NAPWA

HCVHepatitis C virus. treatment can cause very difficult side effects. Depression, difficulty sleeping, moodiness, aches and pains, fatigue, weakness, nausea, hair thinning, weight loss, muscle wasting, changes in taste, loss of appetite, diarrhoea, low red or white blood cell count, changes in concentration and respiratory problems can all occur. (Of course, some people may not get any side effects – and some may get all!) Treating HCV before you need treatment for HIV is often best, so that you and your liverA large organ, located in the upper right abdomen, which assists in digestion by metabolising carbohydrates, fats and proteins, stores vitamins and minerals, produces amino acids, bile and cholesterol, and removes toxins from the blood. have a chance to recover from the therapy before you start taking ARVA medication or other substance which is active against retroviruses such as HIV., which can cause liver side effects. Of course this is not always possible, and sometimes it may be more important to treat your HIV first, especially if your CD4 count is particularly low.

When to treat

Treatment can be quite a commitment, and may take some planning for women with HIV who have children or other caring responsibilities. It’s probably better to assume that you will have side effects and plan accordingly than to hope that you won’t (a nice surprise is better than a nasty one).

Whether or not to treat will be determined in part by your HCV viral loadA measurement of the quantity of HIV RNA in the blood. Viral load blood test results are expressed as the number of copies (of HIV) per milliliter of blood plasma. and liver function tests – blood tests that look at liver enzymes. The only way to determine the extent of liver damage, however, is a liver biopsySurgical removal of a piece of tissue from a living subject for microscopic examination to make a diagnosis (e.g., to determine whether abnormal cells such as cancer cells are present). (a long needle inserted into the liver to take a tissue sample). However, this is not performed often these days.

Treatment is always recommended for people with moderate to severe fibrosis or liver scarring, where the liver still maintains some functionality (compensated cirrhosis). However, some people with HIV/HCV co-infection may choose to treat HCV earlier before there is significant liver damage.

If your doctor has told you that you will require treatment, but have a choice as to whether to do so immediately or to wait, you may want to consider:

• How well you are set up to cope with side effects;
• Any plans you have for getting pregnant (HCV treatment cannot be taken while pregnant or for six months before hand).

If your HIV viral load is low and your CD4 count is high, immediate treatment gives you the opportunity to possibly clear HCV before you start treating HIV. That also leaves you in a good position if you are planning pregnancy in the next few years.

If you have any active HIV opportunistic infections or if your HIV viral load is high and your CD4 count low, HCV treatment is not advisable immediately. One of the HCV drugs (the interferon component) lowers your CD4 count, so treating your HIV first and giving your immune system a boost is better before starting HCV treatment in that instance.

Treat Yourself Right