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Treatment question--Should I start HCV therapy, and should I use Lamivudine (3TC)?

Dr Chung:

My gastro will be conducting a study using peg-intron, ribivarin and lamivudine for Hep C. I am 1b, 300,000 iu/ml almost constant, normal lft's (last two years), stage 1 grade 3 biopsy (Feb. 2000). My internist has told me he would not recommend treatment given currently available meds and the gastro said the same but, the gastro said depending on auto-immune blood test, he would consider me for the study. I have had hep b and cleared it. Have you ever heard of this combination? What effect might the lamivudine have on cleared hep b? Might it make it active again or go wild card as I have heard it does during treatment for chronic hep B. Lamivudine is also a drug for HIV/AIDS. There is some contention these drugs cause michondrial damage, also some thought that HCV causes that kind of damage also....Might a combination of HCV and Lamivudine accelerate the process? Sorry to be so wordy.....considering here.

Dr.Chung writes--

I do not think that lamivudine has much to add to PEG interferon and ribavirin and we do not know the interaction of ribavirin with lamivudine since both are nucleoside analogues. my own view of it is that because you have a reasonable appearing biopsy that you could try treatment for a brief period of time - if no evidence of virologic response by 3 months, you could wait for a better treatment combination in the future. RC


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