Educating Ourselves

[livinhepc]

Hi
My husband has been in prison for 15 years. He is never coming home. As is common last year he wasdiagnosed with Hep C.  This past weekend he indicated that the Doctors want him to begin Peagusus treatments.  Seeing how others reacted to this has made him fearful.  I decided its best to help educate ourselves on the topic. Please understand that in our world the Doctors advise is not always the easiest  to trust.

I understood it to be Hep C a disease that destroys your liver.  In reading the topic online I realize there is much more to it and I find my self thoroughly confused.  Acute vx chronic? Genotype 1,2,3? The virus?

I assume this is all information my husband should know in order to best decide whether to accept treatment? The only thing he has been told is he has hep C and his liver is doing fine.

Any input would be much appreciated.

D

[copyman]

sorry to hear about your husband but it is good he was offered treatment. There is a doctor by the name of Bennet Cecil (google the name for his website). He is an advocate for prisoners with Hep C. He will answer your questions if you email him using the address on his website.  He should be able to advise you on how to proceed. Best of luck

[Texas714]

Under the circumstances, I think he's pretty lucky that they are offering him treatment.  I don't think all states do that.  I would also imagine that if they are offering it to him, he probably needs it.  The meds are expensive and my guess is they would only provide them if there was a real need to treat.  
Good Luck to the both of you whatever you decide.

[jmjm530]

The acute stage only lasts six months after initial infection. So if your husband was diagnosed last year, then that puts him in the chronic stage. This is quite normal as most people are diagnosed when in the chronic stage.

Two of the most important factors in making a decision on whether or not to treat are genotype and the amount of liver damage.

Genotype is the "type" of Hepatitis C he has. Most in the United States have genotype 1A or 1B. These genotypes have around a 50-50 chance of being cured with 48 weeks of current treatment drugs. Genotype 2 and 3 have around an 80 per cent chance of being cured with 24 weeks of current treatment drugs.

As you can see, it's a lot easier to treat genotype 2's and 3's, and for this reason many doctors will recommended those two genotypes to treat regardless of liver damage.

Genotype 1, however, is harder to treat. For that reason, most doctors will perform a liver biopsy on genotype 1's to find out how much liver damage they have. If they have little or no liver damage, then one reasonable option is to wait for better drugs. In general Hep C is a slow moving disease, so people with little or no liver damage can wait for years in many cases. On the other hand, if the biopsy shows significant liver damage, then treatment is usually advised.

Did your husband get a biopsy and what was the result? Do they offer biopsies in prison? If not, there are some blood marker tests like Fibrosure to determine liver damage , but not as accurate.

Also, you want to make sure your husband has had a viral load test. They are someimes called "PCR" tests. This is important because some people test positive for the antibodies but end up virus negative. If you are virus negative, then you don't need treatment, because you don't have the virus.

You also might want to contact Dr. Ben Cecil. He has spent a lot of time working with people in prisions and should know the ins and outs. His web site is: http://hepatitisdoctor.com/

All the best,

-- Jim