what are the last stages of chronicliver &hep.c?

[whitegril]

my husband has this &i would like to know what is next? what are the things to come how long can you live with this? he is 55yrs.old has had this for about 2 yrs. with alote of prombules do to this

[fibroman]

what promblems does he hav?

[jdwithhcv]

Here are some websites that will give you more information about hepatitis and liver disease in general.  Also, you can search the archives of this board for earlier discussions of ESLD (end stage liver disease).

WebMd.com
MedicineNet.com
hcvadvocate.org

Do you have any specific information about your husband's health?  It would be helpful to know:
Has he had a liver biopsy and if so what damage was found (stage and grade)
Has he had other imaging studies (CT Scan, ultrasound, etc.)
Has he been treated for Hep C
His genotype and viral load
Outcomes of any other blood tests
What symptoms does he have

Lots of people on this site (not me!) are very knowledgable about cirrhosis and later stages of liver disease, and there have been a few threads on the subject.  This is a good place to get information and support and it sounds like you need both.  So welcome to MedHelp and good luck.  

jd

[IAmTheWalrus]

It sounds like your husband is in a difficult situation. The answer to "what next" depends on what you mean by last stages of "chronic liver  & hep c".

If by "chronic liver" you mean chronic hepatitis C (HCV), this is just a chronic viral infection and there is no stage associated with it. It's characteristics are mainly viral load (the number of virus cells replicating in the blood) and genotype (the particular type of hepatitis C virus).  Treatment should definitely be an option.

If by "chronic liver" you mean something like the last stages of liver disease (cirrhosis), then options for treatment may be limited and a liver transplant may be the only option. This is also referred to as "end stage liver disease" (ELSD). Sometimes this is referred to as "stage 4" or "stage 4, cirrhosis."  You will definitely need a hepatologist of GI doctor to diagnose and help you determine treatment options for this. If your husband is well enough, treatment of the HCV may be a good option. Even with successful treatment of the HCV, he may still need a liver transplant. It depends on how much liver function he has left and how treatment goes. Either way, if he can eliminate the virus before transplant, the common wisdom seems to be that it is a real benefit. The biggest problem is that many patients with cirrhosis can not tolerate the treatment drugs, and successful eradication of the virus is not a probable as in patients with healthier livers.

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http://www.medscape.com/viewarticle/537740_print

"During recent years there has been a considerable interest in the treatment of cirrhotic patients. Complications related to hepatitis C occur almost exclusively in patients with cirrhosis. The cost of managing cirrhosis in patients with hepatitis C is high. That includes the costs to monitor patients for the development of hepatocellular carcinoma (HCC), the management of decompensation, and the significant cost of LT and subsequent follow-up. Moreover the outcome of patients transplanted with hepatitis C is disappointing, and graft infection is almost inevitable when patients are PCR positive at the time of transplantation.[11, 12] The outcome of transplantation is improved when the HCV can be eliminated by antiviral treatment before transplantation"
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The biopsy is the usual test for determining the stage of the disease.

As far as cirrhossis or ESLD, I have been there, and the next step for me was a transplant. Now I am treating the HCV to trying to eliminate the virus and keep it from seriously damaging my new liver.

Good luck and best wishes!

[IAmTheWalrus]

One question, if you do not mind.  You say your husband has had this for 2 years. Do you know when he actually contracted the virus, or was this when he was diagnosed? Many people have had this disease for decades before diagnosis.

Thanks, and good luck