I need help plzzz

Hi All!
My uncle who is 63 years old was recently getting his master health cheq done as he is a diabetic.Amidst all his tests his SGOT/SGPT and alpha fetal protiens (11.75ng/ml) test came  a little raised.So we got his ELISA test done.It came Hep C reactive.His USG shows liver  firm and parenchmya coarse and spleenomegaly.All other test are within normal range.Doctors say its Hep C related early cirrohsis.

He has a history of  being an alcoholic but stopped few months back.
Now we are awaiting his PCR TEST  to find out if his cirrohsis is Hep C related or alcohol related.

The only symptoms i see in him is tiredness and loss of appetite else he seems fit to me.I am really worried about him .Are there any chances that his PCR comes non reactive? and what do mildly raised AFP levels (11.75ng/ml,normal being 10 ng/ml)indicate?Can i hope there is no cancer!!! I am so scared for him.

[copyman]

at this point it doesn't matter if cirrhosis is from alcohol or Hep C. of course you want to confirm Hep C for possible treatment but main concern is to confirm cirrhosis. he should been seen by a Hepatologist (liver specialist) and get a liver biopsy done, this will tell the condition of liver and confirm cirrhosis. best wishes to both of you.

[HCA]

Mildy raised AFP is not a marker for liver cancer,it would be very high.
AFP is a crude indicator in any case,not a real diagnostic tool.
The cirrhosis will have been caused by both factors,probably with Hep C being the main driver.
As he is cirrhotic it is most likely that that he does indeed have active Hep C-the PCR will confirm (or otherwise).
Most alcoholics do not develop cirrhosis.
As suggested above a liver biopsy will clarify the position and enable the doctor to make a treatment plan.

[franke566]

Was that a clerical error when you said most alcoholics do not develop Cirrhosis?

[franke566]

I just looked up the chief reasons for Cirrhosis by order.  Alcohol being # 1, Fat, toxic metals including iron and copper, Viruses and Auto Immune Disease. The American Liver Foundation. franke

[HCA]

' Alcoholic cirrhosis develops for between 10% and 20% of individuals who drink heavily for a decade or more'
This same figure ( from Wikipedia) appears in all the medical reference sources.
I repeat -most alcoholics do not develop cirrhosis.
The fact that alcoholism is a major cause of cirrhosis is an entirely different matter and does not affect the veracity of the well known fact that most alcoholics do not develop cirrhosis,

[elisa840]

Hi all! thanks for replying.It really helps reading all this information.
WELL I got  to know about my uncles PCR test.His viral load is 92184 IU/ml.
And he is genotype 3a.

I am guessing its a hopefull situtaion to deal with?

[elisa840]

I have my own concerns about Biopsy treatment.
MILD liver cirrohsis shudnt instigate for such an invasive treatment although its minimally invasive.I am hoping for altrenative imaging techniques(fibrospect or CT scan)since all symptoms show early cirrohsis.

[nygirl7]

Elisa

Almost all of us who have had hepC have had a biopsy to determine exactly where we stand - it's the best test out there. CT Scan will only show whether he has tumors or cancer and while it can show cirrhosis it's best as this point to know exactly where he stands (being cirrhotic).

His Viral Load is very low and that is also an indicator of cirrhosis - there aren't that many healther liver cells left to kill so the number remains very low.

Although none of us are doctors I think that we would agree he needs to be seen by specialist in this field to determine exactly how bad his liver is and if he is ready for the transplant list.  If he has enough healthy liver left he might get away with just doing treatment - but you really need to know.

Geno3 while is usually considered one of the lucky genos requiring onlyusually 24 weeks of treatment can also be on the other hand one of the hardest to kill if you have a bad strain. For this reason you want him to get these tests done right away and start being proactive.

AT least you are lucky in the fact that he stopped drinking. Alcohol and hepC is a very bad combo and certainly it helped him to progress to cirrhosis at such a young age.

There's lots we could guess about but the fact is he is lucky to have you and needs to follow up very quickly and thoroughly.

[elisa840]

Hey! Thanks for all the inputs.
But plz tell me one thing,
Does this mean having a low VL count isnt a good news either?? coz i was thinking the opposite!!!!!!!!

[franke566]

Apples and oranges HCA-more alcoholics develop cirrhosis than Hep C patients who aren't combination Alcoholics and HCV positive.  Alcoholism and HCV positive= Likely Cirrhosis.  But lets not quibble over sentence structure.  If the liver biopsy shows Cirrhosis it will more than likely be attributed to his disease of Alcoholism rather than the Hepatitis C virus.  Both diseases will need to be treated.  Most full blown Alcoholics do indeed develop Cirrhosis W/O intervention or dis-ruption of the disease via death, insanity, or stopping the alcohol.

Elisa, having a low VL is good and no more alcohol is also good.  If his doctoer (I hope a Hepatologist) said his early Cirrhosis was caused by the Hep C virus and the doctor knows about his former alcohol abuse then the Doctor not me or anyone on this forum can argue that.  But if your uncle didn't dis-close his Alcohol abuse the cause of his  cirrhosis was mis-diagnosed.  Does that matter?.  Maybe. Maybe not.  I dis-closed everything to my physician(s) to avoid any mistakes.  I think that is the best way.  A friend of mine was a highly functional alcoholic-successful in business and drank at least a quart of Vodka a day.  He also liked the nose candy and somehow got Hep C.  He didn't tell his Hepatologist he was an alcoholic but he did stop drinking and took the Tx and it killed him.  His wife wanted answers and she went to the Hepatologist and told him about his alcoholism.  She said the Hepatologist told her if he had known he would have approached the disease differently.  I don't have a clue what that means-nor does she.  So at least make sure your uncle has made his Hepatologist aware.

[elisa840]

hey thanks frankee!
well my uncle did disclose about his drinking habits.Its all written in his reports.
And his gastroenterologist has diagnosed him with hep C related early cirrohsis.Although without any biopsy.
I am going with my uncel today to the doc with his PCR reports.Lets c what he says.
really scared for the poor soul.
My  worry was whether i should be more concerned about his HEp C or his cirrohsis/?

Thanks all though.

[franke566]

Nygirl answered it best and she is correct to say he is fortunate to have you.  I shudder to think how anyone could do all this alone.  Wish he could get to this forum.  I've only been here a few weeks and feel cyber-close to a number of the good souls on it-and there are plenty! franke566 Please keep me (us) up to date and good luck!

[elisa840]

juz got back from the hospital.Got my uncle's endoscopy done.He has 2nd grade varices for which his treatment has started...gladly there aint no bleeding.His IFN treatment starts next saturday.The doc says no need for biopsy as all his symptoms and imaging studies revael his cirrohsis is bad(80% damaged)but we need to protect the remaining healthy liver.NO CANCER though.so juz hoping he lives well for the remaining part of his life.I gues after science helps us in knowing where our bodies our..its time for the power of within to act and treat ourselves.

[franke566]

80% is  better than 87.9%!  I think that is great news Elisa!  Doctor making sure he won't have any bleeds-he'll be on a low fat low sodium diet I imagine  and will probably out live us all!  Hope you can rest a little easier now. frank

[JennyPenny]

His Viral Load is very low and that is also an indicator of cirrhosis - there aren't that many healther liver cells left to kill so the number remains very low.
.......................................

NYgirl, I think you got confused for a second. It's low liver enzymes when a person is endstage that may mean the liver does not have enough liver tissue to leak enzymes. Viral Load has nothing to do with cirrhosis. I have cirrhosis and my VL is 6.5 million.

[elisa840]

Talkin about IFN treatment and all the horrendous sidefeffects mentioned in literature...Although Its subjective but are there people who do not face any sideeffects or who tolerate it well?