Cigarette Smoking and Hepatitis C: Attention NEW YORK GIRL

NY, Forgive me for singling you out but besides having such a cosmopolitan name, sometimes it's hard tracking you down between coffee and fudgicle breaks :)

I should also preface this by saying I'm not trying to convince anyone to stop, start or continue smoking, but simply passing along some recent study info on the subject. No doubt this will result in debate but if I'm uncharacteristically smart today, I'll stay out of it.

From the article:

(1) (Cigarette smoking) has been associated with increased liver inflammation and fibrosis in people with hepatitis C.

(2) Tobacco smokers with genotype 2 or 3 HCV had significantly lower SVR rates than non-smokers. However, this difference was not observed among genotype 1 patients.

Full copy here: http://www.hivandhepatitis.com/2006icr/ddw/docs/060206_a.html

NY Girl,

You mentioned yesterday, that you read a recent study suggesting the opposite -- that tobacco smoking was OK in terms of the liver. My guess is you're confusing a recent study that I believe said "pot" smoking was OK. Correct me if I'm wrong, but the study presented above is quite recent and there are many others showing tobacco's negative effect on liver, never saw anything recent that said otherwise. Again, not telling you to do anything but thought you should be aware of the most current information to base any decisions on.

-- Jim

[jmjm530]

As an aside (actually two asidess) someone yesterday mentioned why would SVR rates only be reduced in geno 2's and 3's and not geno 1's? I speculated it may have to do with different riba doses and treatment lengths but it could easily have to do with the strain itself.

[cuteus]

up for debates today, huh?

[GrandOak]

For myself, I tend to side with nygirl.  Given all I've been through this past year with several members of my immediate family as well as myself, while quiting smoking while desirable is probably the one vice I'm waiting to let go.

Besides, while it may have some impact upon the liver, it being the toxin filter for the body, giving it up at a time when I'm in the midst of doing battle with the dragon does not seem to be a wise decision, especially since I'm fighting this one without AD's.

I also would be interested in seeing how much analysis when into these findings.  If they simply asked who smoked or not at the beginning and filtered the end SVR results based upon this without considering other lifestyle changes (i.e. diet, exercise, etc.), then I would be less likely to put a lot of stock into it.

[can-do-man]

Hey beagle, you still got your hose and bucket for the blood draw? Hgb in the tank. Started at 17.2 and held at 12 for a long time. Then in the last 1 and a half  weeks it dropped from 12 to 9.9. NP called said doctor didn't want to wait so come in for a shot of Blood juice.

[doglover28]

For those that aren't ready to quit smoking, be sure to eat plenty of organic carrots.  The ones with the green tops on.  Also, leeks are good.    If you ever decide to try an antidepressent, Welburtrin is one that docs prescribe to people that are trying to quit smoking.

[doglover28]

Hi Can-Do-Man and Beagle,

Hope you guys are doing well today.  Happy Friday!

Pam

[Kalio1]

It makes more sense that the difference is caused by the increased fibrosis they see in geno 3s, the 2s were added in with 3s in they study( a dumb way to do it) so the decrease in SVR can be attributed to increased fibrosis in 3s. On top of that this wasn't even a study about smoking and SVR. The fact that geno 1s are not included doesnt mean smoking doesn't also affect geno 1s SVR rates. This is a very poor study to use to bolster an argument that smoking was responsible for the decreased rates, it was NOT a study done on SVR and smoking and there are too many other factors, one glaring one is that geno 1s are not even included in the study, just because they werent included doesnt mean the risk, if any, of smoking decreasing SVR rates doesnt affect them also, they were just not considered at all.
There is not enough evidence to say the lower rate is from smoking given the study wasn't about smoking and the known fact that 3s have increased fibrosis compared to geno 1, and 2s and 3s are treated as one geno in this study. That alone could account for the difference since it is estabished they see more fibrosis in geno 3s than EITHER geno 1 or 2.
Fibrosis is a KNOWN factor for decreasing SVR rates.
One should never use ONE study in isolation to claim fact, especially a study that isn't even about smoking vs nonsmoking and SVR.
They should do a study on smoking and SVR rates in ALL genos. Strange that this one very small study is enough to convince anyone smoking has a bearing on SVR, even stranger is the fact that there hasnt been a large study of all genos and smoking and SVR rates.

[GrandOak]

To heck with smoking vs. non-smoking vs. whatever other social habit one wants to object too study.  I simply want to see studies focused upon MORE alternative tx's, tx's which are MORE effective in slaying the dragon preferably without leaving trampled flower beds behind when the battle concludes, and even better yet one which identifies a HCV vacination to prevent the dragon from entering the kingdom in the first place.

[goldyn]

MAN YOU WENT A GOOD WHILE  BEFORE IT SLAMMED YOU WOW STARTED AT 17 AND NOW 9 THATS A HUGE DIFFERENCE DO YOU FEEL IT? SORRY YOU HAVE TO TAKE ANOTHER SHOT BUT THIS ONE WILL HELP YOU, NOW YOU CAN TELL WIFEY SHE HAS TWO JABS A WEEK INSTEAD OF ONE, BETTER BE GOOD CAN DO.......

[cuteus]

coffee is good...

grandoak although this is a wish many have, with all kinds of conditions: "preferably without leaving trampled flower beds behind when the battle concludes, "

the fact is, I don't know of many treatments for any disease, that is not hard on the body. Chemo for cancer, surgery for cardiac, dialysis for renal failure, etc. No tx seems to be "fun" to do or without some consequences. Maybe a "self repair" gene therapy in the future, that leaves no scars and needs no anesthesia.

[jmjm530]

I said I'll try and stay out of this debate and I will, but I think I'd be remiss to let stand some statement of facts you just made that from my reading of the study simply to not bear out.

You said: ..."geno 1s are not even included in the study"

Where did you get that impression from? Geno 1's were included in this study, as it specifically states regarding SVR's "...However, this difference was not observed among genotype 1 patients."

You said: ...Strange that this one very small study is enough to convince anyone smoking has a bearing on SVR"

Very small study? The Win R trial data is probably the LARGEST study ever done on Hep C. I quote from the the article: "Smoking data was available for 2865 out of 4223 patients (68%) included in the primary efficacy analysis; of these, 894 (31%) were smokers and 1971 (69%) were non-smokers. and used data collected from almost 2900 smokers." This is a large study population.

Are you sure we're talking about the same study?

-- Jim

[jmjm530]

Cuteus says: up for debates today, huh?
-----------------------------------------
Actually no, up for watching World Cup Soccer today, just wanted to pass some study data along to NY Girl.

Sure, everyone knows smoking is bad, but I thought this new data between smoking and SVR would be of interest to anyone treating or about to begin. But speaking of NY Girl, where is she?

BTW I smoked for over 20 years and quit 20 years ago motivated by health concerns. Hopefully, better odds for SVR will be added motivation to help others stop. FWIW I finally stopped cold turkey but did find the organization Smoke Enders very helpful and highly recommend their program to anyone who wants to stop smoking but doesn't feel they can do it alone. http://www.smokenders.com/

[fishdoc]

I know when you feel like your guts have dropped out on the floor, and you can't drag yourself around because their too heavy,...oh sorry, thats me... but remember my earlier post, this may be a good sign for both of us.  Hang in there dude, it's ok to be the can't do man for a while...
c.

[can-do-man]

Heck wifes hopeing for 3 a week. 2 for the blood and one for tx. Now if only my platelets tank. Oh happy day, as for being good? To late for that. Flowers every day wouldn't help now.

[jmjm530]

Just picked up your hgb has dropped some more. Just wanted to say sorry you're going through that ****. Don't know if it's possible, but try and keep physical work to a minimum and stay away from heat/sun as much as possible. Are you currently on Procrit? Hope you feel better soon.

-- Jim

[can-do-man]

Is there room for 2 in that wheel barrow? My first clue was having to have chairs every 5 feet so i could set and catch my breath.

[can-do-man]

No this is first shot. This one is on the Doctor. Said he would deal with insurance next week. Said he would give them to me at no charge till insurance was taken care of.

[amirtracy]

hi there. sorry about your hgb drop. just wanted to say that. and i hope the meds help you fast. i'm feelin' for you.

[rochammer]

Coffee is good for the liver and smoking is bad so if you going to smoke have some coffee too LOL

I am a part time smoker I quit for a year than something goes wrong and I smoke for a year. My doc said I should stop smoking but not until after tx I might kill some one if I tried on tx. Maybe at the end of tx I will quit for good as I will not be drinking any more cigs and booze go together for me

Of course I have liver damage you should not drink alcohol but maybe just a little is ok Hum what is a little?

Liz Highleyman  is a writer not a PhD or MD http://www.black-rose.com/liz.html   Very interesting person Have to love google

[jmjm530]

It usually takes 2-4 weeks until the Procrit kicks in, so try and hang in there. I assume he's starting you at the normal dose of 40,000 units/week. I doubt if anything less given your numbers would help, so make sure to ask him, and I also assume he will give you weekly shots until your insurance kicks in. Let us know how your visit goes.

While you're at the office, you might want to get some blood drawn for a liver store test. This will measure not only your serum iron, but your Ferritin and TransFerrin Saturation levels. While supplemental iron is usually not necessary at this point, if your iron stores are low, supplemental iron may be needed to help the Procrit work. I checked my iron stores every couple of months after starting Procrit to make sure they held up as Procrit can sometimes depelete them.

-- Jim

[can-do-man]

said.....i'm feelin' for you........ Now you tell me, when it wouldn't do any good.:) Take care, and don't forget the popcorn

[NYgirl]

We had a power outage this morning at work how AGGRAVATING since they of course didn't let us go home and the power just came on at 12:05 so we all sat around all morning!

"Tobacco smokers with genotype 2 or 3 HCV had significantly lower SVR rates than non-smokers. However, this difference was not observed among genotype 1 patients"

The study says bad for GT 2 and 3 but not ONE so I am cool and will go buy an extra pack. Then I'll drink my coffee and smoke and eat a fudge pop all at once!  hahahahahaahaha I am JUST teasing here.

I hate smoking if I could quit I would.

Don't worry about "singling" me out - I've done my best to be quite honest on this forum about all my stupidities in the hopes that it might help someone else ... so everybody knows I smoke like the fool that I am.

Hey that's right...Iforgot you see...I'm 'smokin' hahahahahahahaha

Going to go look at it in depth

[susan400]

You can pick any habit that you have which affects the liver and go at it from whatever angle you want to.  For example:  Sugar and fat, bad for liver.  I smoked from the time I was 13 years old until I was 34 years old, been quit now for 11 years.  But, I love my sweets and that's my addiction.  Fortunately, I don't have a big problem with my weight.  I exercise on the treadmill daily and sometimes add in the stationary bike as well, is that an addiction?  I watch too much T.V., is that an addiction.  I know, I know, I'm getting carried away here.

Susan

[lilmoma]

Good afternoon!!!!!!!
How are you doing? I hope you are well, havent talked to you in a while. :( :(

[lilmoma]

I guess I should have read the thread before asking how your doing!!
I am sorry your hgb is so low,........I bet you feel like c**p
I remember that feeling of being out of breath, constant dizzy spells like I was gonna pass out.
Was that a procrit shot your doc had you go get??

[amirtracy]

I'm w/ ya on that one. Not alot goin' on with Lulu and the girls either. I'd rather nap. Sad isn't it? hopefully we'll both rebound bigtime when this is all over ;)

[strator]

Okay cheify, tell ya what, I'll put a little suction tank on the back of the pink caddy. You just pedal up by the little ladies layin by the pool..." Scuse me M'am, need a moment of your time. I'm from the EPA(Extra Platelets Agency), we need your help to keep this fella Can Do Lugosi off the streets after sunset. Best if you just quitely let me pump a pint or two, consider it poor man's liposuction...Gurgle, Gurgle...Ahhh, that's better, thanks doll, nice gams by the way."

[cajunlady]

Before I started tx in May of 2005, my doctor asked if I smoked.  Told him yes, why.  He said if I had to smoke, to switch from my brand to American Spirit Cigarettes.  Said all cigarette carry tons of added chemicals to them.  American Spirit, yes is Tobbacco, but does not have the added chemical.  The chemical he said was hard on the Liver.
I asked if I should quit with the congestion I get from tx/meds and he said you need enough AD's and chill pills to keep you in check right now, if you tried to quit your anxiety will shoot off the scale.  So, for now I still smoke.  

I AM A GENO 1B, F 51  SMOKER,  12 WEEK PCR UND;  JUST RECEIVED MY 24 WEEK PCR YESTERDAY, STILL UND. WOOOOOOOOOOOO WHOOOOOOOOOOO.


Can do man:  Looks like you have been swinging in cages.  Sorry about the drop in hgb.  Mine stated in Dec. with 14 and is now at 8.6.  If it stays there I will start my shots in about 2 weeks, unless I have a drastic drop.  I hate the tired feeling.  Yesterday, I dropped pretty hard in energy level.  Still tired today but not so that I feel like I am going to fall asleep.
Hope you start feeling better soon.


cajun

[can-do-man]

says......yes TV is very bad for the liver............ Please don't tell me the cartoon channel is.

[GoofyDad]

Can-do: Add me to your list of well wishers! I see one of the gals is hoping you're a fast one. Some guys get all the breaks. Why can I never find a gal like that?

This will pass my friend... take it from one who knows things that pass.

[jmjm530]

We were wondering where you were. So what's with treatment? Any VL tests recently? Are you still seeing Dr. J and when?

-- Jim

[GoofyDad]

Doglover says: Also, leeks are good.

Gotta agree there. Back in the day... a few brewskis and it was time for a leek and a smoke.....

[GrandOak]

I know what you're going through.  My first doc botched tx and cut RBN 1 mo into treatment because Hgb tanked to 9.8.  New doc started me on 40,000 Procrit and added medial monitoring clinic when we kicked it up to 60,000.  Finally, back to 1200 RBN after 4 mo thx to Procrit, but results from vamps this week showed Hgb tanking down to 10 again.  Now their weighing going to 80,000 Procrit against RBN reduction and possibly adding in a nuetropenia. Great another peg for the my peg farm, only hope this one is a great breeder.

But I figure, I'm already a human pin cushion, what's another shot.  Ironic that I'm poking myself now more than I did 30 years ago when I picked up this wonderful little spike ball (that's what my 9 yr old son calls it because of the virus imaging) game.

I only pray that it works so that I won't have to be making a trip to doc Frankenstien for body parts.  But, being rnd 1 I hope to be able to don my sunglasses and say "I'll be back" if the Dragon survives this round and I get to shoot the whole dang structure apart again.

BTW, everyone I talked to told me Procrit takes 4-6 wks to fully kick in, which appeared to be the case for me so hang in there.

[GrandOak]

Chin up gal, at least now there's one in the plus column for G1 eh?  I hope you had a cup of joe while smokin the fag waiting for ConEd.

[NYgirl]

Grand - LOL pal you KNOW I did~the BEST part about the lights being off was the smoking and going to dunkin donuts while waiting...I mean no office coffee for any of us this morning! I would have gone to Starbucks and gotten a real jolt...but its just too far from here!

CANDOMAN - 9.9 man you are feeling like garbage huh? Thank GOD it levelled out at 12 for a while and sort of brought you to another plateau BEFORE it went south like that. 17 to 9 would have been MUCH to big of a leap all at once.

Please consider going out and getting some fudgicles - the universal cure for anemia ;)  I thought you were already ON Procrit...isn't it a shame you have to wait to be so dang LOW?

It will fix you up just GREAT but it does take a while to kick in. I hope for your sake you are one of the fast ones...knowing you I think that is the case :)

[linthomas]

Got to comment on this one. I have fought one thing or another since I started trying to have this kidney transplant, 3 yrs ago they told me I could live 15 yrs on dialysis or 5 with transplant with the Hep C. I won another round because I am now waiting to have transplant. They kept telling me to quit smoking, that was the only thing I had left that I still did and had smoked for 33 yrs. Can't eat what I want, no social drinking, never had more than a couple, then they wanted to take my cigarets away. Well, I played with the smoking for months right up till they told me they wouldn't give me a transplant if I continued to smoke. So that got that, it's been 3 mths almost, I can breathe, no wheezing, little cough still there, but have COPD, it will be there. Feel like a new person, went back to gym this wk to work out, And have had no really bad effects from not smoking. It's a good feelingfor them to call me with smoking test and say negative, I did it. Hope it works out for others. Talk to you guys soon. Linda

[NYgirl]

Perhaps you need to find a girl who has the Hep :)

[52TELE]

I think anytime you suck fire in to your face , there is a chance something is going to go wrong. I could be wrong.

I know smoking is bad with liver , but how about onions?

[Forseegood]

Yipeeee for you both, so happy to hear this news on both of your fronts, huh? that didn't come out right but you know what I mean...

CanDo, hope things are better as I write this for you...hang in there!

[can-do-man]

Hey girls, not feeling bad, just out of breath easy. Wheres my smile lilmoma?

POPS, you'd do that for me? Heck i might be able to milk this for a long time.

[fishdoc]

Hey bud, you can share my 'barrow anytime.  Only problem is who the h#lls gonna push it for us?  I am really draggin, still have not talked to my Dr. about my consult, next scheduled bloodwork is July 27, and then I see the Dr. in August.  I will run out of riba by then, so I have to make an appt., and I think given the drop in HBG for me (14 to 12.3) and the increase in dose that he doesn't know about, I need bloodwork more frequently..

[Forseegood]

hope you sort this out, sorry to hear your feeling bad, but you seem to never lose your sense of humor, good on for that, it prob couldn't hurt...

[Kalio1]

Sorry to hear you are dragging but I can relate! Have had some good days lately so I am not complaining ( too much) but sure am getting sick of this drudgery. I hope batter days are headed our way. Since we are both on the same amount of riba, I was wondering if you are bruising? I got this big bruise ( and very strange initial reaction) I looked at my wrist because it suddenly felt odd and tingly, no pain and I had this huge bulging vein, very blue. It bubbled up, pretty scary, never seen anything like it. Then the bubble went down and turned into a big bruise like I had smacked my wrist or something. It looks like a bruise but doesn't hurt like one.
Ever had that?
It's resolving and I haven't gotten any more plus I cut back on the riba just to be safe. See the NP Monday but I thought I'd ask you if you had anything similar.

[lilmoma]

:)  :)  :)  

I do hope you feel better.

[can-do-man]

Cage in lady, Better wait till we get back in our 10's before we hit the cage.

Goof, thanks for asking. Things seem to be passing pretty easy.
You said..............Gotta agree there. Back in the day... a few brewskis and it was time for a leek and a smoke.

Agree there and even after a few brewskis didn't mind the dribbles.

[sunspot]

American Spirit, yes is Tobbacco, but does not have the added chemical.

[cajunlady]

Yeah, those cages can be a little rough right now.  I am hoping Doc gives me a rescue shot before by girlfriend comes in to visit next month.  If not, I don't think I can keep up with all the ventures planned. But, I guess if I get out of hand, they can always put me back in my cage.

You are so funny.  I do shot 26/48 tonight.  I don't know if you caught my 24 week UND.  Woooooooo Whooooooo.  I am kicking butt on those dragons there.  Maybe, I will be able to get back in those cages sooner than I thought.

Have a Great Weekend.

cajun