Aa
concerned wife
My husband was diagnoised with hep C with cirrhosis in 2006, he is 1a. He has treated three times and relapsed each time, the last with Inv. On his last ultrasound in July he was diagnosed with minial ascites and placed on a diuretic. His doctor wants him to wait and treat with the new treatment coming out in the Fall. His platelets are in the 50's. My question is if the new treatment works will this stop the ascities and make his platelet count go back up?
Hi and thanks for the warm sentiments. Just read your comment, and wanted to add a thought for you.
I don't know how long ago your husbands endoscopy was performed but am assuming within 1 year. It takes many years for varicies to show from my understanding, and the fact that none were present at that time is excellent news. I have as mentioned early cirrhosis with varicies and since clearing, am seeing reversal. My hope is that your husband will also follow that trend.
Take Care
...Kim
I don't know how long ago your husbands endoscopy was performed but am assuming within 1 year. It takes many years for varicies to show from my understanding, and the fact that none were present at that time is excellent news. I have as mentioned early cirrhosis with varicies and since clearing, am seeing reversal. My hope is that your husband will also follow that trend.
Take Care
...Kim
Thank you so much for you words of encouragement and for helping me understand what is currently happening with my husbands liver disease. I am so glad that he will still be able to treat with this new treatment. His doctor said at his last appointment (before the ultrasound reading) as soon as the meds are available he could begin treatment, and that they would take care of all the paperwork and deal with the insucrance company.
Hector you are right his doctor is monitoring him every six months, with ultrasound and blood work, he did have a endoscopy done before he started the treatment with Inv and it showed no varices at that time. Thank you again for your indepth explanation. I wish the very best for you on your treatment.
Kim I have googled liver friendly diets and found alot of information, thank you for taking the time to help me and I hope you had a great and relaxing weekend.
Hector you are right his doctor is monitoring him every six months, with ultrasound and blood work, he did have a endoscopy done before he started the treatment with Inv and it showed no varices at that time. Thank you again for your indepth explanation. I wish the very best for you on your treatment.
Kim I have googled liver friendly diets and found alot of information, thank you for taking the time to help me and I hope you had a great and relaxing weekend.
H: So glad tx has begun. I am praying for SVR and for for low, bearable or NO Sides - first, naturally, is SVR.
Keep us posted on your tx. Pat
Keep us posted on your tx. Pat
Hector
Just want to wish you all the best on treating hep c may you win the battle and the war with this beast of a virus.
Good Luck
Lynn
Just want to wish you all the best on treating hep c may you win the battle and the war with this beast of a virus.
Good Luck
Lynn
Hi Cindy.
Your husband is still compensated so he will be able to treat with non-interferon hep C treatment. I assume the hepatologist is waiting for the once a day Ledipasvir/Sovaldi med and has determined that current treatments won’t be effective. It properly has something with him be genotype 1a, having the Q80k mutation and issues with Olysio would be my guess. Hopefully that treatment will be available in November of December after FDA approval before October 10th.
All of your husband’s complications from his cirrhosis are very common. Ascites that can only be seen on imaging is a good sign because over time the amount of fluid can build up to the point where it is obvious visually and then the amount of fluid can cause other issues.
Bruising is common with cirrhosis and portal hypertension due to his low platelet count caused by his enlarged spleen and he may have other issues with coagulation as many coagulation factors are manufactured in the liver and as the liver is damaged it is unable to properly make clotting factors.
The veins that can be seen under the skin of his stomach as called caput medusa. This is caused by the portal hypertension which makes the blood flow around the liver because the liver is so scarred normal blood flow through the liver is reduced. Normally these veins over contain small amounts of blood now they are handling some of the blood that normally flowed through the liver and back to the heart. It is common for cirrhotics with portal hypertension to also have these “varices” in their esophagus which can be seen by doing a endoscopy and they can also be seen on a CT scan or MRI if it covers the upper chest as well as the abdomen.
I am sure his hepatologist is monitoring all of these complications of his liver disease to keep him safe. There are meds that can help reduce his portal hypertension as well to prevent the occurrence of bleeding should these overload veins burst. If this should happen and he starts vomiting blood or defecating blood take him to the ER ASAP as this is an emergency situation.
These are all signs of cirrhosis + portal hypertension. Indirectly they are associated with the hepatitis C chronic infection because your husband’s cirrhosis was caused by the virus. So curing the virus won't cure his cirrhosis and its complications. Low platelet count, varices, etc. Cirrhosis typically takes 20-40 year of injury by the virus to develop, so unfortunately that damage can’t disappear in a matter of months like hepatitis C can with current treatments. It may take years to reverse itself only his doctor who will be monitoring his condition will know.
Once he starts treating the virus within a month or so he will have no viral load indicating the viral level is so low it can’t be measured. I this point the virus will no longer be damaging his liver further. His blood tests may start to normalize during treatment. It is common to see his ALT numbers reduce and platelet count may rise a little. If after 6 months since starting treatment he is still undetectable then he will be considered cured. But he will still have cirrhosis. If his liver disease can reverse itself and how long it may take (usually years) only time will tell. Each person is different so there is no fixed timetable. Hopefully he will be able to stop his progressive liver disease so that he won’t need a liver transplant. If not then liver transplant is always an option should all else fail. Another thing to keep in mind. Not worry about but be aware of. Since your husband currently has cirrhosis and even if his hep C is cured he is still at a higher risk then others who have never had cirrhosis of developing liver cancer (HCC). I am sure his hepatologist is monitoring every 6 months with ultrasound or CT and an AFP blood test for cancer. The good news is his hepatitis C can still be cured despite his cirrhosis thanks to new more effective and safer treatments. His cirrhosis is something that will take time to see how much it can heal itself when it doesn’t have the hep C continually causing continual injury to it.
There has never been a better time to have cirrhosis, not that anyone wants cirrhosis, but to stop it before liver transplant is the only options as it was for many of us only last year before these non-interferon treatments were available. I also suffered with all of the complications that your husband is now experiencing for many years and I am now fine now 10 post liver transplant and just started treating my hepatitis C for the third time today. So no matter how bad things may look at the moment if we hang on there is always hope that tomorrow will be a better day.
Hang in there. Stay positive. One was or another you husband will overcome his present situation of advanced liver disease and hepatitis C infection.
Hector
G1b, Post Liver Transplant, Sovaldi, Olysio + Ribavirin - started 8-29-14
Your husband is still compensated so he will be able to treat with non-interferon hep C treatment. I assume the hepatologist is waiting for the once a day Ledipasvir/Sovaldi med and has determined that current treatments won’t be effective. It properly has something with him be genotype 1a, having the Q80k mutation and issues with Olysio would be my guess. Hopefully that treatment will be available in November of December after FDA approval before October 10th.
All of your husband’s complications from his cirrhosis are very common. Ascites that can only be seen on imaging is a good sign because over time the amount of fluid can build up to the point where it is obvious visually and then the amount of fluid can cause other issues.
Bruising is common with cirrhosis and portal hypertension due to his low platelet count caused by his enlarged spleen and he may have other issues with coagulation as many coagulation factors are manufactured in the liver and as the liver is damaged it is unable to properly make clotting factors.
The veins that can be seen under the skin of his stomach as called caput medusa. This is caused by the portal hypertension which makes the blood flow around the liver because the liver is so scarred normal blood flow through the liver is reduced. Normally these veins over contain small amounts of blood now they are handling some of the blood that normally flowed through the liver and back to the heart. It is common for cirrhotics with portal hypertension to also have these “varices” in their esophagus which can be seen by doing a endoscopy and they can also be seen on a CT scan or MRI if it covers the upper chest as well as the abdomen.
I am sure his hepatologist is monitoring all of these complications of his liver disease to keep him safe. There are meds that can help reduce his portal hypertension as well to prevent the occurrence of bleeding should these overload veins burst. If this should happen and he starts vomiting blood or defecating blood take him to the ER ASAP as this is an emergency situation.
These are all signs of cirrhosis + portal hypertension. Indirectly they are associated with the hepatitis C chronic infection because your husband’s cirrhosis was caused by the virus. So curing the virus won't cure his cirrhosis and its complications. Low platelet count, varices, etc. Cirrhosis typically takes 20-40 year of injury by the virus to develop, so unfortunately that damage can’t disappear in a matter of months like hepatitis C can with current treatments. It may take years to reverse itself only his doctor who will be monitoring his condition will know.
Once he starts treating the virus within a month or so he will have no viral load indicating the viral level is so low it can’t be measured. I this point the virus will no longer be damaging his liver further. His blood tests may start to normalize during treatment. It is common to see his ALT numbers reduce and platelet count may rise a little. If after 6 months since starting treatment he is still undetectable then he will be considered cured. But he will still have cirrhosis. If his liver disease can reverse itself and how long it may take (usually years) only time will tell. Each person is different so there is no fixed timetable. Hopefully he will be able to stop his progressive liver disease so that he won’t need a liver transplant. If not then liver transplant is always an option should all else fail. Another thing to keep in mind. Not worry about but be aware of. Since your husband currently has cirrhosis and even if his hep C is cured he is still at a higher risk then others who have never had cirrhosis of developing liver cancer (HCC). I am sure his hepatologist is monitoring every 6 months with ultrasound or CT and an AFP blood test for cancer. The good news is his hepatitis C can still be cured despite his cirrhosis thanks to new more effective and safer treatments. His cirrhosis is something that will take time to see how much it can heal itself when it doesn’t have the hep C continually causing continual injury to it.
There has never been a better time to have cirrhosis, not that anyone wants cirrhosis, but to stop it before liver transplant is the only options as it was for many of us only last year before these non-interferon treatments were available. I also suffered with all of the complications that your husband is now experiencing for many years and I am now fine now 10 post liver transplant and just started treating my hepatitis C for the third time today. So no matter how bad things may look at the moment if we hang on there is always hope that tomorrow will be a better day.
Hang in there. Stay positive. One was or another you husband will overcome his present situation of advanced liver disease and hepatitis C infection.
Hector
G1b, Post Liver Transplant, Sovaldi, Olysio + Ribavirin - started 8-29-14
Cindy hi and welcome. Heading outta town for the Labor Day wknd but really wanted to help you before I take off. I can totally understand your concern as liver disease can have many uncertainties.
The new meds your husband will taking in the fall are showing excellent promise for the futures of 1a and 1b. I do believe that these will cure your husband, and he will finally rid himself of this horrible virus. The only question that remains is, will it be in time to avoid possible decompensation and further liver injury. This I don't know.
If you can cure the Hep C virus before decompensation occurs, there is a possibility that the existing damage will be halted, and the liver may be able to survive on its own without further injury. From your good description he at this point is walking a fine line. The odds can tip in either direction as he is approaching early decomp with mild ascities and low platelets. In his delicate situation I would be very cautious and try to live as liver friendly with diet as possible. You can google that and a slew of suggestions will help you decifer the best possible course of action. I'm early cirrhotic, have recently cleared the virus, my platelets are holding steady at 120, living liver friendly, taking Dr suggested supplements, and my Meld Score since curing has gone from an
8 to a 6. I tell you this to give you hope that he may be able to rejuvenate what damage has been done without the need for a liver transplant or further complications down the road.
From the knowledge I have acquired thru being a patient, i will optomisticly say that I feel he may be able to turn this thing around since his current status is still in the realm of reversal. Just my humble opinion.
You may also consider trying to get pre approved for the new drugs if possible, so that when they hit the shelves you can get started ASAP.
Please know that this disease has many facets, and at times somewhat confusing. We are a wonderful caring group and will help you navigate thru the process should you have questions or concerns. I'm hoping for a bright future for you and your husband. Try to stay upbeat and remember that we are all so very lucky to live in a time when Hepatitis C will no longer be able to destroy anymore lives.
My best to you and your husband
....Kim
Cindy might add, your husband should have no problem treating with the new meds. Have heard they have little to no side effects, and are miracle pills.
The new meds your husband will taking in the fall are showing excellent promise for the futures of 1a and 1b. I do believe that these will cure your husband, and he will finally rid himself of this horrible virus. The only question that remains is, will it be in time to avoid possible decompensation and further liver injury. This I don't know.
If you can cure the Hep C virus before decompensation occurs, there is a possibility that the existing damage will be halted, and the liver may be able to survive on its own without further injury. From your good description he at this point is walking a fine line. The odds can tip in either direction as he is approaching early decomp with mild ascities and low platelets. In his delicate situation I would be very cautious and try to live as liver friendly with diet as possible. You can google that and a slew of suggestions will help you decifer the best possible course of action. I'm early cirrhotic, have recently cleared the virus, my platelets are holding steady at 120, living liver friendly, taking Dr suggested supplements, and my Meld Score since curing has gone from an
8 to a 6. I tell you this to give you hope that he may be able to rejuvenate what damage has been done without the need for a liver transplant or further complications down the road.
From the knowledge I have acquired thru being a patient, i will optomisticly say that I feel he may be able to turn this thing around since his current status is still in the realm of reversal. Just my humble opinion.
You may also consider trying to get pre approved for the new drugs if possible, so that when they hit the shelves you can get started ASAP.
Please know that this disease has many facets, and at times somewhat confusing. We are a wonderful caring group and will help you navigate thru the process should you have questions or concerns. I'm hoping for a bright future for you and your husband. Try to stay upbeat and remember that we are all so very lucky to live in a time when Hepatitis C will no longer be able to destroy anymore lives.
My best to you and your husband
....Kim
Cindy might add, your husband should have no problem treating with the new meds. Have heard they have little to no side effects, and are miracle pills.
Thank you so much for replying. My husband is being seen by a hepatologist at a transplant center that is a teaching hospital. The only other symptoms he has is bruising and his veins seem very close to his skin on his stomach. The doctor did not say anything about decompensated cirrhosis, but of course the diagnosis of minimal asscites was after the ultrasound was read and by then our appointment was over. The nurse called and talked with my husband and the script was called in. The ultrasound reads: cirrhosis with minimal ascites, stable splenomegaly, no intra-abdominal free fluid.
After reading several posts I am begining to wonder if he will be able to treat with the new meds? I am just trying to understand all of this. I am a little fearful right now.
Nan I wish the best for you and your husband.
After reading several posts I am begining to wonder if he will be able to treat with the new meds? I am just trying to understand all of this. I am a little fearful right now.
Nan I wish the best for you and your husband.
I ask myself the same question. IF I should ever get treatment and then be cured, will the damage done by the hep c and cirrhosis begin to heal? No one knows because each of us is different but for me, I like to think I will get healthier. Things like neuropathy may never go away but I take comfort in the idea that things will not get worse. Hopefully, since the liver is no longer being attacked by the virus everything will get better but I suppose it all depends on the extent of damage already done. Take care.
Hi Cindy Welcome to the Hep C Community.
I too am a caregiver for my husband who was diagnosed with cirrhosis as a result of Hep C in 2010. I know how difficult it has been for the both of you.
Ascites is a sign of decompensated cirrhosis. Does he have other symptoms of decompensation - (i.e. portal hypertension, hepatic encephalopathy, esophageal/stomach varices)? If so, he should be seeing a transplant hepatologist, preferably at a transplant center associated with a teaching hospital. These are the best doctors in the field and will know how best to treat your husband.
My husband had a liver transplant in 2012 and now has cirrhosis again as a result of severe recurrent Hep C. He completed treatment (Sovaldi/Ribavirin 24 weeks) on July 30th and is waiting to see if he has been cured of the virus.
All his labwork showed improvement throughout treatment, including his platelets.
I wish you both the best.
Nan
I too am a caregiver for my husband who was diagnosed with cirrhosis as a result of Hep C in 2010. I know how difficult it has been for the both of you.
Ascites is a sign of decompensated cirrhosis. Does he have other symptoms of decompensation - (i.e. portal hypertension, hepatic encephalopathy, esophageal/stomach varices)? If so, he should be seeing a transplant hepatologist, preferably at a transplant center associated with a teaching hospital. These are the best doctors in the field and will know how best to treat your husband.
My husband had a liver transplant in 2012 and now has cirrhosis again as a result of severe recurrent Hep C. He completed treatment (Sovaldi/Ribavirin 24 weeks) on July 30th and is waiting to see if he has been cured of the virus.
All his labwork showed improvement throughout treatment, including his platelets.
I wish you both the best.
Nan
I am sorry that the treatments did not work for your husband. I know that had to be very devastating, especially since the treatments themselves were so difficult. Hopefully the new treatment will work well for him.
I don't know the answer to your question but I am sure that Hector will know. Hopefully he will see your post and respond.
Best to you and your husband.
I don't know the answer to your question but I am sure that Hector will know. Hopefully he will see your post and respond.
Best to you and your husband.
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