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Can I survive with stage 4 cirrohsis ?
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Can I survive with stage 4 cirrohsis ?

Thanks very much to anyone who can give me feedback.

I have had hep c type i for about 40 years. In january of this year i began hep c treatment with interferon , ribovarin and victrelis. I have compensated cirrohsis and my doctor says it is stage 4. My liver is functioning well. my viral load was 160,000 initially  and another test indicates i should have a favorable outcome. The hep c cleared my blood after 4 weeks of treatment. It is now undectable. My albumin and bilirubin levels are normal. My doctor feels i will be cured. My concern is the cirrohsis. i do not drink alcohol or do drugs even though i have in the past. Can i live a normal life after completing treatment? Will the scarring get better? How long do i need to be on meds? Thank you
26 Comments Post a Comment
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Avatar_f_tn
Wow!!! Sounds like you are doing really well.  Sounds like you are going to be living a normal life. There are many people on the forum who have cirrhosis and treated there Hep C.  it's my understanding that your liver does
have the ability to get better after treatment.  I'm sure many will give you
more support that your on your way to a healthier liver.
Best to You
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Avatar_m_tn
thanks for your response
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Avatar_m_tn
Hi there and welcome to the forum, I also have cirrhosis, did the victrelis treatment and now cured, it is recommened we do treatment for 48 weeks. When you say you were clear at 4 weeks do you mean during the lead in period? Either way your response has been great so stay the course and your odds are very good.

As for how much a cirrhotic liver will heal is much debated, one reason has been there is no reason once we treat to re-do a biopsy... I was Dx in early 2005 and so far doing pretty good, you will need to be screen for HCC, my Hepa feels as long as I behave myself and don't cause any further damage things should work out.............. Wishing you the best going forward.
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Avatar_m_tn
thank you very much for your response. Continued success
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Avatar_m_tn
The liver damage can regress after successful treatment. There have been cases where fibrosis regressed a full stage. Hopefully this will be the case for you.

best of luck
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Avatar_m_tn
Hi papimilk.  There is an interesting discussion about cirrhosis and regression of it over time at http://hepatitiscresearchandnewsupdates.blogspot.com/.

Scroll down, there are several articles about those who have SVR and in long term followup are assessed.  Very few still have a risk of HCC, but the risk is greatly reduced if you have SVR.

I'm curious, how was your fibrosis stage determined?  Biopsy?

Good luck to you and keep us informed.

MarkFly1
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163305_tn?1333672171
Of course you can survive. I have and I had decompensated cirrhosis.
As long as your is still compensated, your liver will be able to regenerate. It takes time but the liver is an amazing organ.
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Avatar_m_tn
thank you for your response. best of luck to you
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Avatar_m_tn
Thanks for your response. The stage 4 cirrohsis was determined from a blood test
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Avatar_m_tn
Thanks. All of your responses give me hope. God bless all of you.
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Avatar_m_tn
Hello again. I wanted to answer one of your questions. Sorry i was not accrate as to when the hcv cleared. I started interferon and ribovarin on 1/18/13. My viral load at this time was about 160,000 . 4 weeks later they started the victrelis. The hcv clered my blood as a result of a blood test on or about 2/24/13 and reported to me on 3/1/13. When my doctor told me this I thought i was cured! He then let me have the facts. Thanks again.  
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5079728_tn?1365553589
WOW! so encouraging! I too have type 1 with stage 4. I have not started treatment yet but this news is so up lifting. Congragulations.

DECLARE YOUR VICTORY TODAY!

GOD BLESS!
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Avatar_m_tn
The liver is remarkably tolerant of disease and injury. Even after 70% of its mass has been destroyed or removed, the organ can still function, albeit with decreased effectiveness. If the conditions that caused the destruction have been removed or corrected, the liver usually can bounce back.

Although function can never be restored to parts of your liver that have turned to scar tissue, you can live a healthy life with the remaining portion if the disease is caught in time. However, there is a point of no return with cirrhosis. As more cells are replaced by scar tissue, fewer healthy cells are left to handle the liver's many tasks. Eventually, function problems arise and may remain. This is why it's important to identify the underlying causes as soon as possible and begin taking steps to eliminate them.

http://www.webmd.com/digestive-disorders/understanding-cirrhosis-basic-information
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1654058_tn?1376739127
I've been researching about how different parts of the liver may be more diseased or cirrhotic than others. I'm stage 4 and decompensated in 8/10. I treated w/ protease inhibitors and am SVR for a year now.
I'm off of the diuretics, but still form varices. I am a believer in reversing scar tissue.
My best to you and I hope your side effects are few. Can-do-man, you're full of good info. Look at you with your brain all clear! xoxo Karen:)
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446474_tn?1404424777
Agree with what many others have said.

Can you survive with state 4 liver disease?
Yes.
Either cure the underlying cause of your liver disease (hep C) or in the worse care if your liver disease progresses to decompensated cirrhosis, get a life-saving liver transplant.

If you can cure the cause of your cirrhosis (HCV), when it is still compensated (still able to carry out all of its functions) your liver disease will partially reversible. And you can live the rest of your life with your partially damaged liver. Many people do. As I think can-do said, you don't need all of your liver cells (hepatocytes) to have a fully functioning liver to live. All body organ are designed with extra capacity to work despite illness and injury.

There are also two phases of compensated cirrhosis. The early stage has no portal hypertension (no varices) and incomplete scaring. The later stage includes portal hypertension (with varices) and a nodular surface on the surface of the liver which indicates a change in the architecture of the liver and its blood supply.

Having less liver damage has better rates of cure (SVR) than more advanced cirrhosis.

When the liver become decompensated it can no longer preform all of its functions which results in complications to other body systems which in time can be become life-threatening. Ascites, spontaneous bacterial peritonitis (SBP) an infection of ascites, bleeding varices, hepatic encephalopathy, hepatorenal syndrome (HRS) renal failure. The only cure for decompensated cirrhosis is a liver transplant.

Good luck with your treatment.
Hector
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Avatar_m_tn
Papimilk, I would not take such a blood test too seriously.  See the thread on Fibrosure.  I had a Fibrosure blood test which indicated F3, much higher than previous assessments.  My doc followed that with a biopsy, the "gold standard" which indicated a fibrosis stage of 0-1.  Quite a difference.  I followed that with another Fibrosure to hopefully confirm the biopsy and it indicated a stage of F4--cirrhosis.  I was quite alarmed and decided to go for a 3rd Fibrosure using a different lab, after fasting, not a drop of alcohol and no Vitamin B complex which I think can irritate the liver.  Waiting to see the results still and I will let you know, but I would not make or recognize an assessment of cirrhosis just based on a blood test without at least an accompanying ultrasound or MRI of the liver or, preferably, a biopsy.  Good luck.

Mark
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Avatar_m_tn
Thanks for your response, but you know in a strange kind of way maybe i need to be scared in order to take care of myself after treatment. I drank socially up until 2 weeks prior to beginning treatment. This will be a major change for me as alcohol has been a form of social stress relief and so on. In any case, i will find a way to feel comfortable without alcohol. Thanks again for your response and sincerely the best of luck and health for you.
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Avatar_m_tn
thanks for your response. I wish you all the health and luck in beating this disease. One thing I am sure of this disease is curable.
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Avatar_m_tn
thank you for your heartfelt reponse. I really appreciate it. the best of luck to you in your recovery
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Avatar_m_tn
Wow. You are a wealth of info. Thanks for your response and the best of luck and health to you
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Avatar_m_tn
Papimilk, you've been provided a wealth of accurate information within only a few days' time - and it's come from some of the most informed veterans within this community.  Hector, btw, is our beloved "Father Superior" - our guru, sage and hero.  I am stage 3/4 well-compensated, and you and I are about the same age.  I am sustained svr of several years, and will be glad to share my treatment experience with you.
I would only add;  in retrospect if an interferon-free tx (treatment) is available to you, consider it seriously.  Post-interferon treatment syndrome (yep....P.I.T.S.... lol...could never have made that one up) is a reality, esp for those of us in our 50's and 60's.  I developed several autoimmune manifestations - lupus, psoriasis, etc - to date manageable, but no fun.  I'm convinced they were caused by, or at the very least seriously exacerbated by, the year of interferon.
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Avatar_m_tn
thank for your response. I'm sorry that the interferon has caused these complications and i hope you get past it. I too am convinced that the interferon is causing some issues with my eyes. My doctor is great but he is not convinced that the inferon caused a floater. My eye doctor says interferon can cause eye problems.A retina specialist found little black dots insidethe eye. my vision is blurry most of the time. They ruled out diabetes. My already thinning hair is thinning terribly and my skin is very dry and itchy,
I was not aware of an alternative to interferon. By the way is it absolutely necessary to have 48 weeks of trea.ment I have type 1 hep, am considered to have a good outcome. the hcv cleared my blood after about 7 weeks of tx. I do have stage 4 compensated cirrohsis ( based on a blood test). Thanks for any response you can give me
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1815939_tn?1377995399
"By the way is it absolutely necessary to have 48 weeks of trea.ment I have type 1 hep, am considered to have a good outcome. the hcv cleared my blood after about 7 weeks of tx. I do have stage 4 compensated cirrohsis ( based on a blood test)."
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Yes, because you have cirrhosis, the treatment protocol calls for 48 weeks of treatment.

Cirrhotics have a considerably higher SVR rate if they do 48 weeks as opposed to doing only 24 weeks.

Since you have cirrhosis, you definitely want to clear the virus for good, attain SVR, because you do not know how long you will stay compensated if you do not attain SVR. So it is best to follow the recommended protocol of 48 weeks of treatment in order to give yourself the very best chance for SVR (cure).

Best of luck.
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Avatar_m_tn
I am in a kind of denial about the 48 weeks thing. At times I want to quit. I have very little energy, can't excercise without my heart racing. My legs are like lead even with small walks. Just before starting treament I was very active, playing paddleball 4x to 5x a week. My doctor reduced my ribovarin dose because I was extremely anemic. This is not easy. I attend a support group 1x a month and have started with you guys on this site. My wife has been my major support but I'm afraid this will bear on her after a while. I'm in my 15th or 16th week of tx. It's beginning to settle in that I will need 48 weeks. Thanks
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1815939_tn?1377995399
I know treatment is difficult. In fact, it is the pits. I did 48 weeks of triple med treatment myself (Interferon, Riba, Incivek). Treatment was no picnic. However, I am now about 8.5 months post end of treatment and I did attain SVR so I am cured.

I had no energy on treatment. Walking felt like I was walking through 2 feet of mud with lead boots on. I was tired, tired, tired. I had no motivation and no stamina and no strength. I was short of breath walking anywhere, from room to room. I could not concentrate and my memory was zilch. My muscles and joints ached. I was weak and light headed. I felt like I was going to pass out half of the time. Food tasted like cardboard. I lost 70 pounds. I had a rash that took up residence from week 10 on for the duration of treatment and afterwards. I got absolutely nothing accomplished except treatment, and that I did very well, missing no doses and taking every pill on time with fat and food. At the beginning of treatment I got frustrated at getting nothing done. Then I just accepted it and was a whole lot less frustrated. I decided early on that this was going to be my lost year in terms of getting most things done. However, I also decided that this was going to be the year that I treated and got rid of Hep C. That was my goal and I kept my eye on the prize. I did next to nothing except take my shots and my pills, get my lab drawn, and see the doc. That was it.

What you are feeling is normal (for treatment). The way you feel is normal (for treatment). Don't worry about trying to do everything you did before treatment. Just try to get through treatment. You are already 1/3 done with your 48 weeks. Pretty soon you will be at the half way mark. Then it will be the 3/4 mark. And finally the home stretch. It is helpful to keep some benchmarks so you realize you are getting closer to the finish line. Try to stay positive.

You will get back to normal after treatment. I feel better than I have felt for 20 years. I am no longer fatigued and my stamina is great. I am back to normal. In fact, I am doing way better than I was before Tx. Once you are off Tx, you will gradually feel better and better.

Here is wishing you the best.

Here is a link to a thread that you may wish to read. The thread is from another person with cirrhosis who is having a difficult time and is thinking of quitting. It may be helpful to read the posts in that thread, many of the posts are from cirrhotics and they stress the importance of staying the course and attaining SVR, especially for cirrhotics.

http://www.medhelp.org/posts/Hepatitis-C/End-Treatment-Early/show/1943787

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Avatar_m_tn
Very happy you responded to me and it has given me more hope and focus. I am extremely happy that you are now cured. You will be a role model to me always. Thank You
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