Ask Your Questions About-HCV! of our Hepatitis Experts:

IL-2 for HCV, HCV Re-Treatment for Relapser.

Dr Chung:

For the past 8 years or so, I have participated in il-2 studies for HIV. Since then, I found out I also have HCV, too. The last time I did il-2 was January of 2000 and in May, 2000 I did 11 months of daily high dose infergen (15mcg + 1000 mg ribavirin daily for 5 months and then for the last 6 mos I did 12 mcg infergen + 800 mg ribavirin daily; I was unsustainable after 3 months but at month 10 had approximately 200 K + virus particles, so I did not finish the last month of therapy). Well, I am thinking of starting therapy again but don't know whick way to go, or if it's possible to integrate both therapies some way. Perhaps do a round of il-2 and then a month or so latter starting starting the pegalyated interferon, if for none other than maintaince.

But then again, perhaps do peg plus ribavirin. But then again, I have heard that Roches Pegasys may be better for the genotypes 1, of which I am type 1a. I know that has not been approved but perhaps will in January.

I really don't know which way to go. I do want to do something in the way of immune therapy because these drugs are murder (been on them well over 10 years). And I think they are killing us oh so slowly. Can you add some insight into this perplexing situation? Incidentely, my t's are 670 but I have noticed my cd4:cd8 rratio has fallen to .8 which I think is important, and why I think il-2 may be good. My primary care doctor is willing to let me go in the direction I choose, and I do know it is my choice. Please give me some input. I know it's a difficult scenario.
--J.

Dr.Chung writes--

There is little evidence at present that IL-2 enhances clearance rates for HCV. However, an upcoming pilot ACTG trial will examine IL-2 in conjunction with PEGIFN + ribavirin. Nonetheless, since you are an interferon relapser/breakthrough, I would strongly advise trying PEG-IFN + ribavirin (either PEG formulation once available). In the meantime, until they are available, a liver biopsy may sort out the urgency to treat the HCV. RC