Reversibility of Hepatic Fibrosis and Cirrhosis--Is it all Hype?

[mikesimon]

"Now that the idea that hepatic fibrosis is reversible is taking root, many clinicians are beginning to ask why, if fibrosis is reversible, is there so little progress in the clinical setting, and will patients ever really benefit from antifibrotic therapies? Underlying such questions is a subtle cynicism that the reversibility of fibrosis and cirrhosis has been overhyped

[GrandOak]

I read somewhere the same information, but I don't know the "second" regenerating organ. Is it skin?

I think so, but there could be another internal one, I'm not sure at the moment.

How are you doing?

Hanging in there and in the monitoring stage of the diabetes which I've developed post-tx.  Sounds like pills are out as treatment for that given abnormal LFT's as a result of HCV still hanging around.


Do you have a direction for your future treatments?

I'm not sure, I've been told there are no other options besides waiting for new meds and seeing if they might provide another chance at treating.  Sounds like specialists here are not in favor of multiple tx attempts.  So in the meantime I'm getting regular AFP and  ultrasound tests.  Although I'm now scheduled for an endoscopy and MRI in a couple of weeks to consider whether banding is necessary and to get a more precise view of liver than ultrasound provides.

I am looking into an Infergen trial just starting for patients who showed some response during tx but did not clear.  Sounds like the Mayo here in MN may be a trial site and I'm looking to get contact information for it. Here's the trial link:

http://www.clinicaltrials.gov/ct/show/NCT00456248?order=7

Did you consider a maintenance therapy?

I was told that maintenance was not an option either.  Perhaps something to due with the fact that my ANC and Hgb battles were areas I got hit hardest with during tx.  It's not really clear.

Other than that I get pushing in and pressing on taking it one day at a time.

[mikesimon]

I wasn't asking the question - that is the title of the article. The author states: "Ample evidence that fibrosis regresses with control of hepatitis B, hepatitis C, or other chronic liver diseases". Mike

[willows]

I do not believe it is hype at all, for two reasons.  The University of Washington is doing the HALT - C trial and has extended the trial, which is low dose maintenance and how much fibrosis is reversed.  Now, whether the damage of cirhossis can be reveresed, I do not know.  But my doc is from the University of Washington and has expressed to me that they are having good results from the trial.  

Whether or not a person's liver is in a stage that would warrant the treatment of low dose is another decision.  My doc wanted to wait until the trials were finished, but I have a liver bx next Wednesday (and I am really looking forward to that, let me tell you), and when we get results, he has given me some options.  Wait for teleprevir, which he is very excited about, try retreating again with the whole nine yards of poison, or try maintenance to keep me in the best shape possible for the FDA approval of teleprevir.  

We had Miles Keaton post here about 6 months ago, he is an author and big HCV advocate, a sufferer himself and after about two years of trying double dose IFN, Zadaxin and some other rat poisons, he posted here, in a stunned state, that his newest biopsy showed he had regressed two stages.  

So, no I do not think it is hype, but still such a new idea with no proven results yet, that I think it is an individual issue.  Soon, I think it will be accepted as fact, but then, to do low dose IFN for a year or two, who among us can even accept the idea?  Two years of IFN?  At best, I think it will become a stopgap measure for someone like me to keep from going into stage 4 until teleprevir or some other PI to be approved.  At least I hope so!

Willow wants maintenance

[Tallahassee]

GO:  "I don't have the studies at my fingertips, but I recall reading something on reversibility on Fibrosis being observed due to the live being one of two organs with ability to regenerate."
------------------------------------------------------------

I read somewhere the same information, but I don't know the "second" regenerating organ.  Is it skin?

How are you doing?
Do you have a direction for your future treatments?

Did you consider a maintenance therapy?

Be well

[GrandOak]

I have heard of cases were Fibrosis damage was reveresed and claims that even Cirrhosis damage was repaired, albeit the claims of the latter are almost nil when compared to those of the former.

I don't have the studies at my fingertips, but I recall reading something on reversibility on Fibrosis being observed due to the live being one of two organs with ability to regenerate.

Many medical professionals I've talked with seem to have differing opinions when Fibrosis is discussed with some believing it can go into remission and others that the damage can be reversed.

However, all have been consistent on Cirrhosis and doubt even the claim of it going into full remission.  Slowed perhaps to the degree that HCC does not develop prior to the patient passing on from other causes.  But none have noted or seen documentation on absolutely no advancement.

[r4c7]

I understand capase inhibitors are currently in early clinical trials and have shown some beneficial effect on hepatic fibrosis.  The other, perhaps more promising therapy, is gene therapy, which just might turn out to be the ultimate long-term remedy for treating hepatitis c as a whole.

But for now, the name-of-the-game is to try and get cured by the current FDA approved drugs, and give your liver a well-deserved break in the process.