Friday, August 04, 2006

Deciding on Treatment

Treatment for Hepatitis C is not pleasant, and deciding whether of not to treat the condition can be difficult. I can't make a decision for you, but I can help to make sure that you have taken all the factors into consideration. Firstly, which genotype do you have? Genotypes 2 and 3 are generally regarded as being easier to cure than all the others. If you have either of these, the treatment is shorter (24 weeks), the Ribavirin dose lower, and the success rate higher than for the other genotypes. Unless you have compelling reasons otherwise, treatment is strongly recommended.

How long have you had the virus? The longer you have had the virus, the more likely it is that it is progressing to the point where it will do serious damage. If the answer is a few years, then you may, subject to other factors, choose to wait. If, like me, you have had it for 25 years, the urgency factor is somewhat greater. Current thinking is that your chances of a cure diminish by 8% for every ten years that treatment is delayed. There are always new treatments in the pipeline, and many are in the fortunate position of being able to wait for these, but it takes something like eight years to get a new drug into use, so don't hold your breath!

How much effect is the virus currently having on you? If the answer is 'very little' then you could choose to wait. Equally, treatment is better tolerated by patients who are fit and well, and treating the virus before it can cause problems is attractive. If you have viral symptoms and they are becoming worse, this is a strong incentive to start treatment promptly.

What is your viral load? If it is low this improves your odds of successful treatment. Low viral load is generally accepted as a count of less that 1,000,000 virus particles per millilitre of blood.

What condition is your liver in, and do any other medical factors need to be considered? This is best discussed with your specialist as his opinion will be based on experience of others in similar situations. The advice of your specialist should always be the most important factor in your decision.