Hep c treatment

[almawe]

l have had hep c for nearly 30 years.  my liver function test are slightly elevated, nut have just found out that l have fibrosis at a moderate level.  am seriously considering going on treatment, but succes rate is low for my geno type (la).  l was wondering if having 'unsuccessful' treatment had any benefit to the liver?

[Bill1954]

While this doesn’t directly address your question, the following is from the HALT-C study which investigated long-term low dose maintenance therapy for null responders of therapy. The gist of it is that SVR is required for substantial reduction of liver damage:

http://www.hivandhepatitis.com/hep_c/news/2010/010510_b.html

“In the HALT-C trial, more than 1000 participants with advanced liver disease who did not achieve sustained virological response (SVR) to standard treatment with pegylated interferon alfa-2a (Pegasys) or pegylated interferon alfa-2b (PegIntron) plus ribavirin were randomly assigned to received either low-dose (90 mcg/week) pegylated interferon alfa-2a maintenance therapy or no further treatment.

As previously reported, after 3.5 years, patients who received maintenance therapy had lower liver enzyme (ALT and AST) and HCV RNA levels, but were not significantly less likely to progress to hepatocellular carcinoma, decompensated cirrhosis (e.g., ascites, variceal hemorrhage, hepatic encephalopathy), fibrosis score increase of 2 or more points, or death.

In the present study, the HALT-C team explored whether persistent HCV RNA suppression during the trial was associated with reduced clinical outcomes. This analysis included 764 patients treated during the lead-in (standard combination therapy) phase of HALT-C and randomized to the maintenance therapy or no further treatment (control) arms.”

More on the landmark HALT-C results:

http://www.google.com/cse?cx=000772985894926410863%3Awvp_6dwxpvm&cof=FORID%3A0&q=halt-c&sa=Search

--Bill

[almawe]

Thanks Bill, it does sort of answer my question.

[Diane12855]

I would think it would be a benefit to the liver and give it the time that you are on treatment to heal itself some because it isn't having to fight the viral attack nearly as much, and the Ribavirin is stopping the virus from replicating.

Do you know what stage of fibrosis you are at? I'm a 1a too and I was stage 2 grade 2 before I started treatment. I went ahead and did my tx now instead of waiting for the new drugs that will be coming out because I wanted to be done with all the bad sx before my last 2 kids started high school... that is such a rough time for them that I didn't want to be a big grump... like I am now... If it wasn't for that, I would have waited.

Diane

[almawe]

Thanks Diane, l am at stage 2 fibrosis (8.1).  Am on a steep learning curve here.  Been looking at what natural remedies l should be taking as well.  All very confusing.  Can't bury my head in the sand any longer though.  

Alison

[eureka254]

The fact that you're on a learning curve is an excellent thing -- educating yourself will be your best ally in helping you manage your hep c.  Much of what goes into deciding if to do treatment and when to do treatment should be based on your individual circumstances.  As a stage 2, you definitely don't have the luxury of burying your head in the sand.  Welcome to the forum.

As a genotype 1, it stands to reason that you're weighing the treatment questions heavily.  You know the odds are 50/50, so you need to consider whether your current insurance, your present life circumstances (and support system), and 'timing' is right for you to take a shot at those odds. As far as whether "unsuccessful treatment" has any benefit, it appears to have some benefit for those who can reach undetected status, but not for those who are null-responders.  Also, take into consideration what increases the success odds for geno 1s, and where you fall in that spectrum: you need to consider whether treating immediately with the current regimen, participating in a clinical trail, or waiting for better cure rates is the right approach for you.  Hopefully your are seeking the advice of a hepatologist who will help guide you through the process.  Hope this helps. ~eureka

[almawe]

Thanks for all that.  l am seeing a hepatologist, saw him for the first time last week.  Have to return in a month to get viral load results and to discuss treatment.  l am up for anything!  In the meantime l am trying to maintain the healthiest diet and taking supplements that support the liver function, usual suspects here (dandilion tea, milk thistle, olive leaf extract, globe artichoke, selenium).  l tick some boxes for successful treatment (female, not overweight, never had hep a or b or HIV) others  not ( had the virus for 28 years, am 56 years old). There is talk of me going on a trial that uses telepvan (spelling!) or some other third ingredient that the doc said was just 'letters', who knows!  Was just reading on the net that there have been trials where the riba is replaced with something else and the side effects are not as severe.  Hope my doc believes in both standard western therapy and all that is known about complementary therapy.  l dont really have a choice who l see.  Am a public patient in Australia.

Almawe