To treat or not to treat? That is not the question.

[fretboard]

I've been a member of this forum for a few months now and what I have learned is all good and I couldn't have learned it from anywhere else.  As far as HepC goes, this is the only forum of which I participate in, most of the posts on this site are pro-treatment and I think that's what initially attracted me to this forum.  Even though it's a pro-tx forum there are some posters who say to treat, however wait until you are having some symptoms.  I wish I had their exact words, but it's really not that important as I think it's obvious.  I am waiting for a clinical trial but I'm having to wait as I have mitigating circumstances concerning prescription meds, so I will be seeing my GI in early July and getting my bloods and an ultrasound done, minimum.  I am also pro-treatment, with all these issues associated with the HepC tx, I am geno 1, so it seems like the genotype with the extra aggressive tx, if there is such a thing.  HepC is such an enigma of a virus and tx often affects, teeth, skin, nerve damage, arthritis, fibro, riba rash, anger the list goes on and I don't want to continue about the bad things that may or may not happen to anyone if they go through tx.  No doubt that HepC is a tenacious bugger and the tx sometimes very difficult, but dang it seems even worse for geno 1's being the longest to tx.  Here's my question, If you choose treatment, is there any indicators that can tell you in advance to get off of treatment as it may cause you a myriad of other ailments and/ or permanent disabilities?  I've read of some heppers who have gone through tx and a couple who even wish they wouldn't have, that's why I ask this question.  I guess it really goes out to the ppl who have had major complications with their tx and have even gotten worse as a result of tx, but of course anyone with an opinion can answer.  Be kind as I'm just looking for an answer, I don't care how good the doctor is he can't feel what you're feeling during tx so my feeling is you really have to stay focused and don't just think your doctor is some God as some of them think they are, they're only human.  I don't know, that's why I'm asking.  I want to have a clue prior to treating as I feel that if I go through anything adverse, I would get off of treatment, but at the same time I don't want to be overly cautious.  God Bless  

[Trish77]

They rebounded just enough...I was at .3 and needed to be at .5 to avoid a dosage reduction and the blood test on the Wed after they pulled the trial drug came back at .5. right on the border.  So once again, no dosage reduction.  Now I don't have to test for two weeks from that Wednesday, so it seems they figure the drop is from the trial drug and the rebound is from the lack of it.  The doc at the hospital I go to wants to test for some other components of the white blood cells as well .. he's getting curious about some other potential impacts.  And so it goes.  

[willing]

jim: 4 years? wow,  your docs  must be prescient :) as far as I know, the hcv-statins connection was first reported at last year's ddw, less than a year ago, and the safety of statins among the liver-impaired is still under review, eg
http://www.ncbi.nlm.nih.gov/pubmed/17542767

trish : so how about those lymphocytes?

[Trish77]

Fret,

Here is a thread that was going not so long ago here.. someone asked about fluvastatin, a cholesterol-lowering drug, that he'd heard it lowers viral load.  The subsequent discussion includes links to studies that have shown current thinking on statins for persons with liver damage and HCV, that they actually not only help reduce viral load but are even being considered as a substitute for ribavirin pending further study.

Here's the link to the medhelp thread:  
http://www.medhelp.org/posts/show/503942

As long as they keep monitoring you, the evidence seems to indicate that not only can you have statins AND do treatment but that it will likely HELP you while on treatment towards having a better outcome.  Always that little roll of the dice you take that says if the adverse effects come, you have to stop.  But the evidence seems to indicate it's potentially worth a throw or two of those dice...however, once again, that's a very individual thing.

Trish

[jmjm530]

WIlling:
I believe Jim's on target - your  Dr might be (slightly) out of date.
------------------------------------------------------------------------------------------
Yeah, about four years "slightly" as are the FDA inserts :)

[willing]

>Why won't my doctor prescribe me statins,

I believe Jim's on target - your  Dr might be (slightly) out of date. Until last year, FDA required package insert for all statins to include "active liver disease" as a contra-indication. This restriction was recently removed for certain statins
"Researchers have investigated the effect of statins on hepatitis C for several years, but the treatment is not approved by FDA. In fact, use of many statins is contraindicated in patients with active liver disease. However, FDA recently removed this contraindication from the package inserts of 3 statin agents"

from
http://www.modernmedicine.com/modernmedicine/article/articleDetail.jsp?id=442867

the link will probably be expunged by the censorship screen, but you  should be able to find the exact FDA regulatory changes on the FDA site.

Also,  Alinia is not a statin, it's prescribed for control of diarrhea caused by parasitic infection.

Overall,  there's not much choice with respect to the ifn, and you won't know how much damage it's done, if any, until it's too late. In terms of planning the best you can do is to avoid taking more than you need (ie if you can put together a combo that decreases your ifn exposure without reducing your odds of svr you're probably better off).

[comeagain]

I know this thread isn´t about you but gotta ask you this.

Your a grade1 stage1 right?
Did you risk to get resistant to protease inhibitors by signing up to that studie your in,
I know nobody could risk not to get riba in future studies, but what about getting to little peg, do you know what meds youve got by now?

The reason I´m asking is that fret seems to be so sure to get in a studie is he knowing the risks? did you?

ca