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Chronic Joint Pain & What HCV Therapy to Use?

DR Chung- I am hcv geno 1a. I am 41+, white female. I had B virus, and believe I contracted C at the same time, although there are a few times I may have contracted it other wise. I did about 20 weeks of combo, in spring 2000, and just recently quit after 10 weeks of Peg, and Riba. I get way too sick, and have small children at home.

Before I started all the TX's, I was biopsy show stage 2 fibrosis, grainy necrosis, and lots of fatty stuff. That is my best take on it. My enzymes are back up as of two weeks ago, and I hope the little bit of interferon I had gave my liver a break. I have suffered from chronic joint pain, for many years. I tested for Lupus 2x, and it came back O.K. Recent Rheum. test came back positive, although the doc I see, still poo poo'd that idea as it was low, he said 24 is normal I was 26.

I felt some relief at the test, as I felt validated for the first time and not patronized. Some days it is all I can do to walk from stiffness and pain. My doc wants me to take vioxx, and other NSAID's, and I am afraid if I take them, they will hurt my liver, and any of the good the interferon may have done. Also, since I have been taking them my bowel movements have turned very pale yellow. Yes my gall bladder is fine.

How would you treat someone with severe extrahepatic sides, that I swear are cryoglobulinemia, that no one else will even consider? I have almost considered suicide a few times as I cannot live with this level of pain. It is off the pain charts, and I am tired of suffering with no help what so ever.

--M.

Dr.Chung writes--

First I would try to confirm that this is cryo with blood test. If it is, and you can absolutely not tolerate PEG + ribavirin, consider suppression with PEG monotherapy. If negative, I would consider treatment with traditional NSAIDs or Vioxx/Celebrex, watching your liver enzymes carefully. RC


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