A bit of history

So here's a bit of background. I was diagnosed with Hepatitis C last September, during a regular physical exam. My liver enzymes were high, my platelets were a bit low, and my doctor, who is entirely awesome, followed up with more testing. Many doctors do not, surprisingly enough. And so I got the bad news...I still have no idea where I picked it up. It ain't IVs, for one. Not me...:) And, of course, years ago, when I had a full checkup last, there were no traces of it--although it could have been below the threshold of detection of a regular blood test.

Anyway, it isn't like I was feeling bad: a bit of tension in the lower abdominal region, and occasional bouts of fatigue that I had attributed to getting old and hangovers.:)

More tests followed: it was genotype 1a (the more resistant one, but also most common in USA); my endoscopy came back clean--I have several awesome pictures of my esophagus I'll post some time soon, and my biopsy came back with fibrosis, level 2 (or slightly above). That is not horrid in itself; serious fibrosis starts at level 3, when fibrous parts in the liver start connecting to one another. Mine apparently are still scattered, but I guess reversible--if I get rid of the causative agents, which in my case were alcohol (easily done) and the damn virus. Quitting drinking was elementary (and easier than I'd thought) even though for several months after the diagnosis I still had an occasional cider. No more of that now: it is counter-indicated with my medicine. (Alcohol increases the production of a protein called nuclear kappa-factor B in bloodstream, and that protein in turn increases replication rates of Hep C virus--my viral load was over 15 mln--and contributes to liver inflammation. What's more, alcohol also interferes with the action of interferon-alfa, making my shots less effective. All around a bad idea...but I love my cider! Grrr.) Anyway, a few nights of mildly disturbed sleep were all I had to go through (and I my sleep is already pretty disturbed).

So finally now, I got through my training class (medicine and injection information, etc.) and started the full course of treatment last night. Now, everything depends on my response to treatment in 4 and 12 weeks. If viral loads do NOT drop to undetectable levels in 4 weeks, the treatment will be discontinued. Contingency plans will have to be followed, which mostly consist of hoping a new different treatment comes on market before my liver decides it's had enough--which could take years, for both. :) If the levels drop sufficiently, another test, at 12 weeks, will determine further treatment. If they are still undetectable then, I will get another 12 weeks and then 6 months of observation to make sure the infection does not recur (hey! then I'll have a cider..or a few! :D)) If they rise from the 4-week mark, the treatment will continue for another 36 weeks. In either case, I will know if I am a part of the lucky 75-80% who respond to it within a month.

The treatment itself involves a 180 mcg subcutaneous shot of Pegasys (interferon) once a week (in the belly!); 600 mg of ribavarin (antiviral) twice a day; and 2x375 mg Telaprivir (Incivek) each 8 hours (between 7 and 9, but the closer to 8, the better). The timing of the latter one is very important; I suspect it is metabolized quickly and one needs to maintain constant levels of it in bloodstream. That last one is the awesome wonder-drug: it is a protease inhibitor that attacks the virus directly. Pretty awesome, but with a host of side-effects, on which more later. Basically, this is chemotherapy-lite. (Interferon was originally developed for cancer treatments...)