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Treatment
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Treatment

Do you have to have treatment if your liver is ok? if you never develop symptoms? Is that even possible?  I have 1a and it seems that it is not treatable or without success.  I recently had some blood work at Mayo and was diagnosed last summer.  I had many questions but only had a short time with the hepatologist.
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Avatar_m_tn
A couple things. While just having bloodwork can give a Hepatologist  a ideal if maybe one might have cirrhosis it doesn't tell them what stage you might be. If one is going to treat anyway a lot of doctors are not doing biopsy's but if one is not going to treat now then a biopsy should be done. Hep C is known as the "silent killer" because one doesn't really have symptoms until the liver is pretty much shot. As for success, the cure rate even for type 1a has never been better and with shorter treatment time.

Also keep in mind Hep C can cause other problems besides ones liver. Good luck to you.
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Avatar_m_tn
I was 1a and I treated successfully in 7 months.  That was a few years back.  Now, I think you can go through treatment in as few as 3 months.

My liver was ok too.  But now, I have it knocked out, and don't have to worry about it anymore.  I also had relatively few side effects during treatment.  They always tell you to expect the worst and people don't usually post to online forums unless things are going wrong.

You don't have to have treatment.  You don't have to do anything.  But it is a good idea.  It may save you some major health issues in the future.

My doctor said it wasn't urgent that I get treatment right away.  You may be in a similar situation.  I'm really glad that I did.  You'll be glad too.
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Avatar_m_tn
You don't have to have treatment . My liver enzymes are always fine, BUT there is NEW EASIER TREATMENT , that doesn't require all the needles & daily treatment. The problem is you don't want to wake up needing a liver transplant, people still pass away from this disease just like Aids. Obviously you should get treatment even if your in " remission". Good Luck! BTW I've had it for close to 10 yrs. enzymes ALWAYS good I'm lucky. I haven't had treatment yet either because of time & no car.
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1747881_tn?1358189534
What are the signs and symptoms of chronic HCV infection?

Most persons with chronic HCV infection are asymptomatic. However, many have chronic liver disease, which can range from mild to severe, including cirrhosis and liver cancer. Chronic liver disease in HCV-infected persons is usually insidious, progressing slowly without any signs or symptoms for several decades. In fact, HCV infection is often not recognized until asymptomatic persons are identified as HCV-positive when screened for blood donation or when elevated alanine aminotransferase (ALT, a liver enzyme) levels are detected during routine examinations.

Can a patient have a normal liver enzyme (e.g., ALT) level and still have chronic Hepatitis C?

Yes. It is common for patients with chronic Hepatitis C to have liver enzyme levels that go up and down, with periodic returns to normal or near normal levels. Liver enzyme levels can remain normal for over a year despite chronic liver disease.

What is the treatment for chronic Hepatitis C?

Until recently, the mainstay of treatment for chronic hepatitis C virus (HCV) infection has been pegylated interferon and ribavirin, with possible addition of boceprevir (Victrelis™) and telaprevir (Incivek™) (both protease inhibitors) for HCV genotype 1 infection.  After given for 24-48 weeks, this treatment resulted in a sustained virologic response (a marker for cure), defined as undetectable HCV RNA in the patient's blood 24 weeks after the end of treatment in 50%–80% of patients (with higher SVR among persons with HCV genotypes 2 or 3 infections versus infections with HCV genotype 1, the most common genotype found in the United States).

In late 2013, The Food and Drug Administration approved two new direct acting antiviral drugs, Sofosbuvir (Sovaldi™) and Simeprevir (Olysio™) to treat chronic HCV infection.  Both medications have proven efficacy when used as a component of a combination antiviral regimen to treat HCV-infected adults with compensated liver disease, cirrhosis, HIV co-infection, and hepatocellular carcinoma awaiting liver transplant. Clinical trials have shown that these new medications achieve SVR in 80%-95% of patients after 12-24 weeks of treatment.

Does chronic Hepatitis C affect only the liver?

A small percentage of persons with chronic HCV infection develop medical conditions due to Hepatitis C that are not limited to the liver. These conditions are thought to be attributable to the body's immune response to HCV infection. Such conditions can include

    Diabetes mellitus, which occurs three times more frequently in HCV-infected persons
    Glomerulonephritis, a type of kidney disease caused by inflammation of the kidney
    Essential mixed cryoglobulinemia, a condition involving the presence of abnormal proteins in the blood
    Porphyria cutanea tarda, an abnormality in heme production that causes skin fragility and blistering
    Non-Hodgkins lymphoma, which might occur somewhat more frequently in HCV-infected persons

http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm#c5
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1747881_tn?1358189534
My liver enzymes were barely out of range when I was diagnosed with late stage 3 fibrosis/borderline cirrhosis, so as you can LFT"s are NOT a good indicator of liver damage

Have a great day
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Avatar_m_tn
Seriously consider NOT doing treatment but changing lifestyle
I was like you and had a perfect liver after having Hep C for 12 years

9 years later my life is still miserable because of the treatment ------ It is a total crap shoot as to how you will react and whether or not it will cure 1A genotype and whether or not the treatment will screw you up worse

They are improving the treatments but it is going to be a few years more before it will be ready. I was told this by my doctors. They told me since neither TX worked for me that I need to wait 5 years for them to work the kinks out of the new stuff before I give it a go (of which I am scared senseless of doing treatment again)

I wished I had never done the treatment ---- I quit drinking right when I was diagnosed and my liver is still in pretty much the same condition as it was when I was first diagnosed but my life is a daily struggle
They can monitor your levels and every 5 years get a liver biopsy

Research more on the problems associated with the treatment and how many people are really screwed up long term before making a decision-----

Just relating how it effected me ---- there are lots of success stories and lots of horror stories --- look at both sides because you wont know until it's too late of which you could be
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1747881_tn?1358189534
":They are improving the treatments but it is going to be a few years more before it will be ready. I was told this by my doctors"

2 non interferon treatments (Abbvie, Gilead) are currently awaiting approval from the FDA and should be approved by the end of the year

February 19, 2014

Gilead Files for FDA Approval of Fixed-Dose Sovaldi/Ledipasvir

http://www.hepmag.com/articles/gilead_fixed_dose_sovaldi_ledipasvir_2501_11455.shtml

AbbVie says it could beat Gilead to huge market for hep C drugs
Both counting on sales of new therapy

http://www.fiercepharma.com/story/abbvie-says-it-could-beat-gilead-huge-market-hep-c-drugs/2013-06-14
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Avatar_m_tn
":They are improving the treatments but it is going to be a few years more before it will be ready. I was told this by my doctors"

I was a non responder to Interferon and Peg combo treatments
Why they told me to wait so that the new treatments can be tweeked or I would have about a 35% chance of success

The only scary part is "AbbVie says it could beat Gilead to huge market for hep C drugs Both counting on sales of new therapy"
I only pray that they don't rush things just for profits ---- there is a market that needs to be helped not taken advantage of

I only hope that the new treatments have a higher SVR rate for everyone and less side effects
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163305_tn?1333672171
IF your liver is healthy, you may decide to delay treatment.
Be aware that about the worst thing anyone with hep C can do is drink alcohol.
Alcohol increases replication of the virus.

Many of us are symptom free but that doesn't mean our livers are healthy, Often symptoms don't appear until advanced cirrhosis sets in. That's what happened to me and I did land up needing a liver transplant.

The health of your liver is paramount.
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1747881_tn?1358189534
AbbVie Oral Regimen Cures Nearly All GT1 Hepatitis C, Phase 3 Trials Now Done

AbbVie announced this week that it has completed Phase 3 clinical trials of its interferon-free regimen containing 3 direct-acting antivirals, with or without ribavirin, for the treatment of chronic hepatitis C. Across all studies, between 90% and 100% of participants achieved sustained virological response, usually with 12 weeks of therapy, including hard-to-treat patient groups such as people with HCV subtype 1a and liver cirrhosis.

AbbVie previously announced findings from the SAPPHIRE-I and SAPPHIRE-II trials, which both produced 96% overall sustained response rates at 12 weeks post-treatment (SVR12) using a 4-drug regimen consisting of the HCV protease inhibitor ABT-450, the NS5A inhibitor ABT-267, the non-nucleoside polymerase inhibitor ABT-333, and ribavirin

Since then, the PEARL-II, -III, and -IV trials have shown that a 3-drug regimen without ribavirin for 12 weeks cures 99%-100% of patients with HCV subtype 1b, but adding ribavirin is more effective for those with harder-to-treat subtype 1a. The TURQUOISE-II study showed that the quadruple regimen for 12 or 24 weeks cures most people with compensated liver cirrhosis.

AbbVie plans to submit data from these trials to the U.S. Food and Drug Administration in the second quarter of 2014, putting the designated "breakthrough therapy" on track for approval by the end of the year.

http://hivandhepatitis.com/hcv-treatment/experimental-hcv-drugs/4507-abbvie-all-oral-regimen-cures-nearly-all-gt1-hepatitis-c-phase-3-trials-now-complete
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1747881_tn?1358189534
The ION-2 study evaluated 440 treatment-experienced genotype 1 HCV patients who had failed past therapy with regimens containing Peg-IFN (including Peg-IFN plus a protease inhibitor). Patients received SOF/LDV with or without RBV for 12 or 24 weeks.

ION-2
GT 1 treatment-experienced
SOF/LDV+RBV - Duration 12 weeks - SVR rate - 96.4% (107/111)

SOF/LDV - Duration 24 weeks - SVR rate - 99.1% (108/109)

http://www.hivandhepatitis.com/hcv-treatment/experimental-hcv-drugs/4456-sofosbuvirledipasvir-coformulation-cures-more-than-90-of-genotype-1-hepatitis-c
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