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Will treatment work if early stages of cirrossis
Will be treating in 2012 will do biopsy if I have cirrosis early will treatment work ? Will cirrossis progress ?
The reason for my concern is this on:
October, 2010 f1-f2 38,
May 2011 f-2 49,
Nov 2011 f-3 58
Joy5116
October, 2010 f1-f2 38,
May 2011 f-2 49,
Nov 2011 f-3 58
Joy5116
Hector this is for you...I'm scheduled to begin a clinical trial Tuesday. The fibroscan came back 58, F-3, necessitating a biopsy (last week) of which I've not seen the results. They did however tell me after the biopsy that I was accepted into the Quantum study. My concern is if I get a placebo for 6 months at f-3 I may be cutting it too close. At this point I wouldn't want to lose time, however if I Hectordraw the right straw I could potentially clear the virus and begin to heal. I've been wondering what you think about this?
Thanks,
Joy5116
Thanks,
Joy5116
I have cirrhosis with non bleeding esophageal varices and am treating: because of anemia and rash (the former was life draining) I was taken off of Incivek at 9 weeks as opposed to 12 as well as having my ribo cut down by a third......Still: I was an early responder and undetectable at 4, 8, and 12 weeks so even with the necessary adjustments my immediate response(s) could not be more positive. I will remain on the rico and interferon for the full 48. I'm also able to work full time, attend to my children, and I'm back on stage at night resurrecting my musical career (after a 3 month Incivek retirement). Go for it! d
--ONLY if you have cirrhosis, then, as I suggested a hepatologist at a transplant center is appropriate. When a person becomes cirrhotic, it is a very different stage of liver disease then the previous stages of liver disease--
_______________________
I wanted to highlight this comment for anyone who might see this thread. In my reading and experience, it seems that many if not most who treat infectious hepatitis are gastroenterologists. When the condition of the liver becomes the primary concern, then it is the hepatologist who takes center stage. As my gastro who is the PI at our research site and won a prestigious award this year at AASLD for her work with both Hep B and C would exemplify; a gastroenterologist is usually the first go to after the PCP. There are gastroenterologists who don't specialize in HepC. I was actually referred by one specializing in upper GI to another who specialized in HepC treatment. Also, many of these people can make a pretty good prediction from the physical whether you are cirrhotic or not. Of course, the biopsy is definitive but a physical from a good gastro/hep person yielding a comment that the liver seems ok should give you some comfort while waiting for other tests.
_______________________
I wanted to highlight this comment for anyone who might see this thread. In my reading and experience, it seems that many if not most who treat infectious hepatitis are gastroenterologists. When the condition of the liver becomes the primary concern, then it is the hepatologist who takes center stage. As my gastro who is the PI at our research site and won a prestigious award this year at AASLD for her work with both Hep B and C would exemplify; a gastroenterologist is usually the first go to after the PCP. There are gastroenterologists who don't specialize in HepC. I was actually referred by one specializing in upper GI to another who specialized in HepC treatment. Also, many of these people can make a pretty good prediction from the physical whether you are cirrhotic or not. Of course, the biopsy is definitive but a physical from a good gastro/hep person yielding a comment that the liver seems ok should give you some comfort while waiting for other tests.
Hope this helps now that I have more info about your liver disease.
"Can my specialist have an idea with all their prior lab work"?
- Yes. If you have had an ultrasound, CT scan or MRI the report would indicate that your liver is nodular due to the scaring of the liver if you had cirrhosis. This is a definitive indication of cirrhosis and then needs to be confirmed via biopsy.
Also one of the first indications of cirrhosis is a platelet count less than 125,000. Platelet count is a common blood test preformed during a blood panel so your doctor should know if this was indicated.
"He initially told me my liver is functionally excellently".
- Your liver can still function well even though a person has cirrhosis. At least at the beginning stage. Which is commonly known as Child-Pugh class A. It is only when a person decompensates which means they then have Child-Pugh class B that the major symptoms and complications (ascites, varice bleeding and serious HE) due to cirrhosis occur. This is when the liver can no longer perform all of its functions properly. Many blood levels will be abnormal at that time.
Do I need I worry about cirrhosis ?
Not according to the story you are conveying. But remember a biopsy should be preformed if cirrhosis is expected so as to have a definitive answer to the stage of liver disease.
ONLY if you have cirrhosis, then, as I suggested a hepatologist at a transplant center is appropriate. When a person becomes cirrhotic, it is a very different stage of liver disease then the previous stages of liver disease. And needs to be managed more closely as treatment can be very rough on a very damaged liver. Cirrhosis also determines how long you should treat for (48 weeks despite response to treatment). Since it appears that you are not cirrhotic a gastroenterologist with experience with treating other hepatitis patients with the new meds is fine.
FYI: I tend to err on the side of worst case in the event someone is cirrhotic as my primary reason for being here in the community is to encourage and help others to not end up in the situation I now find myself and all the suffering I have seen my friends go through due to hepatitis C causing their livers to fail. Luckily most of them are now living their second lives post transplant but many of them had to go to the brink of death in order to finally receive the gift of life from a very generous donor.
Best of luck to you!
Hector
"Can my specialist have an idea with all their prior lab work"?
- Yes. If you have had an ultrasound, CT scan or MRI the report would indicate that your liver is nodular due to the scaring of the liver if you had cirrhosis. This is a definitive indication of cirrhosis and then needs to be confirmed via biopsy.
Also one of the first indications of cirrhosis is a platelet count less than 125,000. Platelet count is a common blood test preformed during a blood panel so your doctor should know if this was indicated.
"He initially told me my liver is functionally excellently".
- Your liver can still function well even though a person has cirrhosis. At least at the beginning stage. Which is commonly known as Child-Pugh class A. It is only when a person decompensates which means they then have Child-Pugh class B that the major symptoms and complications (ascites, varice bleeding and serious HE) due to cirrhosis occur. This is when the liver can no longer perform all of its functions properly. Many blood levels will be abnormal at that time.
Do I need I worry about cirrhosis ?
Not according to the story you are conveying. But remember a biopsy should be preformed if cirrhosis is expected so as to have a definitive answer to the stage of liver disease.
ONLY if you have cirrhosis, then, as I suggested a hepatologist at a transplant center is appropriate. When a person becomes cirrhotic, it is a very different stage of liver disease then the previous stages of liver disease. And needs to be managed more closely as treatment can be very rough on a very damaged liver. Cirrhosis also determines how long you should treat for (48 weeks despite response to treatment). Since it appears that you are not cirrhotic a gastroenterologist with experience with treating other hepatitis patients with the new meds is fine.
FYI: I tend to err on the side of worst case in the event someone is cirrhotic as my primary reason for being here in the community is to encourage and help others to not end up in the situation I now find myself and all the suffering I have seen my friends go through due to hepatitis C causing their livers to fail. Luckily most of them are now living their second lives post transplant but many of them had to go to the brink of death in order to finally receive the gift of life from a very generous donor.
Best of luck to you!
Hector
You can't edit typos. Best thing to do is read over your posts a couple of times and correct typos before posting. :)
Sorry for the typos , I keep asking about ho to edit on here hen I make errors , cannot get a response. Anyway, after the holidays we will kick off the new year with a starting date after eye exam and biopsy . I hope I am nor cirrotic, and my liver has minimal damage . Scared about the long run with this disease . Thank you .
Hi Printze,
I have grade 4 cirrhosis and my liver is functioning normally. I am being treated right now with VIC and responding well with minimal side effects. And as HectorSF said, the odds of success now are really high with the new tx. BTW, I so look forward to HectorSF's posts...what an true inspiration he is!
I have grade 4 cirrhosis and my liver is functioning normally. I am being treated right now with VIC and responding well with minimal side effects. And as HectorSF said, the odds of success now are really high with the new tx. BTW, I so look forward to HectorSF's posts...what an true inspiration he is!
Hector you are more knowledgable than most info I read on the internet as well as so many. I am seeing a hepatolist he is actually one of the best here min Montreal. I have done all labs , ultrsound, in Oct I eent for my mfibroscan, guess what the machine broke while ther were doing me, so they could not get a reading .. my hep c nurse looked at my file and said your next appointment with the hep doc is 4-01-12 maybe he will request a biopsy instead it seems in your file you have mild fibrosis . Can my specialist hasve an idea with all ther prior lab work ? He initially told me my liverr is functionally excellantly . Need I woory aboiut cirrossi ?
Hi Printze, you have not even had a liver biopsy yet. Most people die with hep c, not from hep c. Statistics, which is all you have to go on without a biopsy say you are likely not cirrhotic. It does not help your mental or physical state to worry too much about all of the worse case scenarios and what ifs.
Researching actual published medical information available on the Internet is good so you can prepare questions for the doc, but hope you can take your mind off the worrying and hope you are living healthy, staying active, and enjoying life before treatment.
.
Researching actual published medical information available on the Internet is good so you can prepare questions for the doc, but hope you can take your mind off the worrying and hope you are living healthy, staying active, and enjoying life before treatment.
.
Yes, if you have early cirrhosis, without symptoms or complications (ascites, HE, bleeding varices), treatment can still work for you. The chances of SVR is reduced by the amount of liver disease, but assuming you will be treating with one of the new PI drugs, you will have the best odds any cirrhotic has ever had to be cure of hepatitis C. You still have options. Please use them before you run out of options like myself.
Just a reminder - You should be seeing a hepatologist NOT a gastroenterologist as far as directing your treatment. Preferably they work at a liver transplant center. They are the only doctors qualified to treat you and they have the expertise and resources to manage the side effects of treatment that someone with cirrhosis can experience. This is critical because you don't want to stop treatment due to complications if at all possible! Time and the opportunity to stay on treatment and being successful are extremely important when you have cirrhosis. This get very worse if you don't treat and the inevitable progression of liver disease continues. You want to give treatment every possible chance of working BEFORE you progress to End Stage Liver Disease (ESLD) when you may not be able to treat your hepatitis C and will then need a liver transplant. YOU DO NOT WANT THIS TO HAPPEN IF AT ALL POSSIBLE! Take it from me and my friends pre and post transplant experience.
As long as you have chronic hepatitis C it is damaging your liver every day. If you can clear the virus you can prevent further damage to your liver. Whether your liver can recover at that point depends upon how damaged your liver is and your own biology.
Good luck to you!
Hector
Just a reminder - You should be seeing a hepatologist NOT a gastroenterologist as far as directing your treatment. Preferably they work at a liver transplant center. They are the only doctors qualified to treat you and they have the expertise and resources to manage the side effects of treatment that someone with cirrhosis can experience. This is critical because you don't want to stop treatment due to complications if at all possible! Time and the opportunity to stay on treatment and being successful are extremely important when you have cirrhosis. This get very worse if you don't treat and the inevitable progression of liver disease continues. You want to give treatment every possible chance of working BEFORE you progress to End Stage Liver Disease (ESLD) when you may not be able to treat your hepatitis C and will then need a liver transplant. YOU DO NOT WANT THIS TO HAPPEN IF AT ALL POSSIBLE! Take it from me and my friends pre and post transplant experience.
As long as you have chronic hepatitis C it is damaging your liver every day. If you can clear the virus you can prevent further damage to your liver. Whether your liver can recover at that point depends upon how damaged your liver is and your own biology.
Good luck to you!
Hector
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