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When to begin HCV therapy

Dear Dr Chung,

I am a 43 year old hemophiliac, HIV+, HCV+. I am on combivir and viracept for the last 3 1/2 years. I have always had good CD4(700-800) and no detectable HIV viral load. However, I have been having elevated ALT and AST results. I also have been very fatigued as well.

Question is, when should I begin PEG/ribavarin and should I have a biopsy? Should I be seeing a GI guy as well as my hematologist?



answer from Dr Chung:

I would strongly suggest a biopsy to stage the liver disease due to HCV. If there is active HCV disease, then it would be worth strongly considering antiviral therapy for HCV. Yes, a GI/hepatologist would be in order. RC Ask our Experts All Questions