What about the liver — can it recover after a person is cured of hepatitis C?

[Rockerforlife]

Yes — we’ve found that, by the time a person successfully completes treatment, the amount of scarring in the liver usually has regressed. We measure liver scarring in stages, with four stages between 0 (no scarring) and 4 (cirrhosis/advanced scarring). A patient who successfully completes the interferon/ribavirin treatment typically improves by one or two stages during the course of treatment. Once cure has occurred, the hope is that the liver has the potential to return to completely normal, which we believe may happen in a majority of patients. Even in people with pretty severe cirrhosis, if the medications cure the hepatitis C, our experience shows that the liver scarring improves and the risk of liver failure is reduced.

http://www.providence.org/oregon/health_resource_centers/hepatitisc/faqc.htm

[Rockerforlife]

only about 5 percent of all people with hepatitis C develop cirrhosis complications.


http://www.providence.org/oregon/health_resource_centers/hepatitisc/faqc.htm

[proud48]

Thanks,
That is very great news and encouraging.
I just pray I'll still be SVR next month.
proud48

[Rockerforlife]

if you are SVR for 5 months now....as i percieve your predicament....you are home free...95% cured....

[Rockerforlife]

make that 99%

[Rockerforlife]

9999999.9%

[lalapple]

my doc said something like tx can help heal the liver even if tx isn't successful that's an advantage to start txing

[lalapple]

but of course we always hope for successful tx and SVR

[Rockerforlife]

but in some cases tx does not help the liver...it can damage it more...but for the most part..it helps...this monster is insidious....meaning evil...sneaky   and out right made by the devil himself...its got a mind of its own...

[lalapple]

are you talking about when it mutates?  and becomes resistant if tx is unsuccessful?  

[CoWriter]

"How do you define “cure”?
If the level of virus in a person’s system is undetectable by the time treatment has been completed, we consider that person cured."

He's talking about the EOT being "cure" and that's not true.

Co

[zazza]

According to the Swedish site "internetmedicin.se", 20% of chronic hep C patients develop cirrhosis within 20-30 years. Of these cirrhosis patients 1-4% annually develop HCC.

[zazza]

The above post should read:

20% of chronic hep C patients develop cirrhosis within 10-20 years.

[geterdone]

There is NO cure for Hepatitis C only the submission of the virus only to that of below  detectable levels. The antibodies or left over carnage of the remnants will always be there in your system. There is no real cure as know as complete eradication.

jasper

[zazza]

You must have misinterpreted your link. Here is what it says:

"What are my chances of developing cirrhosis or other complications?
Only about 20 percent of people with hepatitis C develop cirrhosis of the liver, and of those, only about one in four develops complications from cirrhosis. So overall, only about 5 percent of all people with hepatitis C develop cirrhosis complications."

[mikesimon]

What did you think about the statement in the subject article that 50% to 60% of genotype 1's achieve SVR? I haven't seen that number before.
Mike

[zazza]

Neither have I. But considering what CoWriter pointed out above, maybe we shouldn't be so surprised.

By the way, I AM getting a 1 year post PCR. I didn't know they offered that at my clinic.

Hope all is well with you, my friend,
Za

[mikesimon]

I'm well Za and thanks you for asking.
I know your one year results will be great - UND - but I always get a little apprehensive when my fax starts rolling. I get tested every month and I still get like that.
Have a Merry Christmas and a healthy and happy New Year.
Mike

[Rockerforlife]

YOU ASKED:
are you talking about when it mutates?  and becomes resistant if tx is unsuccessful?  

no...because they can catch mutation as its happens by the weekly blood tests and stop tx ...im talkn about the tx drugs actuly doing damage to the liver,i have read this in study papers on the net...very rare tho...but i guess it happens...anyone else got some info on this...JIMBO?...you ?

[CoWriter]

"A patient who successfully completes the interferon/ribavirin treatment typically improves by one or two stages during the course of treatment. Once cure has occurred, the hope is that the liver has the potential to return to completely normal, which we believe may happen in a majority of patients. Even in people with pretty severe cirrhosis, if the medications cure the hepatitis C, our experience shows that the liver scarring improves and the risk of liver failure is reduced."


You know Rocker, this sounds like an add for their clinic.  Because what he's saying is not true.  Here's a study that showed that on patients with cirrhosis (stage 4) who obtained SVR, the damage was improved in 46% of patients.

25% improved by one stage and 13% improved by two stages (and 8% improved by three stages).

And on patients with bridging fibrosis (stage 3) who obtained SVR, the damage improved in 36%.

20% improved by one stage and 16% improved by two stages.

So what he's saying is not even close to reality.

Co


(from 43rd Annual Meeting of the European Association for the Study of the Liver, April 2008, Milan, Italy)......

SUSTAINED VIROLOGICAL RESPONSE IS ASSOCIATED WITH REVERSIBILITY OF CIRRHOSIS IN CHRONIC HEPATITIS C PATIENTS

A.C. Cardoso1, R. Moucari1, N. Giuily1, C. Figueiredo-Mendes1, N. Boyer1, M.P. Ripault1, C. Castelnau1, T. Asselah1, M. Martinot-Peignoux2, S. Maylin2, P. Bedossa3, P. Marcellin1
1 Service d Hepatologie et INSERM U773-CRB3, 2 Service de Microbiologie, 3 Anatomie Pathologique, Hôpital Beaujon, Clichy, France

Background and Aim: The reversibility of cirrhosis in chronic hepatitis C (CHC) patients who achieved sustained virological response (SVR) is controversial. The aim of this study was to assess the histological outcome of CHC patients with bridging fibrosis or cirrhosis following antiviral therapy.

Patients and Methods: 123 consecutive patients with CHC and bridging fibrosis or cirrhosis were retrospectively evaluated. They had all received at least one treatment course with interferon (conventional or pegylated) with or without ribavirin for at least 12 weeks. SVR was defined as undetectable serum HCV RNA 24 weeks after treatment discontinuation. Paired-liver biopsies obtained within a median interval of 4 years (1-17) were assessed by the same pathologist (PB) using the METAVIR Score.

Results:

Baseline characteristics of patients were: male gender (71%), mean age (55±9 years), mean BMI (25±4 kg/m2), mean serum HCV RNA level 5.7±0.6 log10IU/ml, HCV genotype 1 (66%), 2 (7%), 3 (11%), 4 (15%).

Fifty-five patients (45%) had cirrhosis (F4), and 68 (55%) bridging fibrosis (F3).

Among the 55 patients with cirrhosis, SVR developed in 24 patients (44%) and was associated with REGRESSION OF CIRRHOSIS in 11 patients (46%).

Liver histology showed a regression by one, two and three points according to METAVIR score in six (25%), three (13%), and two (8%) patients respectively.

By contrast, regression of cirrhosis was observed in only 5 patients among the 31 patients without SVR (16%), by one and two points in 4 (13%) and 1 (3%) patients respectively (p < 0.01).

Among the 63 patients with bridging fibrosis, SVR developed in 25 patients (40%) and was associated with REGRESSION OF FIBROSIS in 9 patients (36%), by one and two points in 5 (20%) and 4 (16%) patients respectively.

Progression to cirrhosis was observed in 8 patients (32%) despite SVR. By contrast, among the 38 patients without SVR, only 6 patients (16%) showed a regression of fibrosis by one point, whereas 24 patients (63%) showed progression to cirrhosis (p < 0.01).

Conclusion: CHC patients with bridging fibrosis or cirrhosis, SVR is associated with regression of fibrosis and reversibility of cirrhosis. NR is associated with progression of fibrosis and development of cirrhosis.

In patients with bridging fibrosis or cirrhosis treated with interferon alpha-based antiviral therapy, amelioration of liver fibrosis occurred significantly more frequently among those who attained SVR than among those who did not.

[Rockerforlife]

I agree...it does sound a little intense that the liver would go back 2 stages just while on tx alone....good catch....BUT....maybe the odd case it does happen.

[smaug48]

Thanks for posting that study.  I was surprised by:

"Progression to cirrhosis was observed in 8 patients (32%) despite SVR."

Alcoholics maybe?  I wish there was some explanation about that statistic.

smaug

[ejoli]

Yeah, I'm one of the ones that tx didn't help my liver...accually made it worse.   I txed in '06 and my biopsy just before tx was stage 3 grade 4. I relapsed in '07 at three months eot.  My biopsy in May '08 was stage 4 grade 3. And I was on tx for 48 weeks of that time. My liver enzymes never went down during tx (they accually went up) even though I was undetectable from 12 weeks on.    I'm going to try it again though...what choice do I have.         -Libby

[zazza]

"Progression to cirrhosis was observed in 8 patients (32%) despite SVR."

Or a reason why not to wait until stage 3 to treat.

[Rockerforlife]

My doc says treat at stage 2,at the latest if you decide to wait

[zazza]

The new Swedish consensus which was published December 10, 2008 by The Food and Drug Administration of Sweden recommends treating if biopsy shows stage 2 or greater. If biopsy shows stage 0 or 1 but the grade of inflammation is 2 or greater, tx is recommended since progression rate is not linear.

[Rockerforlife]

awwww...i was bang on

[ejoli]

Yeah, that's great if you have been dianosed by then.(Stage 2)   I wasn't dianosed till I was stage 3 grade 4 in '06    I txed right away but relapsed.   Now I'm stage 4 grade 3.
I accually know alot of people that weren't dianosed till they were pretty far along. They just weren't symptomatic.  I 'm hoping to get in a trial and will find out the 1st of Jan.
                                                                             -Libby

[zazza]

So true, Libby. You have done all you could. The point is not to wait IF you know.

Maybe screening for hep C at health controls would be a good idea?