Aa
Just Wondering
This question doesn" t really pertain to me,however I found this somewhat interesting and thought if some ,especially the ladies .were interested and would chime in.
Yesterday when I was getting my labs done I was sitting in the waiting room chatting with another lady that was in treatment.She was telling me that her Hepa had said to her that in his experience he found that premenopausal women(gee hope I spelled that right ladies) seemed to have a somewhat better success rate at treatment than post.He also mentioned he felt that overall women seem to have somewhat less degree of progression of fibrosis early.as the estrogen can sometimes have a protective property to the liver.
This is not,my Hepa however he is considered one of the leading Hepa"s at one of our large liver clinics in Canada.So what I thought some might find interesting . ,is this something that is a well known fact either buy study,or clinical practice or is this just one Hepa"s opinion and personal experience?
WILL
Yesterday when I was getting my labs done I was sitting in the waiting room chatting with another lady that was in treatment.She was telling me that her Hepa had said to her that in his experience he found that premenopausal women(gee hope I spelled that right ladies) seemed to have a somewhat better success rate at treatment than post.He also mentioned he felt that overall women seem to have somewhat less degree of progression of fibrosis early.as the estrogen can sometimes have a protective property to the liver.
This is not,my Hepa however he is considered one of the leading Hepa"s at one of our large liver clinics in Canada.So what I thought some might find interesting . ,is this something that is a well known fact either buy study,or clinical practice or is this just one Hepa"s opinion and personal experience?
WILL
So I wonder how this might relate to me, and I know im driving everyone crazt since ive not even been to the hepatologist yet and really dont know that much but ive had a full hysterectomy since April of 08'. But ive took a 1mg estrogen pill every single day since then. I dont know what you call me, I guess im one of those women that are menopausal and taking hormone replacement but ive never felt like I was in menopause cause im not, everything is just fine, lol, just fine!! Ive not been back to the dr. since the surgery, I hate doctors and dont go unless im dying. Maybe thats why all the questions, im trying to figure out if I need to go to the doctor, lol! No im kidding but I dont know how this would relate to me, like I said, ive took estrogen every day for 3yrs!
So this Hepa I mentioned seemed to know his stuff. Great info Hector,thanks for that .
WILL
The data is well known but more studies need to be done in this area to flush out the full scope of the issue.
Yes, menopause plays a significant role in determining the progression of fibrosis along with response to treatment.
Yes, women typical don't progressive to fibrosis and cirrhosis as men do.
Some notes of studies below expound on these issues:
---------------------------------------------------------------------------------------------------
Article From HCV Advocate From 2009 December 2009 HCV Advocate
http://hepatitiscnewdrugs.blogspot.com/2010/10/women-treating-and-living-with.html
HEALTWISE: Hepatitis C Update
Lucinda K. Porter, RN
"In the first study, Hepatitis C and Menopause:
Interplay of Age, Gender, HCV Replication and Activity in Progression and Consequence for Therapy, Trépo, Bailly, Moreno, Lemmers, Adler, and Pradat investigate the differences in fibrosis progression among HCV patients. Previous studies revealed the possibility that estrogen may have anti-fibrogenic effects, so researchers specifically looked at fibrosis development in the light of gender, age, and menopause.
They looked at 163 enrollees, ages 23 to 84 years with a mean age of 55; 56% were male. Slightly more than half (55%) had progression of fibrosis, measured by a METAVIR fibrosis score of at least F3. Overall, males had higher progression rates at 66% versus 41% for women. However, for those under the age of 50, fibrosis progression was 51% for males versus 11% for females. Over age 50, the rate jumps to 77% for males versus 61% for females.
These data show a strong relationship between gender and fibrosis progression. The researchers surmise that estrogen may have a protective benefit for younger women with HCV. They recommend the use of estrogen replacement therapy for menopausal women.
Another interesting discovery appeared in this study. In general, viral loads dropped with age except in the group of post-menopausal women. There was no explanation for this.
The second study examined similar issues. Early Loss of Exposure to Estrogens is Critical in Determining Entity of Fibrosis and Response to IFN in Women with Hepatitis C is the title of a poster presented by Karampatou, Pazienza, Lei, Di Leo, Francavilla, and Villa. After observing that post-menopausal women with HCV had increased progression of fibrosis, these researchers wondered whether the correlation was due to aging and/or longer durations of infection or to menopause.
They analyzed data from 945 HCV-treatment patients of evenly-distributed genotype—541 men and 404 women. In the female group, 252 were menopausal. Most of these were spontaneously menopausal although 50 were surgical. Body weight was lower in pre-menopausal women; however histological steatosis (fatty liver) was not significantly different between the two groups.
Pre-menopausal women had the highest response to HCV-therapy. The sustained virologic response (SVR) was 63% versus 51% of males and post-menopausal women. In short, post-menopausal women responded similarly to treatment as men did.
The researchers concluded that menopause plays a significant role in determining the progression of fibrosis along with response to treatment. Estrogens have a powerful role in the regulation of inflammation and immunity. They recommended that interferon-based therapy be initiated at the youngest possible age, preferably prior to menopause."
----------------------------------------------------------------------------------------------------------------
"HCV Progression & Symptoms in Women
Various studies have shown that hepatitis C progression is slower and liver damage tends to be less severe in women than in men. For one thing, it appears that women are more likely to completely clear HCV from their bodies after infection and never develop chronic disease. It is usually estimated that 80-85% of all people infected with HCV will go on to develop chronic hepatitis C, but the rate is lower for women. A German study of 1,018 young women infected with HCV in 1978-9 through contaminated immunoglobulin transfusions found that after 20 years, about 45% had cleared the virus. Researchers do not know why the HCV clearance rate is higher in women than men.
Women who do have chronic hepatitis C (that is, they still have HCV after six months) tend not to develop liver cirrhosis (scarring), liver cancer, or liver failure as rapidly as men. For all people with chronic HCV, disease progression is usually slow. A majority of people with chronic hepatitis C never develop serious liver damage. Among those who do, the process usually takes years or even decades; the usual estimate is 10-40 years, and may be longer for women. In the German study, only four of the 1,018 women had developed cirrhosis after 20 years. Some experts believe that the female hormone estrogen protects women from liver damage; if this is the case, the protective effect may diminish after menopause, as women’s bodies produce less of the hormone.
Many people with HCV have no symptoms and lead normal lives. Those who do develop symptoms may experience prolonged fatigue (tiredness), fever, headache, loss of appetite, nausea, pain in the abdomen, or pain in the muscles or joints. The types of symptoms are similar in women and men, but women may develop symptoms later or may experience more mild effects.
Several autoimmune conditions, in which the immune system attacks the body’s own tissue, are associated with HCV (for example, cryoglobulinemia, glomerulonephritis, and Sjogren’s syndrome). Because women in general are much more likely than men to have autoimmune conditions, it is not surprising that women with HCV seem to be at greater risk than HCV-infected men for developing these conditions. However, according to Norah Terrault, MD, MPH, of the University of California at San Francisco Division of Gastroenterology, while women with HCV may be more predisposed than men to autoimmune conditions, this does not necessarily mean that these conditions are directly associated with HCV; women may simply be more likely to have co-existing autoimmune conditions that may not be caused by HCV. More study is needed in this area."
Cheers!
Hectorsf
Yes, menopause plays a significant role in determining the progression of fibrosis along with response to treatment.
Yes, women typical don't progressive to fibrosis and cirrhosis as men do.
Some notes of studies below expound on these issues:
---------------------------------------------------------------------------------------------------
Article From HCV Advocate From 2009 December 2009 HCV Advocate
http://hepatitiscnewdrugs.blogspot.com/2010/10/women-treating-and-living-with.html
HEALTWISE: Hepatitis C Update
Lucinda K. Porter, RN
"In the first study, Hepatitis C and Menopause:
Interplay of Age, Gender, HCV Replication and Activity in Progression and Consequence for Therapy, Trépo, Bailly, Moreno, Lemmers, Adler, and Pradat investigate the differences in fibrosis progression among HCV patients. Previous studies revealed the possibility that estrogen may have anti-fibrogenic effects, so researchers specifically looked at fibrosis development in the light of gender, age, and menopause.
They looked at 163 enrollees, ages 23 to 84 years with a mean age of 55; 56% were male. Slightly more than half (55%) had progression of fibrosis, measured by a METAVIR fibrosis score of at least F3. Overall, males had higher progression rates at 66% versus 41% for women. However, for those under the age of 50, fibrosis progression was 51% for males versus 11% for females. Over age 50, the rate jumps to 77% for males versus 61% for females.
These data show a strong relationship between gender and fibrosis progression. The researchers surmise that estrogen may have a protective benefit for younger women with HCV. They recommend the use of estrogen replacement therapy for menopausal women.
Another interesting discovery appeared in this study. In general, viral loads dropped with age except in the group of post-menopausal women. There was no explanation for this.
The second study examined similar issues. Early Loss of Exposure to Estrogens is Critical in Determining Entity of Fibrosis and Response to IFN in Women with Hepatitis C is the title of a poster presented by Karampatou, Pazienza, Lei, Di Leo, Francavilla, and Villa. After observing that post-menopausal women with HCV had increased progression of fibrosis, these researchers wondered whether the correlation was due to aging and/or longer durations of infection or to menopause.
They analyzed data from 945 HCV-treatment patients of evenly-distributed genotype—541 men and 404 women. In the female group, 252 were menopausal. Most of these were spontaneously menopausal although 50 were surgical. Body weight was lower in pre-menopausal women; however histological steatosis (fatty liver) was not significantly different between the two groups.
Pre-menopausal women had the highest response to HCV-therapy. The sustained virologic response (SVR) was 63% versus 51% of males and post-menopausal women. In short, post-menopausal women responded similarly to treatment as men did.
The researchers concluded that menopause plays a significant role in determining the progression of fibrosis along with response to treatment. Estrogens have a powerful role in the regulation of inflammation and immunity. They recommended that interferon-based therapy be initiated at the youngest possible age, preferably prior to menopause."
----------------------------------------------------------------------------------------------------------------
"HCV Progression & Symptoms in Women
Various studies have shown that hepatitis C progression is slower and liver damage tends to be less severe in women than in men. For one thing, it appears that women are more likely to completely clear HCV from their bodies after infection and never develop chronic disease. It is usually estimated that 80-85% of all people infected with HCV will go on to develop chronic hepatitis C, but the rate is lower for women. A German study of 1,018 young women infected with HCV in 1978-9 through contaminated immunoglobulin transfusions found that after 20 years, about 45% had cleared the virus. Researchers do not know why the HCV clearance rate is higher in women than men.
Women who do have chronic hepatitis C (that is, they still have HCV after six months) tend not to develop liver cirrhosis (scarring), liver cancer, or liver failure as rapidly as men. For all people with chronic HCV, disease progression is usually slow. A majority of people with chronic hepatitis C never develop serious liver damage. Among those who do, the process usually takes years or even decades; the usual estimate is 10-40 years, and may be longer for women. In the German study, only four of the 1,018 women had developed cirrhosis after 20 years. Some experts believe that the female hormone estrogen protects women from liver damage; if this is the case, the protective effect may diminish after menopause, as women’s bodies produce less of the hormone.
Many people with HCV have no symptoms and lead normal lives. Those who do develop symptoms may experience prolonged fatigue (tiredness), fever, headache, loss of appetite, nausea, pain in the abdomen, or pain in the muscles or joints. The types of symptoms are similar in women and men, but women may develop symptoms later or may experience more mild effects.
Several autoimmune conditions, in which the immune system attacks the body’s own tissue, are associated with HCV (for example, cryoglobulinemia, glomerulonephritis, and Sjogren’s syndrome). Because women in general are much more likely than men to have autoimmune conditions, it is not surprising that women with HCV seem to be at greater risk than HCV-infected men for developing these conditions. However, according to Norah Terrault, MD, MPH, of the University of California at San Francisco Division of Gastroenterology, while women with HCV may be more predisposed than men to autoimmune conditions, this does not necessarily mean that these conditions are directly associated with HCV; women may simply be more likely to have co-existing autoimmune conditions that may not be caused by HCV. More study is needed in this area."
Cheers!
Hectorsf
Yes, I believe that being postmenopausal is actually one of those strikes against us going into treatment (as far as attaining SVR). It didn't stop me though. :)
Yes on the premenopausal women having better success clearing - you can google the studies that have been done (although I don't recall if they gave any % #'s) - haven't heard anything about progression but have heard that estrogen helps keep cholesterol #'s good and that occurs in the liver, so maybe?
I heard doctor Drew (yes a very reliable source *cough*) saying on Celebrity Rehab (yes I watch brainy tv) that women that drank generally had more liver damage/fibrosis than men because their stomachs dont have some chemical that helps it break down.
I bring that up because as many folks didn't know they were infected and continued to drink it seems to me (an obvious lay person) - that someone with Hepc in this case would be worse off than a man, so I assumed anyways.
I haven't read anything about the most of it though. Just my two cents and Dr. Drews questionable input but it came to my mind.
I bring that up because as many folks didn't know they were infected and continued to drink it seems to me (an obvious lay person) - that someone with Hepc in this case would be worse off than a man, so I assumed anyways.
I haven't read anything about the most of it though. Just my two cents and Dr. Drews questionable input but it came to my mind.
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