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I'm doing well on Pegylated Interferon plus Ribavirin, but I'm worried about side effects & toxicities

Hello Dr Rodriguez-

I was diagnosed with hep c in November 99 and a biopsy determined I had grade 2 fibrosis . Initially I went to the doctor complaining of consistent upper right quadrant pain and internal irritation which I thought was strictly a digestive problem. Obviously it was a great shock when I learned all about the disease.

Currently I'm on pegylated interferon with ribavirin in conjunction with epogen to maintain red blood cell since I fell under 9.5 hemoglobin count, my white blood cells are also very low, I recently had to have serious root canals and also had to take amoxicillen, plus the occasional Tylenol to help with all side effects of therapy. Although I'm undetectable right now, I'm not confident about when therapy ends in 6 more months of the peg. I am afraid the virus will again attack. This brings me to the big question--

HOW MUCH DAMAGE AM I DOING TO MY LIVER TAKING ALL THESE DRUGS WITH THE PURPOSE OF ERADICATING THE VIRUS, BUT AT THE SAME TIME ACCERLATING FIBROSIS AND SUBSEQUENT SCARING, WHICH MY 6TH SENSE TELLS ME THAT'S WHAT'S HAPPENING? MAYBE IM BETTER OFF STOPPING ALL MEDS, HAVING BLOOD CELL ACTIVITY RETURN BACK TO NORMAL LEVELS, AND JUST LIVE WITH THE VIRUS, AND HOPE MY LIVER DOESN'T PROGRESS TO CIRRHOSES. WHAT DO YOU THINK I SHOULD DO?

--J.

Dr. Maribel writes--

Dr. J:

You already started in the best treatment, combo of peg. and RBV. You should expect a sustained response of between 53-57%.(non detectable 6 mo. after treatment ends.) Your chances are better if you are an early responder (neg at week 12). The opportunity to be a sustained responder can go up to 85%,if you comply with treatment. So the worse thing you can do now, is to stop.

Adherence to the full course of treatment is very important at this point. I do not think you should worry about the effect of Epogen, or low doses of antibiotics or Tylenol to your liver. If you are a responder your liver will not progress to cirrhosis, and even may have reversal of the fibrosis.

I know that treatment is difficult, but your best chance now is to go ahead and complete 48 weeks. MR