Re: Hepatitis C Test Results

Posted By Chris on July 13, 1998 at 10:32:47:

In Reply to: Re: Hepatitis C Test Results posted by HFHSM.D.-ym on June 25, 1998 at 20:32:34:






: : My  Liver Profile A and HCV RNA, PCR,Quantitative test results are as follows:
: : Bilirubin Total/Direct 2.0/0.59 mg/dL
: : ALT 55 IU/L
: : PCR 615.23 X1000 mL
: : All other reults within normal range.
: : Apparently I have had Hepatitis C since the early 80's.
: : While I understand the implications of Hep C and am scheduled to see a Gastroenterologist, my family practitioner feels that the disease has not progressed to a dangerous level and I should be hopeful.
: : Your Impression?
Dear Chris,
Hepatitis C is currently one of the most common causes of chronic liver disease in the United States. The quantitative hepatitis C RNA by PCR confirms the presence of active viral replication. It is impossible to state with certainty where you are in the spectrum of liver disease based on the level of the hepatitis C RNA or based upon the level of elevation of the liver enzymes. A liver biopsy can define the presence of inflammation, detect scar tissue, look for cirrhosis of the liver and to rule out other causes of liver disease. A liver biopsy is a test where a needle is inserted into the right side of the abdomen and a small piece of tissue is sent to lab to be analyzed by a pathologist. When you see your gastroenterologist, he or she will be able to discuss this test with you in more detail.
Nonetheless, most patients with mildly elevated liver enzymes and good overall health without symptoms or signs of liver disease have mild inflammation and/or small to moderate amounts of scar tissue present. Few patients have cirrhosis already present on the initial liver biopsy. Furthermore, there is treatment available with alpha interferon that helps reduce inflammation and may even clear the hepatitis C virus (10-40%). A lot of research is being done to try to develop new medications to help treat hepatitis C. You should be hopeful. Good luck with your appointment.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you wish to be seen at our institution please call 1-800-653-6568, our Referring Physicians Office and make an appointment to see Dr. Muszkat. one of our experts in Gastroenterology.
HFHSM.D.-ym
: *Keywords: hepatitis C, quantitative hepatitis C RNA by PCR, liver biopsy
: _
I have read about additional therapies in addition to Alpha Interferon with Ribaviron such as  Amantadine HCl and  Zadaxin. It appears they work better when combined with Interferon and/or Interferon with Ribaviron. What about a Quadruple therapy of all four? Also, there is a report by Nancy Burtis dated 2/19/98 regarding the United Cancer Research Institute in VA. about MTH-68/B, an attenuated form of BDV, which appears to have had success. Any knowledge or thoughts of these therapies ?
Thank you
Chris
__Dear Chris,
Thank you for your recent reply. All of the therapies that you describe are considered either experimental or second line therapy for hepatitis C infection. These medications are currently given within the context of a research protocol. At Henry Ford Hospital we are participating in a trial with the combination of interferon and ribavirin. Another protocol exists with interleukin therapy. If you wish to be considered for these you may want to contact Dr. Dilip Moonka, one of our hepatologists at Henry Ford by calling the Referring Physicians Office 1-800-653-6568.
HFHSM.D.-ym
*Keywords: hepatitis C, therapy

I had a liver biopsy and the diagnosis is chronic hepatitis,mild activity,with early portal fibrosis.In particular,"Sections display delicate fibrous bands abutting from the inconspicuous small portal triads except for a few chronic inflammatory cells and plasmacytes that are attending slightly irregular limiting membranes.There is mild to moderate bile ductopenia with evidence of ductal epithelial injuries. The parenchymal cells show scattered cytoplasmic fats. Occasional apoptotic cells are being scavenged by the Kupffer cells. Neither the ground glass hepatocytes nor sandied nuclei are observed. Bile stasis is not identified. The trichrome stain confirms the beginning fibrosis stemming from the portal triads hugging the portion of liver lobules.
Am I in an early stage of liver damage?
What would be the typical longevity of someone with this diagnosis under typical disease progression?
My hepatologist has both the Schering Interferon with Ribaviron and Amgen Interferon therapies available. I am leaning towards the Schering combination although he stated that the Amgen Interferon was appearing to have greater success. What would you do?