How severe?

[mayping]

my husband has been diagnosised hep C 1a in Nov, 2009.  dr has no treatment for him and referred him to gastroenterology b/c his white blood count (3.1) and platelet count (45 by the end of nov, in dec 21, only 39) are too low, dr only said he has severe/advanceed liver disease, so i am not sure how severe it is.  dr only kept asking jon if he drinks, but he didn't anyway.  his albumin (3.3), red blood count (3.98), hemo (13.1) & hema (38.0) are low too.  Bilirubin is 1.1 still ok.  AST 52, ALT 47, Glucose in fact only 115 (pre diabetes).  Jon said that primary dr told him that his spleen is swollen and has scar on his liver.  i read quite of few articles about liver disease and supposed he already have cirrhosis and some complication issues...  he has a little adema on his shins.  he has diabete type 2 and high blood pressure and he is obeses, most of his weight is around his belly.  he just had two (cysto) surgeries on kidney stone and will be finished up the third in jan 12.  he will have his first egd (upper) test in jan 5.  

so how bad his situation is?

[mikesimon]

Mayping said: ".....and platelet count (45 by the end of nov, in dec 21, only 39)".
Dr. Thomas Schiano said: "...his platelet count is not that low, so as to preclude an attempt at treating the HCV".

We have heard a lot about platelet count precluding HCV treatment. Here our transplant surgeon seems more comfortable treating a patient with a "low platelet count".

Mike

[mayping]

Thank you, Dr. Schiano.  That's really help a lot.

Hope that his doctor will take your advice to give Jon treatment and HCC screen.

Anything else he can do to prevent the low MELD and subclinical cirrhosis become worse?

His EGD test was postponed, so is it urgent to have that test done?

[Thomas D Schiano, MD]

it seems like he has a low MELD score and subclinical cirrhosis.  hopefully he can do well long term as long as he does not develop HCC--he needs appropriate screening for liver cancer.  there are new medications for HCV that hopefully will be available soon.  his platelet count is not that low, so as to preclude an attempt at treating the HCV.  he must make sure that his diabetes is well controlled.