.

Avoid alcohol for sure; and keep an eye on developments with the new protease inhibitor drugs, Telaprevir in particular. All the best to you in the future—

Bill

[nygirl7]

No I'm sorry I never heard that before but maybe somebody else has.  The meds would definitely dehydrate you but I'm not sure why he believes you would have to do 72 weeks - viral load isn't really an indicator all of the time, sometimes folks with a low VL have a much harder time clearing then those with a high number.

I'd think adding another drug on top might make it harder for you in the long run but then I'm not a doctor......it sounds like it's 50% of one half of the other here and if he thinks that you have time to wait to see if the new drugs come out soon then good.  

Good luck!