is this right

[johnbyrnes]

went to the doctors on friday 14-5-2010 he told me that my virul load was low at 264,086,and he was going to start me on a six month treatment of interferon only,
he said i stand a good chance of clearing this virus ,i have phoned the hospital several times and they cannot answer this, why just the one?
and do i stand a good chance,
one more thing,
he also said that they dont do liver biopsys anymore.
i think he is talking out of his a*se.
he is supposed to be a specialist in his field,
but saying that he works at the training hospital,of manchester royal infirmary.

[Trish77]

That's a good point, Bill - and a good question for your doc, John.  Does he consider you to be in the Acute Hepatitis phase?  That would explain the lack of biopsy as well, no need for it in an Acute situation.  If you don't mind clarifying on this point?  Changes everything if that's where you're at, if your Hep C is considered to have been acquired only within the last few months or so.

[Bill1954]

John, have you been diagnosed with chronic or acute HCV? Some doctors will treat acute disease with interferon monotherapy; if you’ve progressed to chronic phase, then I agree that ribavirin is critical for success. If you have any doubt as to your status, be sure to discuss this with your doctor. Good luck—

Bill

[nygirl7]

Glad you posted this JB I didn't want it to be only me telling you this information so that you would see - you really DO need the riba like I said....it's really important. Now I had a low VL too (568k) and had a tougher time clearing than most people with high viral loads.........sometimes in rare cases it's just that way - you need to ask him why no riba? It still makes no sense to me my friend........

They haven't done monotherapy in years......

[newleaf09]

I don't see biopsy in exactly the same light as Trish does.  Biopsy is used as a tool to help people decide to treat the disease.  If the results are not bad, say only stage 0 or 1 on fibrosis (scarring), the patient might decide to wait a while to start treatment, until it fit into their life a little better.  If it was stage 3 (extensive scarring) that information could encourage a patient that they needed to start treatment soon before the disease progressed any further and caused worse damage.  If the patient is already decided to begin treatment, it's less important to do a biopsy in most cases.

It is very well documented that it greatly increases the rate of successful treatment by adding the antiviral drug, ribivirin, and keeping the weight based dosage at full dose for as much of the treatment period as possible.  The down side to ribivirin is that it destroys hemoglobin.  Do you have some hematological problem that would make the doctor put successful treatment at risk by avoiding ribivirin? I have the same doubts Trish does about whether this doctor is as well informed as he needs to be to manage the serious drug regimen required to cure viral hepatitis.

[Trish77]

You just got diagnosed in March.  What Genotype are you?  If the doctor hasn't told you that, please ask.  That determines how long your treatment should be, 24 weeks or 48 weeks.

I don't understand the Inteferon only approach.  Interferon is effective in combination with Ribavirin and ribarivin at the right dose for your weight as well.

As for the biopsy, if they don't do biopsies do determine the stage and grade of existing liver damage, what DO they use for that?  Sometimes in government funded healthcare, the docs will decide to forgo a biopsy if you're going to do treatment as they figure it's a cost that's not necessary and I disagree.  It affects treatment decisions as you go along and before you even get started if you know what kind of shape you're in and how much time you have to play with when making treatment decisions and what KIND of treatment decisions are best for you.  I'm in Canada and my first doc who is a specialist in his field so I was told takes the same approach, no biopsy if you're going to do treatment anyway and I asked for it regardless.  Helped me as I made decisions to know I had minimal liver damage.  

I dunno about this guy.  Sounds like he may be a specialist in gastroenterology but hepatology maybe not so much.  Keep asking questions and get these things sorted out.  Interferon only??  What's his basis for that?

Good luck with this.

Trish