Moderate Fibrosis, Genotype 4

[omyst]

I posted earlier in regards to ALT levels that went from being normal long term, to 240 to 300 to 500 then the most recent at 241 in the last four months.

I had a biopsy about two weeks ago that showed I now have moderate fibrosis ( stage 2 ) and with moderate inflammation ( 3's all the way around ). My last biopsy was now about six years ago, then I had 0 fibrosis with mild inflammation. This is a fairly rapid progression in six years from what I have read. I

[omyst]

Thanks Judi

It really helps to hear positive posts like yours. One issue I have is that my insurance co. will cut me off at 12 weeks if I have not responded. So I will insist on higher dose ribavirin. I don't think I can afford the treatment otherwise. Your right this is a great place, I'm lucky to have found it.

I wish you well Judi

[hepcgetlost]

Hi Omyst...
I too am a genotype 4 (also known as "The African genotype" because it's common in Central Africa and parts of the Middle East. Congratulations on choosing treatment...I agree with Dirac, you do have a better chance of clearing than previously thought. I am on week 68 of 72. I didn't clear at week 12, but did clear at week 19. So far so good. Do make sure that you take the highest dose of ribavirin possible based on your weight. My doctor originally put me on 800 mg.  I'm convinced that's why I wasn't an early responder. After several weeks of nagging and sending him study results, he finally relented and increased my riba to 1000 (I agreed with him that 1200 was out of the question, since I'm fairly small and thin). Attitude is everything, so stay positive. Try to surround yourself with positive stable people. Keep coming back here and you'll find lots of support, good information and good friends to help you through. I wish you good luck and will be looking for your posts to see how you're doing. Judi

[Tallblonde]

There's always the possibility that your first biopsy results weren't accurate.  Biopsies may be the "gold standard," but they're still not 100 percent reliable.  Perhaps you were really a Stage 1, rather than a Stage 0.  That would be a more plausible explanation for the jump to Stage 2 in such a short period of time.

Not that any of this speculation makes any difference, at this point.  I'm sorry it worked out this way for you.  But the good news is, you'll now have a chance to put HCV out of your life once and for all.  That's the good thing about treatment, versus waiting.  

Good luck.

Susan

[omyst]

Tallblonde:
I did take Milk Thistle, however I developed a large rash everytime I took the recommended dose. So I went on a low doseage. I guess I wasn't getting a threshold amount. I ate mostly Organic food from 2001.

Dirac thanks and glad your SVR, did you have any side effects with the high dose ribavirine? Were you able to work during tx?

Cuteus: I think your right on the age factor, I had no fibrosis for 20 years then all the way to stage 2 from 49 to 55. My guess I would be stage 3 in two years or so. Not enough time for me to hold out for protease inhibitors.

[cuteus]

hepcgetlost/Judi, is geno 4 and in her last stretch of 72 wks tx. She might check back later this week.
That is quite a rapid progression statistically speaking, but that is the problem with statistics, you never can tell which % you will be. some studies do show a faster progression the older we get. and females dwindling hormone levels play a negative factor also.
tx is crappy, but ESLD is worse and tx is temporary.

[omyst]

Thanks Susan

This has always been in the back of my mind but no matter how it shakes out I will try to keep a positive perspective.

Take Care

[Dirac]

The side effects in my case were minimal and I did not miss one day of work during treatment. Good luck.

[Dirac]

Please read the following article:
http://www.hivandhepatitis.com/hep_c/news/011703b.html
The important point for you is this:

Although genotype 4 HCV patients, like those infected with genotype 1, need to be treated aggressively for optimal response, they seem to be able achieve SVRs similar to the very high SVR reported for patients with genotype 2/3 infection (Hadziyannis SJ et al. EASL 2002; Shiffman ML et al. AASLD 2002).
Therefore, it may no longer be appropriate to categorize infection with HCV genotype 4 as a 'difficult-to-treat' disease.

As you can see with genotype 4 you can achieve a high rate
of SVR.
Another article for genotype 4:
http://www.pslgroup.com/dg/222676.htm

I was a genotype 4 and I am a year and half post treatment and I am already an SVR. The only thing I want to advise you with is to ask your doctor to give you the highest dose possible of ribavirine. I read this in another article for our genotype. My doctor gave me 1200 of ribavirine every day for 48 weeks along of course with the peg-intron.

I wish you the best of luck.  
Dirac

[Tallblonde]

I'm sorry to hear that your HCV has progressed.  If I were in your shoes, I'd be signing up for treatment, too.  I don't know much about Genotype 4, but I'm sure someone will come along shortly who can be more helpful in that regard.

I do have a question for you.  Have you been doing anything during the past six years to attempt to slow down the progression?  Most of us non-treaters are taking Milk Thistle and other herbs and supplements.  It too early in the game for me to fully know their impact, so that's why I'm curious about whether or not you tried some of these things.

Best wishes to you as you prepare to make some tough decisions.  

Susan