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Which would have the best chance of eliminating my virus or otherwise helping me?
Dear Dr. Chung,
I'm 68 with HCV (genotype 2) and liver fibrosis - incipient cyhrrosis. I've had two sessions with interferon - ribivaran, one time for 6 months, one time for a year (ending last May), both times the virus came back after the treatment. My health seems pretty good, I get tired in the evenings, hard for me to say whether its from hepititas or just age.
Supposedly there are two new treatments which might benefit me. One is Pegasys - ribavain, which is supposed to come out next October. Another is Novirio - Akros (?), pills, which I might be able to get into this summer through some kind of testing program, which might be free.
Which would have the best chance of eliminating my virus or otherwise helping me? Since I haven't been taking anything, is my liver deteriorating? Can I wait till next fall? Are they sure the Pegasys will be available in October? How much will it cost? Medicare won't pay for my prescriptions and I recently moved from Miami to Austin Texas. If the cost of Pegasys will be like my previous treatments, I'll have to go back to Florida to get my medicare-HMO to pay for it, it won't be covered in Texas.
Thanks very much.
  Dr Chung Writes-  
If you can tolerate another combination therapy for a year, i think getting the Pegasys + ribavirin combination may be your best bet. if you were a relapser, then i would wait until this combination becomes available later in 02. if you were a nonresponder, then you may consider referral into a trial known as HALT-C, an NIH sponsored trial which is treating patients who have advanced liver disease and will offer PEGasys + ribavirin treatment to all subjects as a leadin, and in the event of nonresponse, then examine the merit of long-term maintenance therapy (low dose PEG) versus observation. you can consult the NIH website for site nearest you.
  Dr. Chung      
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