It depends on what Doctor you talk to. Dr. Dieterich seems to think there is quite a bit of reversal. But I really wonder. I noticed that right after I was finished tx my Cholesterol went back to normal from 90 total to 175 total. It was normal for the first time in 15 years. Which was great. But my sonogram this time after being SVR was about the same as 2 years ago. But I wonder if the Dr. reading the sonogram really looks at it or just assumes it is the same as the last one. I really wonder about this because the first couple of sonograms were not that informative then when they asked me why I was having a sonogram and I told them HCV all of a sudden it was a lot worse with a lot of detail that i didn't have before. Now for the last 3 or 4 years they all seem to be the same. I really think they are not sure of whatthey are looking at unless they see some cancer or something really bad.
Stumbled on this
"A histological improvement in necroinflammatory activity, but not in fibrosis was observed in the follow-up biopsy performed 0.5–5.5 years (mean: 1.9 years, n = 51) after end-of-treatment. Among patients without SVR, there was more activity improvement in 6-MU group. The durability of SVR was 100% (18/18) and 97.8% (45/46) for 3-MU and 6-MU group, respectively, in a mean follow-up period of 6.81 years (5.25–9.18 years). For 163 baseline non-cirrhotic patients, 9 of 84 (10.7%) non-responders and 3 of 79 (3.8%) sustained responders progressed to cirrhosis during a mean follow-up period of 5.52 and 5.74 years, respectively (p = 0.067, Kaplan-Meier survival analysis, log-rank test). For all 200 patients, hepatocellular carcinoma was detected in 12 of 113 (10.6%) non-responders and one of 87 (1.1%) sustained responders during a mean follow-up period of 5.67 and 5.73 years, respectively (p < 0.01, Kaplan-Meier survival analysis, log-rank test)."
Here is a question that may go in the stupid column but, would the above data be applicable to me, a white Vt. male? We know african americans have a tougher time clearing hcv than other populations, so are there structural differences in liver makeups between different races people (I hope that is the proper word)? I confess I no nothing about liver transplants, or other organ transplants for that matter (hope mike will chime in here), I'm assuming blood types have to match. But, could an asian's liver be transplanted to an african american, vt. white male, or whatever, or visa versa, or are there structural differences that prevent this? Just curious, and wondering if data from one population can be blanketed over all populations....
.....gosh I can't wait to start back to work......booooooooored (g) pro
guess I found the answer to the first part of my question, actually took me awhile just to find this simple statement addressing the race issue.
"Generally, there are no restrictions on age, sex, or race. The only matching requirements for livers are that the donor and recipient must be about the same size and have compatible blood types."
As to the second part, is data from one population truly applicable to another, the search continues...;^)
I have not responded as far as viral load is concerned but my ALT and AST have come back to normal first time since 2005 after I stopped interferon and started herbal therapy. What does that mean about cure? My sonography was always normal.
Thanks mike, I think my question might have been so stupid, that amny sites, including the mayo clinics didn't even both mentioning race in the context of compatibilty....So on to another stupid question...How exactly does "liver regeneration" play into a reduction of liver fibrosis ? Is a reduction in fibrosis directly atributed to "liver regeneration" or is there something else at work, like a softening of the diseased tissue ?
I've read varying accounts of amount fibrosis score improved after svr, if any, and none were very earth shattering as I recall(peginterferon fda testimony mention less than 15% improvement and not in everybody). Yet, the speed of liver regeneration in both liver donor and recipient, especailly the donor is really pretty amazing...
"In living donor liver transplantation, the safety of the donor operation is the highest priority. The introduction of the right lobe graft was late because of concerns about donor safety. We investigated donor liver regeneration by the types of resected segments as well as recipients to assess that appropriate regeneration was occurring. Eighty-seven donors were classified into 3 groups: left lateral section donors, left lobe donors, and right lobe donors. Forty-seven adult recipients were classified as either left or right lobe grafted recipients. Volumetry was retrospectively performed at 1 week, 1, 2, 3, and 6 months, and 1 year after the operation. In the right lobe donor group, the remnant liver volume was 45.4%, and it rapidly increased to 68.9% at 1 month and 89.8% at 6 months. At 6 months, the regeneration ratios were almost the same in all donor groups. The recipient liver volume increased rapidly until 2 months, exceeding the standard liver volume, and then gradually decreased to 90% of the standard liver volume. Livers of the right lobe donor group regenerated fastest in the donor groups, and the recipient liver regenerated faster than the donor liver. Analyzing liver regeneration many times with a large number of donors enabled us to understand the normal liver regeneration pattern. Although the donor livers did not reach their initial volume, the donors showed normal liver function at 1 year. The donors have returned to their normal daily activities. Donor hepatectomy, even right hepatectomy, can be safely performed with accurate preoperative volumetry and careful decision-making concerning graft-type selection."
So is that to say that alcohol has no direct influence on Hep C? Once the virus is gone, it's gone! I have heard it said that "so and so's" hep c came back because they started partying too soon. I personally didn't see how that could happen.
Why would you think liver regeneration would occur after treatment when it takes years for the liver to become diseased. Think about that. You can expect regeneration in 24 wks, 48 wks, 72 wks even with the toxicity of the drugs? I don't buy that. SVR and time maybe regeneration will occur. The liver has to have a break. I agree the inflammation is reduced but complete recovery of the liver right after tx just doesn't happen. Two hepatologists have told me that.
It never left! Minute quantities of mutated virus remained and then started to replicate freely.
Relapse happens quickly sfter stopping medication.
Alcohol is bad with Hep C because it affecting a liver whih is already at war.
After SVR has occurred 24 weeks post therapy you can drink enough alcohol to finish off your already damaged liver but it wont bring the virus back.
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