Are you a para or a quad?  Doug

Hello, David, Merry/Happy <fill in the rest>, and welcome to our little group.

"Minor scarring" is a bit difficult to correlate, did your liver doc give you
the actual fibrosis score (aka "Stage") and Inflammation level (aka "Grade")
from your biopsy? Could be expressed as something like "F2, A1", respectively.
I'm guessing F1, in your case, but it might be higher.

And do you have any idea how long you've been graced with HCV?

Your viral load is in the "low" spectrum, which ought to be a good thing vs
the alternative. It doesn't relate well to the level of accumulated liver
damage, but there is data that indicates lower viral loads are easier to
"cure".

Has the root cause of your diabetes ever been investigated? There is
significant evidence that HCV can be the trigger of immune system wackiness
that can lead to diabetes. Interesting stuff, we've had one person here who
appears to be rid of diabetes as the result of antiviral therapy.

HCV antiviral therapy is a strange beast, some people get hammered by therapy,
others seem to virtually coast through it. To my knowledge there's no good way
to predict at which end of the range one will find themselves. Thus, though
you surely are carrying multiple burdens going into treatment well beyond the
typical hepper, you may well get through it without remarkable consequence.

And on the positive side, the standard treatment for Type 3b lasts for 24
weeks, instead of the 48 weeks Types 1 and 4 get to do. Though I think we're
starting to see an emerging philosophy to customize treatment based on the
individual response to therapy - resulting both in extending treatment
duration for some, as well as ending treatment early for others.

Questions I'd ask my liver doc:

- are your current blood counts sufficient enough to initiate therapy? RBC,
Hemoglobin, Platelet and Neutrophil counts could be affected by therapy, if
any of your counts are significantly low it might set you up for early
termination of therapy.

- have you been tested for Hepatitis A and B antibodies yet? If you're
negative for both/either, does your doctor recommend vaccination? For Hep A,
he really ought to, as it is easily transmitted and you're always reading
about some food service worker than infected a hundred people in one day. Hep
B isn't as easily come across and the vaccination doesn't always work, so that
one could be considered optional.

- will the doctor favor intervention with Human Growth Factors over anti-HCV
dose modification (read: reduction or cessation)? Ie: will your doctor
prescribe shots of Epoetin Alpha (aka Procrit, Epogen, or simply EPO) if you
experience significant anemia? Will your doctor prescribe shots of Neupogen if
your white blood cell counts (and specifically, your Neutrophil count) trends
too low? A clear key to treatment success is maintaining the optimal dosages.

- how often will blood tests be taken? The typical game plan is weekly for the
first few weeks, then bi-weekly for another month, and if by the end of the
second month your counts have plateaued, monthly from that point on.

- when will Viral Load checks be done? At the minimum you should have VL
checks at the end of Week 4, 12 and 24 for the 24 week plan.

- given the already present GI issues, are there any preventive or even
palliative measures to be taken - or be ready to take - if therapy aggravates
these conditions? For what it's worth, other than not being interested in
eating much during treatment, I never had any particular GI issues or pain
problems. Virtually all of my significant side effects were related to anemia,
so I don't have anything to offer here.

- who will you see if you have problems or questions? And how easily can you
make sure connections? Does your doctor have good assistants on staff (be they
RNs, LPNs, PAs, NPs, etc) that are HCV-knowledgeable, experienced with
treatment and managing same, etc? I ended up dealing with a certifiable nitwit
with zero experience in dealing with heppers on therapy. On the downside, it
sucks waking up to the reality that I had a nitwit between me and remaining
vertical. On the upside, it inspired me to get educated as best as I could as
quickly as possible.

- as you're already on SSRI's, what does your doctor recommend - or what will
he be prepared to recommend - should mood-altering side effects get too heavy?
Interactions between different medications should be understood, and the
option of changing meds before or at the start should be discussed - both pro
and con.

Whoops - gotta run - wife is hailing from the kitchen that my presence is
needed. I'll try to add more later today.

Stick around, ask lots of questions, there's a whole community of peeps here
that will share...

Cheers, and good luck.

/greyhackles

Welcome to ash-c, David, and congratulations on having Genotype 3 because it
requires only half the length of treatment and (with Geno 2) has the highest
odds of success. It's also a bit of good fortune that you've got only minor
scarring to your liver. With treatment, this could very well be reversed. As
well, it's possible that many of your other, unrelated problems are in fact
related to hep c, i.e. diabetes, depression and upset stomach.

Greyhackles (as usual) is providing you with excellent information. I'm sure
he'll have just about everything covered after his wife releases him from
kitchen duty.

You take care,

Waterspider

Welcome aboard!! Sorry we have to meet under these circumstances. You were
rather insulting in your first post, don't you think. Not a good way to ask
for help.