How is Stage 4 Cirrhosis Grade 4 "early" cirrhosis

I have known I had hep c since 97 no time line to folllow.  Did treatment in a trail in 98.  NOTHIng genotype 1A.
So after my last biopsy 5 years ago I was told your liver looks so good they couldnt believe I had anything wrong. 5 years later extremem fatigue, another biopsy and stage 4 cirrhosis.  THen they say oh its early.  HOw can stage 4 cirrhosis be early.  stage 1 maybe!  Doc said 6 years ago, you are going to be one of the lucky ones it wont progress. Now I have cirrhosis. stage 4.  Between hep c, cirrhosis and related depression/anxiety Im a mess. He says if I am ok he will treat me with new drugs in 2011.   OMG, just shoot me. I am just waiting for the hep c to finish off my liverf for the next year??? I mean there is no treatment for me NOW..wait and see and testing for liver cancer and nodule on pancrease.  THOUGHTS and advice very welcome.

[Bill1954]

As fibrosis progresses through stage 3 into stage 4 cirrhosis, it can be staged again according to Child-Turcotte-Pugh (CTP) into class A, B and C.

Child-class A is also known as compensated cirrhosis, as opposed to decompensated disease. With compensated cirrhosis, the liver continues to perform its designated functions; it metabolizes, synthesizes, and filters as designed.

There are quite a few in this forum with this degree of liver damage; some in your position that have experienced null response from previous treatment, and are waiting for better options.

Have you considered treating now with current meds, but changing up the brand, dosage or duration of treatment? Standard treatment has improved dramatically since ’98; genotype 1 patients now have roughly 50% chance of success overall; although with early cirrhosis, you’re odds are probably substantially lower.

The new protease inhibitor drugs look quite promising; are you somewhat familiar with their success in clinical trials?

Welcome to the discussion group by the way, and good luck—

Bill

[Bill1954]

Good luck as well on the imaging results re: liver cancer…

Bill

[IAmTheWalrus]

I imagine that "early" cirrhosis really means compensated cirrhosis as indicated by Bill above.

Wow! I really feel for you. REALLY! Your story is just like mine. Stage 1, then a biopsy 5 years later reveals stage 4! My hepatologist told me that rapid progression like that essentially never happens. But you and I both know differently.

I was in your situation exactly 4 years ago, but my situation was complicated by elevated AFP and a tumor that showed up on CT and MRI as HCC. So, for me it was straight to the transplant list, do not pass go, do not collect $200 (actually had to pay a bunch)!

If you have a chance to treat using your original equipment (liver), and succeed, then you may be able to avoid transplant. If a TP is still needed then it would not need to be followed by treatment for HCV. On the other hand I suppose there are some risks of doing TX with cirrhosis. There's a fair amount of risk with a TP as well. Having had the TP, I would want to try the TX instead. Then again, I haven't had the experience of doing TX with cirrhosis.

Tough decision. I hope whatever you choose works out for you.

Brent

[22hamilton]

I am also in that position-10yrs ago stage 0,now I am in 'early cirrhosis',had two failed treatments am gen 1a non responder.I am living in hope these days,there are many new meds in the pipeline and coming to trial.Am waiting for assesment for a trial this summer which could stop further damage.I know my odds are diminished for a variety of reasons but as I say I live in hope, all is not lost yet.

Take care

[child24angel]

As Brent and Hamilton say, it can and does happen. The same thing happened to my son.
I also think early cirrhosis is well compensated.

I wish you the very best outcome.

Hugs sent your way
Elaine

[nygirl7]

I'm very sorry for your situation.  This is a good post however it does show the need to follow your liver damage CLOSELY no matter what stage you are. People think because they might be stage 1 and have had the disease for 20 years that it will take another 20 to get to stage 2. Wrong as you yourself know.

There is a lot to be said for watching and waiting when you have little damage but it's the WATCHING part that is so crucial.  I personally think you should try and find a new reputable heptologist with a big practice - at least for a second opinion here.

We try hard but are only heppers and their family - none ofus are doctors although as you can see  many here certainly do understand too well what has sadly happened to you. Damn it's a shame they didn't follow up with you in two years - I've never believed in the 'five year followup' personally.........it just seems way too long. (Although now I'm three years post treatment and almost five years  since my last biopsy when I was stage 3 already- but I was cured so I stupidly assume i am fine.........good lesson for me to take away from this too, one just never really knows).

I wish you all the best.

[joyceaball]

Well there is more of us than you thing. I also was diagnosed with stage 1 cirrohsis in 2000. Wouldn't have found it then but applied for half million in life insurance and bam. Sure messes up your life. I am in the medical field luckily so I understand alot of the rigamaroll they give you for answere. Had my second biopsy in 2005, after treatment failed 4 time of the interferon. That put me through hell and I was still working. Then it destroyed my thyroid gland the interferon did, and I developed hyperthryroid and almost did from complication from the thyroid disease. Was sent to Philly in 2006 due to decompensated health, it has affected every system in my body. Don't work anymore.

Well philly would not list me they said I was to early and I was displaying signs of depression. Well first who wouldn't be depressed in this situation, especially since I contracte Hep C in the Medical field. Had a Hep C patient spit blood right in my face and it was in my eyes, my nose, my mouth. They tested for a full year after and I didn't display numbers showing Hep C so they say it wasn't from that. But I never did drugs or any illicit behavior that would cause me to contact hep.

Then in 2009 I really got bad, and finally  I got listed at Hershey Med Center. I am 18 on ther list, but there are criteria while on the list I can only take a liver from a blood type A donor and even though more people have type A blood less livers are available to type A patient than anyone else. You can do live donor if someone in your family matches, and evaluates well enough to do it but if I go over 23 on the list I can't have live donor. Higher on the list sicker you become and ones your so sick you may not make it through the surgery so they don't want to put a healthy person to risk there life in case you don't make it.  Well good luck and god bless. And remember you are your on best advocat. learn everything you can and manage your care you can demand that you want certain things done

jb

[Angel4hope]

My husband was diagnosed last Thurday with Stage 4 Cirrohsis. He has Advanced Hep C. We have to back in the liver transplant clinic to see where we go from here. This is happened so fast. He was injuried in a car wreak and work several years after but, since he's getting older,His doctor told him that he needed to apply for disablity, And now its crazy that he was this sick. I was reading on the symptoms of this disease. He drank some before we were married, And after he quit, and yet he has it. This the hardest things that I ever had to deal with.

[Bill1954]

Hi there,

Sorry to hear of your troubles. You’ve added to an old post in here; if you like, you can repost in a new thread by going to the top of this page and clicking on the green ‘post a question’ button.

Good luck-

--Bill

[sam2906]

My LFT is perfectly normal, PT & INR are also normal.  I have no symptoms other than very occasional mild itching on knee.  I did an Ultra sound sonogram and the radiologist wrote " very mild echo texture - irregular nodular margins - Early liver cirrhosis " I did not consult a physician.

I am an alcoholic on abstinence last 2 months.  Am I on cirrhosis and if so on which stage?  Having stopped alcohol what is the progress.

I am terribly worried.

Thanks

Patta

[hrsepwrguy]

Hi if you go to the top of the page and use the post a question button it will start a new thread and you will get more responses to your question. An ultra sound will pick up on cirrhosis but really can't be used to grade liver damage, however a liver biopsy is the best way to determine the exact amount of liver damage you may have.

[Interfurgen]

I am also at stage 4 failed the first round will start again but we are trying to stop the vac'iss bleeding in the throat. i have 2 cm damge, they S.F. liver center are now involed so will see.what happen in the next months. T-1a stage -4 one tx failer.