interferon in SLE

[salehnassar2011]

45 years old femail with SLE on hemodialysis for 4 years  developed HCV . viral titre 1500 000 . liver enzymes tripple normal. can she recive interferon ?

[HectorSF]

The best advice I can give you based on if you were here in the U.S. is to see the most knowledgeable doctors in the fields of SLE and treatment of hepatitis C. Both doctor would need to collaborate in the decision to treat or not. And if you were to treatment to monitor you very closely to make sure the treatment is not doing more harm then good.

I am not sure how experienced and knowledge your current doctors are but in general I would say the best doctors in both of these fields would be found at teaching hospitals.

I don't know if you have had a biopsy performed but if possible it would be helpful to know if you only have very little liver disease. If that is the case, you may be able to wait for non-interferon treatments that will be available in the next few years here in the US and Europe. It time I would assume they would be available in Egypt and other areas of the world.

Liver disease is a slow, progressive disease and normally takes many decades before it becomes advanced and irreversible. So if you have been infected only recently, you may have many decades to treat your hepatitis C. Only a biopsy can provide this very important information to you.

To learn more about Lupus here is a link to some very good information about SLE.

http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/lupus.asp

I wish you the best of luck!
Hector

[HectorSF]

Systemic Lupus Erythematosus (SLE) complicates treatment of hepatitis C with interferon treatments. One of the impacts of hepatitis C interferon treatment is very common for treating patients to experience anemia and other blood level issues.

As you know SLE also impacts these blood levels. So the combination can lead to very abnormal values which can, if extreme, be dangerous for the patient.

Blood Disorders
These disorders are, unfortunately, very common in people with lupus. Four potentially severe lupus-associated complications are blood count abnormalities. Blood cell counts are typically measured as number of cells in 1 mm3 (cubic millimeter) of blood.

Anemia: Too few red blood cells. A complete blood count (CBC) is a common blood test in which all of the blood cell types are counted in a fixed volume. Normal results for men are 4.7 to 6.1 million red blood cells/µL of blood and normal results for women are 4.2 to 5.4 million red blood cells/µL (MedlinePlus 2010).

Thrombyocytopenia: Too few platelets in the blood. Platelets are small cell fragments that, when activated, stick together to form blood clots. Too few platelets may cause a delay in clot formation and excessive bleeding. Normal levels are between 150,000 to 450,000 platelets/mm3 (McCrae 2006); thrombocytopenia in context of lupus is defined as platelet levels below 100,000/mm3 (Hochberg 1997).

Leukopenia: A reduced level of leukocytes, also called white blood cells due to their lack of color. Defined as a count below 4,000/mm3 (Hochberg 1997). Leukopenia increases the risk of potentially severe infections.

Lymphopenia: A reduced level of a subset of white blood cells called lymphocytes, defined as a count below 1,500/ mm3 (Hochberg 1997). B and T cells fall broadly into the leukocyte group and can be more specifically defined lymphocytes. Lymphopenia also increases the risk of severe infections.