Re: Genotypes...Vaccines... ALT's , AST's..THE GOOD...

[Guest guest]

Hi,

Sounds like your levels are very low and that you have a normal liver function. Hopefully, you will clear the virus on the first go round. Many people with levels such as yours choose to not do treatment and wait until something better comes along - something without the side effects.

Has your doctor also tested you for any autoimmune disorders or run a celiac panel? How are your blood cell counts? Did your doc also do a homocysteine test? It can help predict low red blood cell levels during treatment. Also, if you have any pre-existing autoimmune disorder, it will almost certainly worsen with treatment. Particularly if you have the celiac genes as treatment often times spurs celiac disease which is intolerance of the wheat protein. This can also cause problems with your thyroid and also bring about diabetes and vision problems. Here's a link with contraindications:

http://www.medscape.com/viewarticle/503764_3

Absolute Contraindications to Pegylated Interferon Alpha and/or Ribavirin

Hepatic Decompensation

Any evidence of hepatic decompensation precludes treatment with IFN alpha combined with ribavirin (unless in rare circumstances just prior to a liver transplant).[22] It is important that the treating physician appreciate the sometimes subtle findings of hepatic failure, e.g. any elevation in serum bilirubin (in the absence of haemolysis or Gilberts' syndrome), an elevation of the internationalized ratio or a lowering below the lower limit of normal for serum albumin. The more obvious signs of liver failure such as jaundice, variceal haemorrhage, hepatic encephalopathy, and ascites are not difficult to miss! Such individuals if suitable candidates are better off referred to a liver transplant centre.

Autoimmune Disease

Both IFN and ribavirin modify the immune response, and it is likely that it is the combination of this stimulation of the immune response together with the antiviral activity of IFN (less so with ribavirin) that promotes viral clearance. Thus in individuals who have an autoimmune disease, treatment with IFN and ribavirin could worsen their autoimmune condition, so it is not recommended that individuals with active autoimmune disease undergo antiviral therapy, except in situations where simple drug therapy, e.g. thyroid replacement, is all that is required to control the effects of the autoimmune disease. Additionally, the need for immunosuppressive therapy to control autoimmune disease causes HCV RNA titres to be very high, which may reduce the chance of an SVR. Hence the management of hepatitis C in individuals with autoimmune liver disease requires careful assessment of the risk:benefit ratio.

Cardiac Arrhythmias

Although rare, IFN therapy may induce a reversible cardiac arrhythmia[23] or cardiomyopathy[24] and it is inadvisable to use IFN in individuals with ventricular arrhythmias or any other form of significant cardiac disease. It is rare for such individuals to be contemplated for anti-viral therapy as their cardiac disease usually presents a much greater risk of death than their hepatitis C.

Anaemia/Ischaemic Vascular Disease

Ribavirin therapy is complicated by varying degrees of haemolysis in at least one-third of individuals undergoing combination therapy,[25] which may induce a sudden fall in haemoglobin. As it is a bone marrow suppressant IFN monotherapy is also associated with a more gradual fall in haemoglobin. Thus, individuals who are anaemic at baseline need correction of their anaemia prior to the initiation of therapy. The risk incurred by a sudden fall in haemoglobin upon introduction of ribavirin means that individuals with ischaemic vascular disease (cardiac in particular) are unwise to undergo therapy for their chronic hepatitis C, if it involves the use of ribavirin.

Renal Failure

Ribavirin is excreted via the kidney, and so any renal impairment will promote high blood levels (particularly within erythrocytes) and as the usual half life of ribavirin is 120 days, the presence of renal failure promotes severe ongoing haemolysis, and thus its use is contraindicated in renal failure. Very low dose ribavirin has been utilized in end stage renal disease in a few studies.[26] PEG-IFN, because its molecular size is much larger than that of standard IFN, has less renal excretion and may be better tolerated in patients with end stage renal failure. Pharmacokinetic studies conducted in patients with varying degrees of impairment indicate that when the creatinine clearance is <30 mL/min blood levels of IFN when given as PEG IFN alfa 2b become markedly elevated,[27] not so with PEG IFN alpha 2a (the larger molecular weight form of PEG IFN alpha).

Pregnancy

Ribavirin is teratogenic whether the ribavirin is taken by the male or the female in a partnership and thus it is essential that all treated patients and their sexual partners perform safer sex, not only during the entire course of therapy, but for at least 6 months after the cessation of therapy because of the prolonged half life of ribavirin.

Patients with Hepatitis C: Who Should Be Treated?

http://www.hcvadvocate.org/hcsp/articles/HEATHCOTE.html

Good luck, but please educate yourself about this treatment before you do your first shot.

Chris

I turned out to be GT 2b with a ALT of 22 and HCV of 3.85M. I'm actually looking forward to treatment at this point! My internist told me, "I've been doing this a long time and I can usually tell those who will do well and those who are going to have trouble, you fit into the first category" ... no previous or existing counter meds, no hiv, generally in good health for a 51 y/o save for a high blood pressure issue, good nutrition plan, good attitude, and walk 5-7 miles a day.

Let you know more ...

Mr. MikeMake your life easier with all your friends, email, and favorite sites in one place. Try it now.

[Guest guest]

-I learn more and more each day. Some of it good, some not so much. I

know that we will never learn it all. Even the so called MEDICAL

EXPERTS don't but the more we know the better armed we are to make

our personal decisions on treatment. I have both severe Psoriasis (

autoimmune disease ) and Premature Cardiac Contractions so I know

even more so that treatment is not for me.-- In

Hepatitis_C_Central , smalk50@... wrote:

>

> Hi,

>

> Sounds like your levels are very low and that you have a normal

liver

> function. Hopefully, you will clear the virus on the first go

round. Many people

> with levels such as yours choose to not do treatment and wait

until something

> better comes along - something without the side effects.

>

>

>

>

>

> Absolute Contraindications to Pegylated Interferon Alpha and/or

Ribavirin

>

> Autoimmune Diseas Thus in individuals who have an autoimmune

disease, treatment with

> IFN and ribavirin could worsen their autoimmune condition, so it is

not

> recommended that individuals with active autoimmune disease undergo

antiviral

> therapy, except in situations where simple drug therapy, e.g.

thyroid replacement,

> is all that is required to control the effects of the autoimmune

disease.

> Additionally, the need for immunosuppressive therapy to control

autoimmune

> disease causes HCV RNA titres to be very high, which may reduce

the chance of an

> SVR. Hence the management of hepatitis C in individuals with

autoimmune liver

> disease requires careful assessment of the risk:benefit ratio.

> Cardiac Arrhythmias

> Although rare, IFN therapy may induce a reversible cardiac

arrhythmia[23] or

> cardiomyopathy[24] and it is inadvisable to use IFN in individuals

with

> ventricular arrhythmias or any other form of significant cardiac

disease. It is

> rare for such individuals to be contemplated for anti-viral

therapy as their

> cardiac disease usually presents a much greater risk of death than

their

> hepatitis C.

>

>

>

>

> **************Make your life easier with all your friends, email,

and

> favorite sites in one place. Try it now.

> (http://www.aol.com/?optin=new-

dp & icid=aolcom40vanity & ncid=emlcntaolcom00000010)

>

[Guest guest]

pita hon,, what do you mean by premature 'cardiac' contractions? Are they PAC's ( premature atrial contractons) or PVC (premature ventricular contractions).. both of these can be controlled by either medications or pacemaker... >> Hi,> > Sounds like your levels are very low and that you have a normal liver > function. Hopefully, you will clear the virus on the first go round. Many people > with levels such as yours choose to not do treatment and wait until something > better comes along - something without the side effects.> > > > >

> Absolute Contraindications to Pegylated Interferon Alpha and/or Ribavirin>> Autoimmune Diseas Thus in individuals who have an autoimmune disease, treatment with > IFN and ribavirin could worsen their autoimmune condition, so it is not > recommended that individuals with active autoimmune disease undergo antiviral > therapy, except in situations where simple drug therapy, e.g. thyroid replacement, > is all that is required to control the effects of the autoimmune disease. > Additionally, the need for immunosuppressive therapy to control autoimmune > disease causes HCV RNA titres to be very high, which may reduce the chance of an > SVR. Hence the management of hepatitis C in individuals with autoimmune liver > disease requires careful assessment of the risk:benefit ratio. > Cardiac Arrhythmias> Although rare, IFN therapy may

induce a reversible cardiac arrhythmia[23] or > cardiomyopathy[ 24] and it is inadvisable to use IFN in individuals with > ventricular arrhythmias or any other form of significant cardiac disease. It is > rare for such individuals to be contemplated for anti-viral therapy as their > cardiac disease usually presents a much greater risk of death than their > hepatitis C. > > > > > ************ **Make your life easier with all your friends, email, and > favorite sites in one place. Try it now. > (http://www.aol. com/?optin= new-dp & icid=aolcom40van ity & ncid= emlcntaolcom0000 0010)>

[Guest guest]

-JAX, I meant Ventricular. -- In

Hepatitis_C_Central , Jackie on <

>

>

>

>

>

> >

>

[Guest guest]

ok so you have PVC's.. arent they giving you medication for that? if you had an R on T , it could be very dangerous! Did they give you an option of a pacer/defibber? I sure hope they can get this straightened out for you! that can be very scary! PAC's are not that risky, PVC's can be.. do they know where the stimuli site is? You dont have WPW, do you?> > >>

[Guest guest]

No have never been put on meds. Have had stress test done about 5

yrs. ago. I have no idea what an R on T is. I've had a lot of

episodes of some kind especially a few weeks ago when I had to get 3

injections in 3 days of prednisone. Are you meaning Wolfe Parkinson

White's Syndrom? I don't think so but my sister does and it was scary

to watch them have to stop and restart her heart about 4 times before

she finally agreed to have the procedure done to burn out the bad

part.

>

> ok so you have PVC's.. arent they giving you medication for that? 

if you had an R on T , it could be very dangerous!  Did they give you

an option of a pacer/defibber?  I sure hope they can get this

straightened out for you!  that can be very scary!  PAC's are not

that risky, PVC's can be.. do they know where the stimuli site is? 

You dont have WPW do you

> >

>

> > >

> >

>

[Guest guest]

yes that was what I meant in WPW..

Subject: Re: Genotypes...Vaccines... ALT's , AST's..THE GOOD...To: Hepatitis_C_Central Date: Tuesday, December 9, 2008, 5:17 PM

No have never been put on meds. Have had stress test done about 5 yrs. ago. I have no idea what an R on T is. I've had a lot of episodes of some kind especially a few weeks ago when I had to get 3 injections in 3 days of prednisone. Are you meaning Wolfe Parkinson White's Syndrom? I don't think so but my sister does and it was scary to watch them have to stop and restart her heart about 4 times before she finally agreed to have the procedure done to burn out the bad part.>> ok so you have PVC's.. arent they giving you medication for that? if you had an R on T , it could be very dangerous! Did they give you an option of a pacer/defibber? I sure hope they can get this straightened out for you! that

can be very scary! PAC's are not that risky, PVC's can be.. do they know where the stimuli site is? You dont have WPW do you> > > > > >> >>