GUIDECE FOR THE MANAGEMENT OF HEPATITIS C.

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DEAR MEMBERS. PLEASE GUIDE FOR WHICH I SHALL BE THANKFUL. CASE HISTORY I AM PATIENT OF HCV+ AND GENOTYPE IS 3a. I am sending herewith Case History and other relevant Laboratory test results. Please advise for treatment, management and medical prescription. For the time being I am getting treatment from homeopath doctor. I live in Pakistan and hope you will reply for which I shallbe thankful. My main questions are as under,1. what is stage of my hepatitis. My physician is of the opinion thatit is about 4 years old.2. can I wait for interferon therapy for a year or two.3.what is the superiority of inj pegintron over inj interferon.4. my homeopath physician is o the pinion that I am just career.5. in case of interferon therapy, how to manage depression. CASE HISTORY.NAME : MOHAMMAD SALEEM CHAUDHRY S/O CH.DIN MUHAMMAD AGE. 52 YEARS.MARITAL

STATUS. MARRIED 23 YEARS.GENDER. MALE.FAMILY HISTORY. FATHER SUFFERED FROM PROSTAT CANCER DUE TOWHICH his KIDNEYS FAILED.MOTHER IS PATIENT OF HYPERTENTION.NO SUGAR IN THE FAMILY. SUFFERING FROM:- 1. HYPERTENTION SINCE 1995. FIRSTLY TAKING TAB. TENORMIN 25 M.G. ONE DAILY, FROM 1999, 50. M.G. DAILY. FROM 2002, 50. M.G TWICE A DAY. FROM DEC 05. TAB TENORMIN 50 M.G. ONE DAILY AND TAB NORVESIC 5.M.G ONE DAILY.2. DEPRESION.SINCE 1998. TAKING TAB. CIPRAM 20.M.G.ONE DAILY.3. GASTRIC PROBLEM SINCE 15 YEARS. NO CONSTIPATION.HELICOBACTER PYLORI TEST POSITIVE. AS PER DOCTOR'S

ADVICEAPD+HELICOBACTER PYLORI ANTIBODIES NEEDS TREATMENT.4. HEPATITIS C POSITIVE.THE TESTS REPORTS ARE REPRODUCED HEREUNDER:- SEROLOGY DATE OF TEST TEST NAME RESULT NORMAL RANGE NOVEMBER 09, 2005 Hep Bs Ag Negative See below * Performed on 3rd Patient S/N 0.6 <2 No

reactive generation MEIA -DO- Anti - HCV Positive See Below * Performed on 3rd Patient S/CO 109 <1 NonReactive generation MEIA 1-8

Borderline 8 Reactive QUALITATIVE HCV PCR Hepatitis C Virus (RNA) detected.METHOD: The HCV RNA detection test is based on RT - PCR of HCV RNA followed by hybridization to specific probes and colorimeteric detection. The sensitivity of HCV assay is 95% and the specificity is 99%.Genotyping. HCV + Genotype

3a. test report dated April 8, 06. LIVER FUNCTION TEST APRIL 03,2000 Total Bilirubin 0.6 mg/dL 0.1 - 1.01 SGPT (ALT) 30 mg/dL Upto 40 Alkaline Phosphatase 230 U/L 80 -

306 Na 145 mmoi/L 130-145 K 3.8 mmoi/L 3.2 - 5.2 Inozied 1.1 mmoi/L 1.1 -1.3NOVEMBER 08, 2005 Total Bilirubin 1.0 mg/dL 0.2 - 1.1(Adult) < 12.0

(Neonate) SGOT (AST) 111 U/L 9-40 SGPT (ALT) 186 U/L 9-40 Alkaline Phosphatase 123 U/L Adults

30-115 Upto 15 years <345 15 to 17 years <483 DATE OF TEST TEST NAME RESULT

NORMAL RANGE DECEMBER 05, 2005 Total Bilirubin 0.9 mg/DL 0.2 - 1.0 Mg/DL SGOT (AST) 142 U/L 10 - 40 U/L SGPT (ALT) 218 U/L 10-40 U/L Alkaline Phosphatase 261 U/L 100-290

U/L T. Protien 7.9 G/dl 06-08 G/Dl Albumim 4.2 G/dl 3.2 - 5.6 G/dl DECEMBER 16, 2005 Total Bilirubin 0.7 mg/DL 0.2 - 1.0 Mg/DL SGOT (AST) 145 U/L 10 - 40

U/L SGPT (ALT) 215 U/L 10-40 U/L Alkaline Phosphatase 287 U/L 100-290 U/L DECEMBER 27, 2005 Total Bilirubin 0.6 mg/DL 0.2 - 1.0 Mg/DL SGOT (AST) 126 U/L 10 - 40 U/L SGPT

(ALT) 196 U/L 10-40 U/L Alkaline Phosphatase 251 U/L 100-290 U/L JANUARY 17, 2006 Total Bilirubin 0.6 mg/DL 0.2 - 1.0 Mg/DL SGOT (AST) 88 U/L 10 - 40 U/L SGPT (ALT) 163 U/L 10-40

U/L Alkaline Phosphatase 243 U/L 100-290 U/L FEBRUARY 02, 2006 Total Bilirubin 0.9 mg/DL 0.2 - 1.0 Mg/DL SGOT (AST) 88 U/L 10 - 40 U/L SGPT (ALT) 102 U/L 10-40 U/L Alkaline Phosphatase 278 U/L 100-290

U/L FEBRUARY 14, 2006 Total Bilirubin 0.9 mg/DL 0.2 - 1.0 Mg/DL SGOT (AST) 123 U/L 10 - 40 U/L SGPT (ALT) 101 U/L 10-40 U/L Alkaline Phosphatase 241 U/L 100-290 U/L March 1, 2006 SGOT (AST)

128 SGPT 197March 8,2006 SGOT (AST) 155 SGPT(ALT) 213March 28,06 SGOT(AST) 88 SGPT(ALT) 169RENAL FUNCTION

TEST NOVEMBER 08, 2005 Blood Urea 18 Mg/dl 10 - 50 Mg / dl Creatinine 0.8 Mg/dl 0.7 - 1.2 [Men] Uric Acid 6.3 Mg/dl 3.4 - 7.2 [Males] FEBRUARY 02, 2006 Blood Urea 34 Mg/dl 10 - 50 Mg / dl Creatinine 0.9 Mg/dl 0.7 - 1.2

[Men] Uric Acid 5.6 Mg/dl 3.4 - 7.2 [Males] DATE OF TEST TEST NAME RESULT NORMAL RANGE BLOOD COMPLET PICTURE NOVEMBER 08, 2005 WBC COUNT 6000 / mm3 4000 - 10,000 RBC COUNT 5.33 mil/mm3 4.5 -

6.0 HEMOGLOBIN 15.7 g/dL 14-18 (Males) HEMATOCRIT 46% 40 - 50 MCV 87 fl 82 - 98 MCH 30 pg 27 - 31 MCHC 34 g/dL 32 -

36 RDW-CW 14% 11 - 16 PLATELETS 171,000mm3 140,000-425,000 DIFFERENTIAL COUNTNOVEMBER 08, 2005 Neutrophils 39 % 55 - 70 Lymphocytes 50% 25 - 40 Monocytes 07% 2

-6 Eosinophils 04% 0 -4 Basophils 00% 0-1 Bands 00% 0-1 ESR 16 mm/ 0-15 Males 1st hourLIPID PROFILE NOVEMBER 08, 2005 Cholestrol 154 mg/dL <200 Preferred 200-220borderline

HDL Cholestrol 44 mg/dL 30 -65 (Males) 35 - 80 Females LDL Cholestrol 87 mg/dL 90 - 160 Triglycerides 116 mg/dL <150 Preferred 150-200 BorderlineSEROLOGY NOVEMBER 08, 2005 Helicobacter Pylori Positive (Antibodies) ULTRASOUND ABDOMEN AND PELVIS LIVERIt shows smooth margins and

normal texture. No focal lesion or dilated channels are seen. Right dome moves freely. The portal vein is normal. GALLBLADDER It shows multiple stones, largest measure 11 mm. No mass or thickening of its wall is seen. No fluid collection is seen around it. CBGis of normal caliber. PANCREAS It shows normal echotexture. No mass/focal lesion is seen. Pancreatic duct is normal in caliber. SPLEEN It is normal in size and echo texture. No focal lesion is seen. Rt. KIDNEY Normal in size, shape and echo texture. No mass, cyst, calculus or hydronephrosis is seen. The ureter is not

dilated. Lt. KIDNEY Normal in size, shape and echotexture. No mass, cyst, calculus or hydronephrosis is seen. The ureter is not dilated. URINARY BLADDER No stone or mass is noted. PROSTATE It is midly enlarged measuring 34 x 35 x 53 mm and weighs 25 gm. No ascites detected. No para-aortic lymphadenopathy is seen. MEDICAL DOCTOR OPINION 1) Long term use of B-Blocker [Tenormin] may have depressive effect.2) Cipram [Citalopram] may also raise Liver enzymes.3) APD+ helicobacter pylori antibodies needs

treatment. Gastereonologist advice. Inj. Pegintron once a week for six months.Cap Rebazole. __________________________________________________

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Saleem,

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