Cirrhosis and Treatment

My husband just found out he has Cirrhosis. He has had Hep C about 30 years. He is Genoptype 3a. Two years ago he was told he was stage 2, so he decided to hold off on treatment. Now he has been told he has Cirrhosis and should treat now. I guess we are confused. First we thought if you had cirrhosis you die, the doctor says this is not the case? How do you go from
stage 2 to Cirrhosis in two years? Biopsy said 2, ultrasound shows the cirrhosis.  

And if he treats and it is successful, does the damage just stop? His blood counts are slightly off but not bad except the platlet count is 79,000 w/an enlarged spleen, and his viral count is 60,000. The doctor told his no alcohol or drugs.

Three years ago he had back surgery and was on painkillers for a few months, could this have caused the cirrhosis.

Please tell me your thoughts on this, especially surviving with Cirrhosis.

[sindog]

My wife's father had Cirrhosis from alcohol addiction and almost died. The dr told us that even if a small portion of the liver is still functioning and the cause of the damage is stopped, in his case alcohol, then he would continue to improve. He recovered after about six months in the hospital and was active and healthy two years later. The liver is an amazing organ. Hope this helps.

[Kalio1]

Cirrhosis is a scary thing to have. Is he treating now? I am a geno 3a like him and I too have cirrhosis. I too had rapid progression. How's his liver  doing metabolically? Your husband's stats, platelets, etc. are virtually identical to mine prior to treating. I have "early cirrhosis" the first stage. The answer to how can it go from stage 2 to this so fast is, it just does that in some  people, they don't know why exzactly but there are factors that play in is what I was told. I too had a back problem and had surgery and lots of steroids and drugs.I think it contributed but who knows. Im sure the drinking I did before I found out didn't help either! The important thing to remember is that your liver CAN regenerate even if you do have cirrhosis. I know it says all onver the internet it isnt so but look for "liver regeneration and cirrhosis" or reversing scarring in cirrhotic patients, etc. lots of info about. The chances of it improving do depend on the level of cirrhosis you have. I had the same platelet count as him but now, after 50 some weeks of treating, they are 137.
Interferon has shown in studies that it can improve liver histology even if the treatment fails to clear the virus. Of course no drugs, alcohol or bad dietary items. There are also new drugs and treatments like stem cell therapies that are being developed that are showing great promise in reversing liver scarring even at the cirrhotic level so don't despair. Take top notch care of yourself and treat the virus to stop the viral assault are key things you/he can do to work towards healing his liver.

[FlGuy]

Biopsy results are deemed to be the most reliable means to determine liver condition, moreso than scans and ultrasounds. But, you should assume that whatever the liver condition is , whether firbrosis or cirrhosis, that the damage will continue over time even if it is a very slow progression.  Even if it has progress to cirrhosis he can still be treated.  Similar to Kalio I also have early cirrhosis, am a 3a, and deficient in platelets.  There are a few other indicators, in addition to the biopsy, that indicate that liver damage is marching on.  Also like Kalio, I treated and then realapsed.  Where she continued, I took a break and will treat again.  Assuming that your hubby's situation is fairly similar, it's not a death sentence and something can be done.  You should have him hook up with a doc (like a hepatologist) who has extensive experience in treating hep-c in the the presentce of advanced liver involvement.  Good luck - It's not as bad as it appears to you right now.

[Cindy10]

Thanks for the info, I am bit relieved. He too drank quite a bit many years ago and quite a bit after, but not now.
They want him to start AD's at least a month before he starts treatment. So he will be doing the treatment soon. He was devasted to hear the news and thought he was on his way out. We have lost two people to this but he just did not want to face it, now he has no choice. I dont know how bad the cirrhosis is, but I assume it must be early as the doctor says the treatment could help.  It is so strange, because he looks and feels so healthy you would never know. Thanks again for the info and I will keep you in my prayers as well.

[GoofyDad]

Hi Cindy,

Another (former) 3a with cirrhossis here. Just from what I see on this board, 3a seems to be more agressive in cogging up the ol' liver.

I think it's not altogether uncommon to see the rapid progression you've reported, for a couple reasons. First, biopsies aren't all that accurate (scary, huh?). The small sample and subjective interpretation leave things a little looser than what we would like to believe. Also, as I understand it, progression is non-linear - it can really accelerate as it progresses.

I always encourage people to try to watch things more closely than the standard protocols. I'm another one who was caught with my pants down in the barn......oooops maybe that wasn't the best metaphor....

Anyway - it's not the end of the line for your husband by any means. I'm clear 6 mos after ending treatment, and my doc is hopeful I will recover, hopefully having not yet  "crossed the point of no return", as he so compassionatly puts it. It seems that mild cirhossis, whatever that means, is reversable, where as once you go too far....I dunno, does it arrest and hold, or continue to progress? Time will tell in my case.

PS: I left this on my screen without posting it while I was called away. Maybe this has all aready been said in this thread. Probably not the part about the barn though.

[Cindy10]

Your too cute Goofydad, I needed a laugh. Thanks to you all!
He will be very relieved to hear what you all had to say!

[mycoldfeet]

Just so happens the hcv advocate has an artical on Hep and cirrosis (cirrhosis) and explains it very well, might want to read it. Just came out.

[tipiwoman]

I live in the UK and am wondering what the hepc advocate is? I take it it's only available in the US?

[motheroffour]

Hang in there Cindy.  I was surpsied when my husband was diagnosed with Hep C. I was shocked and dumbfounded when his bx came back as probable cirrhosis.  He's treating the Hep C right now and he has high hopes about halting the progression of the cirrhosis. It's no secret that anyone at this stage hopes that treating the Hep will not only halt the cirrhosis but knock back the cirrhosis.  From a routine physical with slightly elevated liver enzymes, it took many months of CTs, Ultrasounds, eye doctor appointments, family doc appointments, etc. to get to the actual shots and pills, but we have high hopes for SVR.  Take care of your husband.  Make sure he doesn't put any alcohol again in his body as alcohol is fuel for the Hepatitis fire and hang on, it's a wild ride.

[niceguy2007]

what an informative thread.  i'm also 3a, though infected recently and hopefully dont have cirrhosis.

i see that many here seem to suggest that 3a progresses rapidly to cirrhosis.  I also observe that many geno 1s and 2s here also have cirrhosis.  

but...i get this disturbing feeling that all (or almost all) 3a's infected for about 30 years on this forum have cirrhosis? is that true?

[Kalio1]

The dosages you gave are the standard dosages. They often make people's hemoglobin "go crazy" and also raise glucose levels in some people. It seems he decided to reduce your dosages to lower than normal dosages to help with those issues but he also gave you Procrit which is to help normalize your hemoglobin. Sounds like he is trying all he can to keep you on he medication for the full length of time, which is the right thing to do, but he had to reduce your meds for now. the thing is reducing meds lowers your chances of the medicine working so you might ant to talk to him about that. It could be he is planning to increase your meds back to normal doages when the Procrit starts working.
You were not "over dosed" on any of the medications, including the Procrit going by the amounts you posted. Because the doctor lowered the medications doesn't mean you were "over dosed" before. Before you were on the normal dose that most doctors prescribe.Now you are on a reduced dose.

[shawn_hsp]

Since the biopsy needle goes in a random area in your liver, so the biopsy may have been underrated. But then life style and a person's genes can have great impacts on the progression of the virus.

[SaphiraQueen]

I have been on treatment for 6 mo. told i have 12mo. Told i am type 1 and stage1 slash 2, doesnt make no since he highly overdosed me but i went in remission in three months and he is overdosing me again. My heymgloban have been down for last month.Totally burning up.

[Kalio1]

What do ou mean "over dosed"you? How much were you taking? How much Interferon, how much Ribvirin?

[mycoldfeet]

I asked same questions she has a thread above on treatment.

[SaphiraQueen]

He overdosed me Peg-intron,Ribavirin,Procrit

[Kalio1]

But what actual dosages are you taking of those drugs? Are you saying your Hematologist gives you your Hep C medications? A Hematologist isn't usually the administering doctor but who knows.
Without the dosage amounts there is no way to tell if you are being overdosed or not.

[SaphiraQueen]

when the doctor told me he highly overdosed me.I was unable to eat,my hymglobon went crazy,my sugar levels went high,mouth was so burnt

[mycoldfeet]

hcv advocate is online and you get an e-mail alert when the newsletter comes out, has the latest info and a great way to see new drugs coming out. www.hcvadvocate.org

[Cindy10]

Mother of four, thank you for you kind owrds. I will try to take care of him. I too have Hep-c Genotype 3a, and starting treatment this friday, so I hope I can stay strong for both of us. Flguy, I dont believe all 3a's go on to cirhosis, I have had this about 20 years and I am stage 1, so take care of yourself, dont drink and think about doing the treatment.
I myself and not going to wait for this to progress.

[FlGuy]

There are several people here who are starting treatment in the next few weeks, and some who started recentlty.  You are coorect that fibrosis does not always result in cirrhosis. But keep in mind that just because it took 20 years to get at your cuurent level it does not mean that progression can't pick up speed.  I'm at about 33 years and at early/beginning cirrhosis and except for treatment there's not anything that I see that will slow it down.  Good luck.  I'm also re-starting treatment by the end of the month.

[Cindy10]

Flguy, I am sorry I meant to respond to niceguy 2007, not you. I have read your posts and you definately know more about this stuff than me. I wish you well in your retreatment and will watch for more of your posts. I appreciate hearing the "veterans". You have obviously passed the panicked stage, and can offer comfort to others. Thanks again!