Do you suggest interferon therapy on Liver Cirrhosis?

[dhksaife]

Friends,

I was suffering HCV Gentype 3. My Age 42 yrs.

On July 2007 My Hepatologist given my Pegasys 180mcq + ribavirin 1200mg/per day 135mcq when platelet count decreases.

After six months of my therapy I found the report:

ULTRA SOUND: Portal fibrosis, Scarred Tissues & Mild splenomegaly
Had my pathology reports followed:


21.07.2009 ALT(SGPT):73 U/L
           S.Bilirubin:1.0 mg/dl
           Prothombine: 1.13 INR
           HBsAg:Negative
           Anti HCV:Reactive
           HCV Quantitive: Less than detectable limits/Super Raligare SRL Mumbai
           Andoscopy: Grade ii-iii Oesophaegal Varix
           Moderate Degree of portal hypertensive gastropathy
           Duodenal Ulcer
           CBC & Blood Film: are normal except lower platelet count 108x10

After that they Made EVL
From the day the made EVL I was unable to eat very well,It was paining.
Doctor gave me some 3rd generation antibiotic
After that he made pathology test on  

22/08/2009

ANA=Negative
SGOT=100 U/L
SGPT=125 U/L
Serum Total protein: 85gm/l (63-84gm/l)
Serum Albumin:38.00gm/l( - )
Anti –HBs:<3.0mIU/ml
Anti-HAV IgM:Non Reactive
Total Cholesterol:167.0mg/dl
H.D.L:51.0 mg/dl
LDL:102.0 mg/dl
Triglycerides:70.0 mg/dl
Chest P/A View:Normal

Now I am Taking medicine:
1.Leganon 75mg (Sylimarin)2x3 times daily
2.Losartan Potassium 25mg 2 times daily
3.Amino Acid 2 times (Hepa-Merz) daily.
4. Vitamin E 400 mg
5. Vitamin C 500 mg

After 1 month he advised me to made another HCV RNA test report follows:

HCV RBA: POSITIVE
HCV RNA IN IU/ml:4.7x10(7)
HCV RNA COPIES :1.9X1(9)

Above PCR report are wondering me! is it possible to increase viral load as stated above?

He adviced me to take pegasys therapy & wants to see the response after 1 months

My questions to you is it fatal for me to go on pegasys therapy while i am suffering Liver cirrhosis?

Thank you.

[orphanedhawk]

I just reread your post and saw you are genotype 3. Goofydad is geno 3 and successfully treated with cirrhosis. I'd suggest writing to him. He's a good guy.

[orphanedhawk]

I had decompensated cirrhosis when diagnosed with HCV and thought what did I have to lose by doing tx?

In retrospect, I think tx may have made the cirrhosis worse.
I broke an arm after tx, from a minor fall, after years of never breaking anything no matter how clumsy I was. Tx was hard on my bones.  
Less than two years after ending tx, I had a transplant.

However, lots of people with cirrhosis here on this forum, have treated, beat the virus and done fine.  The liver will regenerate in time.

Write down a list of questions for your next doctor's appointment.
Eat well, stay active and good luck with your decision.
OH

[franke566]

I see major inconsistencies also.  It is completely possible someone slipped up.  Because I have a common last name and my first name is Francis (everyone calls me Frank-so no jokes) I was given a Frances with same last names medication-the pharmacy caught the error.  The woman Frances had my meds and I would have had hers.  Ofcourse they wouldn't tell me if she took mine or not.  Anyway labs have controls but things get mixed up more than we probably know.

[hippygem]

http://www.hepcaustralia.com.au/News/AIIMS-advocates-special-test-to-make-blood-transfusion-safer.php

[mpace6983]

Is there a chance that you could have been reinfected from another source, after  you showed RNA HCV undectable?

[FlGuy]

Yes. But after 6 month clear pcr is odd.  And, the fact that there was another pcr a month later...

[hippygem]

Hmmmm, sounds like relapse.

[FlGuy]

You said that you finished treament in January, 2009.   Your post above included "HCV Quantitive: Less than detectable limits/Super Raligare SRL Mumbai " which you reported as being in July 2009.

Then you wrote "After 1 month he advised me to made another HCV RNA test report follows:

HCV RBA: POSITIVE
HCV RNA IN IU/ml:4.7x10(7)
HCV RNA COPIES :1.9X1(9) "

My confusion is this:  You seemed to be virus-free after six months, then a month after that you seened to have a viral load again.


I suppose the re-testing that you are doing now is appropriate.

[dhksaife]

Holla Debi,

Thank you.
My platelet counts are 105000.
I am taking beta blocker Losarten Potassium 25mg.
Some other doctor advised me that Anti oxidant can reduce the free redicals,thats why i am taking Vit-E Capsule with another multivitamins.

Any way thank you for your concern.

Wish your best health & best of luck.

saife

[dhksaife]

Thank you.
Doctor advised to made another HCV RNA test from a reputed LAB.
Also he planned to give me pegasys 135mcq.

[FlGuy]

I don't see anywhere in what you wrote that you have cirrhosis. What test did you have that confirmed cirrhosis, a liver biopsy?  Something else does not make sense; on July 21 you were non-detected for hcv and one month later it was detected?  Your treatment was in July 2007, are you still on the Peg/riba treatment?  Several things do not make sense in your post.

[Mr Liver]

Treating while cirrhotic demands more scrutiny by your treating team., e.g., more frequent labs, more frequent office vsits, and the possibilty of doing a diagnostis test or two if needed.. My doctor has been treating cirrhotics for about ten years and decompensated patients for almost as long. One of the risks of cirrhotics treating is the possibility the treatment itself will lead to liver failure and decompensation. And a patient who is decompensated has to be watched like a hawk as if it has a worsening effect it can push the patient into fulminant hepatic faiure. Try to find a hepatologist at a teaching med school that has experience with the special population you are in.
SVR rates stink ranging from 10% to 20% for G1. Slightly higher for G2and G3. New drugs coming may improve SVR rates for G!s and have a shorter tx duratioon of  IFN/riba therapt as well.
Good luck in your study research and decision.
ML

[Lindaz]

I have heard that if you have cirrhosis you can still treat.  Your medical team will keep an eye on you and your progess......... but ultimately, you should take your doctors advice.

[tulsatime]

Hi, I did treatment having cirrhosis. But I was wondering why they have you on vit- E ,that is a blood thinner and with cirhosis you should not take any bloodthinners, asprin, IB prophin, and tylenol also. You should ask about a beta blocker for the varices. Some of the meds you mentioned I wasn't sure if it was a beta blocker or not. You definately should do what your dr wants you to. I have spleenaligamy also, plus very low platelets, where are your platelets at? I also had early portal hypertension 5 yrs ago. As long as you have compensated liver function they can treat. I was 42 when I treated first time too. Best of luck... Debi

[mpace6983]

The best thing to do is follow your docs advice. GOOD LUCK

[JennyPenny]

No, many people go on hepatitis C treatment when they have cirrhosis, myself included. If your doctor wants to treat you, I would seriously consider it. Good luck to you.

[mpace6983]

What did the doc say?