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my x- in stage 3
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my x- in stage 3

Hi Everyone, I had a question for anybody willing to answer,,, my x-husband who I am still very close to and the father of my daughter recently brought up the fact that he had gone to the dr. and he is now in stage 3. That scared me so I asked if there was treatment he said the dr. said there is a drug he could try but once he starts on it he has to see it through..My x said he is not starting the drug because what if it make him so sick or puts him in the position where he cant work how would he survive he does not  have great benefits. I cant believe it I am scared for him. So the question is can he just keep waiting till his saving account fills up or I mean isn't this issue of being at stage 3 a time factor? Thank you in  advance for any input!          
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1840891_tn?1383280315
Hi Michey, and welcome to the forum. I'm sorry your x is at stage 3. You are right about it being a rather urgent thing now, but there are a great many unknowns here. How old is he, does he have other medical issues that might complicate treatment, how strenuous is his normal job and what genotype is his viral infection? All of those things make a difference in treatment - which drugs would be needed, how long he'd have to treat, and how likely he'd be to be able to continue working through treatment. If you can give us more information you will probably get a bunch of varying replies that might help you piece together some possible scenarios. In the meantime, make sure he knows that until his liver health is fully restored he should consume no alcohol and take no NSAIDs (such as Ibuprofen or aspirin). He also should be very cautious with Tylenol, not using it too frequently and never taking more than a total of 2000 mg in one day.
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hi ceanothus, thanks for responding I checked with him he is genotype 1 and he is 46 years old. His job does require him to be on his feet all day he does
do a lot of heavy lifting. Good to know about the info on the drinking and the
ibuprofen.  
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   There is an easier Treatment for Hep C, which will hopefully be approved by the FDA in 2013, or 2014 for another one.
   These new Treatments will be "Interferon Free", with little to no side effects.
Please pass this info on to your Ex, to give him hope. Have him "line up all his ducks", as in: find himself a Docotr or clinic who treats Hep C, and will accept his insurance. He can start doing the blood tests, and let his Tretment Docotr know that he is waiting for the new Treatments to be approved, and wants to be first on the list, to treat, etc.
   There are many new Treratments in "the works", and they are conducting Cliniacal Trials as we speak(write)  He can mention "Sofosbuvir" to his Doctor, as that is the first one that will mostlikely be approved, and actually has a real name, instead of a #.
    My husband is currnetly a guinea-pig in one of thes Interferon free studies, but not with Sfosbuvir, which is made by Gilead Scince, but he is on something called Abt 333 and Abt 226 (i think that's the #) and it also has Ritonevir, and Ribaviran in it...and no shots! He feels good, and is able to work.
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Hey Michey,
Your x has a real tough decision as stage 3 is of coarse just below cirrhosis...and where at stage 3?...a lot of difference between 2.9 and 4.0. Chances of a cure drop an average about 5% for those with stage 3 but by about 15% in stage 4 (cirrhosis). Most people fid it impossible to work on the current therapy's (though a minority have very few problems). I am 59, stage 3 and genotype 3 and have probably had it for 40 years and known about it for 21. I waited and saved (paid off debt, sons college, now my turn- liver/unemployment time). But, I didn't get a biopsy till last year (ignorance is bliss) and when the doc told me sage 3 followed with "well, you can wait 2 months to start treatment...but you can't wait 2 more years" that is what I needed to hear. I finished treatment 2 1/2 months ago, the treatments worked, have only minor lingering issues and back to my pre-treatment work-out routine. Don't think Sofsobuvir is very effective against geno 1. I think he really needs to self educate on HCV (read medical studied published on the net) and find a way to take off work for a year (as a back up plan in case he needs it) and a few months to recover. I understand the triple therapy is very rough on most but also VERY effective if completed against geno 1. Good Luck
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Tylenol is the worse pill u can take for pain it eats at ur liver I think advil is better then Tylenol I take advil for paain as I was told by my dr to stay away fr Tylenol and also advil but hey have to take something for pain \
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1840891_tn?1383280315
I'm sorry Countrygirl, but you are wrong about the pain killers. Many people fear Tylenol because it IS really dangerous to the liver in large doses or in daily use, and an overdose of Tylenol is a frequent cause of death by liver failure. Nevertheless, most hepatologists consider limited doses of it to be the safest pain killer for those with damaged livers. Most liver transplant clinics tell their patients to use nothing BUT Tylenol, with the restriction of no more than 2000 mg per day. Small amounts do not injure the liver, whereas small amounts of NSAIDs can sometimes produce injury. I used to take a lot of them (due to autoimmune arthritis) before all this was known and in retrospect I see that they did elevate my liver enzymes and probably contributed to my unusually rapid progression to cirrhosis. They did work better than Tylenol, so I miss having them in my arsenal, but I wouldn't dream of taking them anymore. Look for some of Hector's posts on this topic to get more info on Tylenol usage, and keep yourself as safe as possible!
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There is both good news and bad news in the info you gave. 46 is still pretty young and that is a really good thing in terms of tx (treatment). I treated 3 times overall - first when I was about 40, then at about 52, and finally at age 58 I was successfully in beating the virus. Of the many variables that affect tx, I personally feel that age at time of tx is a big one. I found each tx to be much harder on me. I have a spinal cord injury and severe chronic pain that prevents me from working, but if not for that I believe I could have worked through my first tx okay, and through my second tx with difficulty. I could not have worked through the last one, no matter what. The drug regimens were somewhat different, but I think my age had more to do with it. The last tx was triple tx with Incivek, ribavirin and interferon, but all three drugs are only taken for the first 12 weeks, and then its just the ribavirin and interferon for the rest, which is the same combo I took throughout my second tx. It was much, much harder at 58 than it had been at 52. So I think his current age is a plus for treating soon. Genotype 1 is the hardest to cure (its the one I had too), but current tx is pretty darn effective against it. He would have to take the triple tx, with a choice of either Incivek for the first 12 weeks or instead having Boceprivir added later in tx and then continuing throughout. You can research here and also at http://hcvadvocate.org and learn all you could want to know about the drugs. It does get harder to cure as the stage of fibrosis gets worse, although it is still fairly treatable even with cirrhosis. However, if you have cirrhosis the treatment length becomes a mandatory 48 weeks rather than the length being based on the response to the meds, and the tx is more likely to cause more severe sx (side effects). Mine did progress to cirrhosis in between my first and second tx's, so both of those treatments were quite long. If he doesn't yet have cirrhosis, and if his viral load becomes undetectable early enough in tx, then he would only have to treat for 24 weeks instead of 48.

If he chooses to wait for sofosbuvir it looks like he would still have to take interferon but for only 12 weeks. I'm really not terribly well- informed about sofosbuvir but I had the impression it did work for genotype 1 as well as others, so I checked and found a very recent study at medscape (at http://www.medscape.com/viewarticle/802956) that showed:
-----------------------------

Rapid, Sustained Response With Sofosbuvir in Hepatitis C
Pam HarrisonApr 23, 2013

Treatment with sofosbuvir results in a rapid and sustained virologic response in patients with hepatitis C virus (HCV), report investigators.

The nucleotide analogue that inhibits HCV replication is showing promise when given together with ribavirin or in addition to pegylated interferon (peginterferon) alfa-2a for a variety of genotypes and in different patient populations, new studies show.

"Interferon is always a challenging therapy and depending on the genotype we're treating, patients are going to require 6 months to a year of treatment," Eric Lawitz, MD, from the University of Texas Health Science Center in San Antonio, told Medscape Medical News.

"With sofosbuvir, patients with genotype 1 hepatitis C virus are only going to need 12 weeks of interferon, and in patients with genotype 2 and 3," Dr. Lawitz explained, "we can eliminate interferon completely so sofosbuvir offers a higher efficacy rate, a more favorable safety profile, and either a reduction in the time on interferon or its elimination entirely, which is a significant paradigm shift in the management of hepatitis C."
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The downside of waiting for sofosbuvir is not knowing how much the liver damage will progress while waiting. No one can know this, so it becomes a very difficult and very personal decision. I can say that quite a few people on this forum were able to work throughout triple tx. It doesn't look that way at a glance, but that is because the sicker members post a lot more than do the ones who are managing to muddle through. Especially if they are working full time, they don't have as much free time for posting. I don't think any of them would call tx easy, but for most people it is manageable. Good luck to him, and bless you for helping him.
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Just did some searching and C... is right about the Sofo....  Sorry, I indicated it might not be effective for geno1 as I recall last year it (with ribavirin) didn't trial well enough with geno 1 for FDA approval submission (as it did with 2 & 3) but now this years trials (adding interferon) are quite promising. After decades of virtually static treatment regimens with not very hopeful outcomes, they can change 180 degrees within a few months these days. All apologies.
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to Ceanothus,medic54 & all others, Wow thank you so much ! I have to say It amazes me that people who are going through difficult times and serious issues such as yours have no problem to give a response and such informative ones at that, to a total stranger. Goes to show me and others that this terrible virus that takes so much is unable to take one thing and that is your human kindness, You have no idea how lacking in knowledge I was until now, sure its out there if you want to break stuff down and dissect it but to cut to the chase and get the answers that count without confusion again I can only say wow!! I appreciate you all so much my x is going to review this info with me since I approached him with a leg to stand on. Thank you again and your all in my prayers may all your days be as pain free and healthy as possible! michey333    
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