Does Cirrhosis heal

[GP7852]

Hi
I was stage 4 cirrhosis when I started sovaldi-olysio.I cleared at the 4th week bloodwork and everything is looking good with just 2 more days left.I would like to know if my cirrhosis will heal to the point where I don't have to worry about tumors developing.A nurse practitioner told me that I will have to keep getting ultrasounds twice a year to keep on the lookout for tumors even though I am negative and stay negative.I am aware that the scarring wont heal up,is it the actual scarring that poses the threat of tumors?
                                                                                     Glen

[Sarah1949]

Hi Livelife, Thank you.
I have been in the midst of an insurance appeal for Olysio for about a month now. Waiting on the results from my Q80K test, which should not really matter, but the insurance wants it. The Sovaldi has been approved for awhile now. My doctor doesn't want me to do Riba cause of my low platelets. Such is life. Yelp, I'm getting bitter. :)

[Livelife777]

Hi Ruby and glad to see you on this site.  Do think you bring alot to the table and happy that your here.
Great article.  Gives cirrhotics, including myself much hope for the future.  Noticed that you are perhaps getting ready for Tx?  If so, its amazing that we finally have an option in our own health care.  Hope whenever you choose to start, SVR will not allude you.  It's been a game changer in my life, and so worth the experience.
Take Care
...Kim

[Sarah1949]

When I was first discussing treatment with my doctor back in January, he told me if I can get rid of the virus then there is hope that the liver will begin to heal. There have been studies that support this. -- "Patients with SVR have resolution of inflammation and fibrosis and many resolve cirrhosis."

http://hepatitiscnewdrugs.blogspot.com/2014/07/long-term-changes-in-liver-histology.html

[Livelife777]

Hi and welcome.   That's an important question and one you may want to ask the group.  This is an older post from May, and you would get more responses if you started a new question.   At the top of the page there's a Post a Question option, and you can address any thoughts, questions or concerns.
So very happy that you are going to start treatment.  Many of us are either going thru treatment or waiting to begin.  It's a wonderful site, and since your just getting started you may have thoughts as to expectations and treatment issues.
This is a great time in history as we are now able to finally cure the Hep C virus.  Welcome aboard and if you need help or a few new friends, we will be there with you as your new journey begins.
Take Care
...Kim

[Shiloh376]

I am working with a physician at the Cleveland Clinic who is about to start me on simeprevir +Sovosbuvir.  I have had hep c for over 30 years but am treatment naive.  I have tried nothing.  Now that I started to lose weight w/o trying, tests were done and they are saying I have 20%  liver function.  what I am wondering is how advanced was the cirrhosis for you when you cleared the virus and were told the cirrhosis could possibly be reversed?  Thanks so much.  God bless you for continued health and a full life!

[GP7852]

Thanks Nan
I would never doubt anything Hector says on here,especially when it turns out to be good news.As far as Hectors knowledge is concerned I would let him treat me for this virus anytime.
                                                    glen

[nan535]

This quote is from Gilead's full prescribing info on Sovaldi. It confirms what Hector posted.

"Plasma HCV RNA values were measured during the clinical trials using the COBAS TaqMan HCV test (version 2.0), for use with the High Pure System. The assay had a lower limit of quantification (LLOQ) of 25 IU per mL. Sustained virologic response (SVR) was the primary endpoint which was defined as HCV RNA less than LLOQ at 12 weeks after the end of treatment."

http://www.gilead.com/~/media/Files/pdfs/medicines/liver-disease/sovaldi/sovaldi_pi.pdf     See  14.1  Description of Clinical Trials

[GP7852]

Thank you everybody-just the first day off treatment and the rash I had on my forehead since beginning treatment has started to subside and is looking like its going away.I see that Hector mentioned SVR12 is considered cured.I thought you had to be negative after 6 months to be considered cured.Could someone elaborate on that?
                                              Glen

[Dee1956]

Congratulations on your great news!  A year after I finished treating my doctor said my cirrhosis could improve, my blood work looks great.  I do need to go in once a year for sonogram and blood work to check for cancer.  It used to be twice a year.
Good luck :)

[nan535]

Congratulations on completing your treatment!  That's great.

Now onward to SVR!

Nan

[HectorSF]

SVR is undetectable at 12 weeks, not 24 weeks.
(SVR12 = considered cured)

Hector

[GP7852]

I'm with you Kim,this disease has got to go and stay gone.Today I took my last pills and now I will sweat it out till my 6 month bloodwork.I am so relieved that the nose bleeds and those horrible cramps in my legs and hands have stopped.I feel like like I just lost a friend when I put my last two olysio and sovaldi bottles in the trash can.I cant go back to being positive again,I flat out refuse.I hope everybody on here slays this horrible dragon and he stays dead where he belongs.
                                          Good Luck Everybody   Glen

[HectorSF]

"could a cirrhotic liver like mine handle chemotherapy (or and possibly both)radiation should tumors show up?"

By "chemotherapy" I assume you mean Transarterial Chemoembolization (commonly called TACE)? TACE is a very common treatment for HCC. It uses chemo coated microbeads that are inserted into the tumor in the liver. The beads cuts off the tumor's blood supply and then the chemo drug slowly is released from the beads treating a very tiny area over a period of weeks.

There is other oral systematic chemotherapy treatment (Nexavar (sorafenib)) but it is generally only used in those whose HCC has metastasized (spread outside of the liver). Since HCC that has spread outside of the liver is terminal transplantation is no longer an option and this treatment only extends life for a median time of 4 months.

Radiation is not commonly used on liver cancer tumors (HCC). I had radiation but it was an experimental treatment after all standard treatments failed (I had 7 different standard HCC treatments including 4 TACE procedures.

Basically in order to treat HCC the liver disease usually needs to be compensated (no bleeding varies, large ascites, etc.) because the treatments can be of high risk to patient's who livers are in the process of failing. HCC treatment can cause further liver damage and in some cases liver failure.
----------------------------------------------------------------------------------------------
Adriaan Van der Meer of Erasmus University Medical Center in Rotterdam looked at ongoing risk for liver cancer among hepatitis C patients who achieve sustained virological response, or continued viral suppression for at least 6 months after completing treatment.

Successful therapy strongly reduces but does not eliminate the risk of HCC for hepatitis C patients who have already progressed to advanced fibrosis when they achieve SVR, the researchers noted as background.

Over a 5 year period of time in 1000 hep C patients who achieved SVR 9.7% for those age 45-60 developed HCC, and 12.2% for those older than 60 at the start of treatment developed HCC.  Having diabetes was also a significant risk factor for the development of HCC in these people.

Hope this helps.
Hector

[Livelife777]

Thanks for the post Glen as I've wondered also.   Would like to ask if the current risk after the the underlying cause is eliminated, be 1-2%?   And, if caught early would a transplant be the best and only treatment for cure?    Congrats on just about finishing treatment Glen.    I'm 6 weeks post treatment geno 2, and was UND at the 4 week post blood draw.   Lets hope that hep c will be eradicated for ours, and future generations.             ..Kim

[GP7852]

Thank you for your replys,they were very informative.One last question,could a cirrhotic liver like mine handle chemotherapy (or and possibly both)radiation should tumors show up?
                                                     Glen

[HectorSF]

"I would like to know if my cirrhosis will heal to the point where I don't have to worry about tumors developing."

Cirrhosis can reverse itself in some cases if the underlying cause of liver damage can be stopped such as hep C. It depends on many factors but most importantly how advanced the cirrhosis was when treatment was started.

The risk of developing HCC is reduced if a person is cured of the virus but unfortunately anyone who has had cirrhosis will always be at higher risk of developing HCC than someone who has never had cirrhosis.

Besides the scarring cirrhosis has many other characteristics that make a liver more prone to developing primary cancer. For a person to develop cirrhosis from hep C they have usually been chronically infected from 20-40 years and the liver cells have been damaged in many ways that make them more likely to become malignant. The DNA of the liver cells can become damaged and the normal regulators of the cell's life cycle may not function properly in the cirrhotic liver which can cause the development of malignancy (cancer). This is why that once a person develops one HCC tumor it is highly likely they will continue to develop future tumors. The environment of the liver is prone to develop more cancerous cells. This is why the only "cure" for someone with cirrhosis, portal hypertension and HCC is transplantation. Only by getting rid of the cancerous liver does the patient have a good prognosis.

Your NP is correct. Even if you cure your hepatitis C you will be still at a higher than normal risk for HCC due to the damage that has already been done.

HCC is currently the fastest growing cause of cancer-related death. Since HCC is so deadly it needs to be found as early as possible for the best outcome. Surveillance and early detection and treatment is essential. Like most cancers HCC has no symptoms in the early stages. When a person does experience the effects of liver cancer unfortunately it is usually too late for any curative treatment. So proper surveillance for early detection and treatment are very important for anyone with or who has had cirrhosis.

Good luck with curing your hep C.
Hector

[AWorriedMom]

Many people with cirrhosis who have cleared the virus, have gone on to get improvement in the histology. It takes time though. The nurse practitioner who told you that you should continue to be monitored for HCC is correct. However, your risk has gone down. Enjoy your new found health and undetected status.

[dontworry_behappy1]

You are asking a question about "cirrhosis of the liver".   I see your just finishing Hepatitis C treatment .   Medhelp has a "cirrhosis of the liver" forum.
The experts on that forum (many who have had Hepatitis C) have extensive personal knowledge.   I would post your question there.  I have read there is some liver improvement but it's best to hear directly from those with the most knowledge.  

Best to you