Double Your Chances of SVR (cure) on SOC

[jmjm530]

hat's correct. Double your chances of SVR (cure) on SOC (standard treatment) by treating with a Hepatologist (liver specialist) as opposed to treating with your Gastroenterologist or Family Doctor. At least so it appears according to this recent study, posted earlier by "Orleans" but lost in yesterday's shuffle:

http://www.hivandhepatitis.com/hep_c/news/2007/100507_b.html

The difference was absolutely astounding:

SVR (cure rate) WITHOUT Hepatologist: 66% (genotype 1 and 4)
SVR (cure rate) WITH Hepatologist: 34%  (genotype 1 and 4)

SVR without Hepatologist (signficant liver damage): 25%
SVR with Hepatologist: 69%
--------------------------------------------------------------------------------
While the incredible difference in SVR rates is more than anyone would have guessed --  from what I've seen posted here over the past two years it doesn't surprise me that treatment outcomes would be signficantly higher when treating with a hepatologist versus a GP or Gastroenterolgist.

While the study mentioned "less frequent treatment interruptions or dose reductions" as the primary reason, there's no doubt a lot more to it, including more liberal use of helper drugs like Procrit and Neupogen as opposed to pulling patients off of treatment prematurely (or as mentioned in the study, "dose interruptions"); plus the overall knowledge and experience a hepatologist imparts to the treatment process which can be manifest in other numerous ways.

For those not familiar, Hepatologists can usually be found at your larger, teaching hospitals. They are NOT the same as Gastroenterologists or Gastroenterologists that treat Hep C.

For anyone thinking of treating -- or anyone treating not happy with their doctor or in need of a second opinion -- take this study to heart and see a Hepatologist (liver specialist).

-- Jim

[GrandmaA]

I mean to say I switched FROM a gastro to Dr. Gish.

[GrandmaA]

Thanks for the information. Your contributions to this forum are very important.
I switched to a gastro (Dr. Gish) at 11 weeks when I my viral load was still 680. I don't know when I went UND sometime between week 12 and 15 when I had my next test. I'm over 4 weeks post tx now and almost feel normal. I have had about 9 hours of body work the past month (especially the last 10 days- massage and Jin Shin Jyutsu) and 8 infared sauna baths. I have 2 more to go next week. When I was on tx I never thought I would feel this good again. There is definitely a good life after tx.

[Trish77]

Albany, I should explain my own situation better ... I'm going for a second opinion because I'm not comfortable with the kind of information my GI gives me and his methods.  He wasn't going to do a biopsy even and I had to request it.  I like plenty of information and he doesn't give me nearly enough and the independent reading I do contradicts some things he's said and backs up other things he's said.  Confusing.  To go into 48 weeks of tx with someone I have doubts with is just not a good scene.  So, if I'm going to go for a second opinion, I might as well go somewhere that specializes in treating HCV.  As it turns out, the doc I'm getting a 2nd opinion from who I thought was a hepatologist, might not be one but she's very experienced in this...however, there will BE hepatologists she can refer me to if it comes to that.  I just need that second opinion before I proceed with tx.

I can't see a GI suspending tx if you decide to see a hepatologist instead, but seems to me you'd have one or the other, not both and a hepatologist would take over your care.  However, that's a guess on my part so for what it's like to switch docs midstream while doing tx, I'll let other more experienced people answer that as I wouldn't know and I'll let those same people explain the difference between having a hepatologist vs a GI.  I'm newer than you at this cause I haven't started tx yet.  Good luck to you.

Trish

[albany]

damn ... scary poop ...specially as i am using a gastro.  didn't even know there was really a difference until now.  do have family dr app;t tomorrow...western you say ...can your gastro kick you outta Tx if you ask to have a hepatologist follow your case as well, or instead?

[Trish77]

Thanks for posting this, Jim.  And your other comments on questions I've had.  I did finally bite it and go for the second opinion and I'm really happy....I contacted a clinic that PSP told me about that's an hour away from me (Toronto Western, PSP!!) and got in touch with a doc there she recommended and I have a referral!!  I'm feeling remarkably relieved.  My family doc was really good about it and I didn't have to get my GI to do the referral and my family doc is backing me up.  They have a whole hepatology department at this hospital and I'll be in good hands.  At the least, I'll get a second opinion and this time I'll know more going in than I did before.  And if I go for tx in Jan like I'm thinking...I'll do it with alot more peace than I've had about it lately.  

I just wanted to thank you for caring enough to share the information you do on an ongoing basis.  I don't know what I'd do without this forum and all the supportive people in it.  Just very grateful.  So a humble thank you for all your help.

Trish

[jmjm530]

Good luck with your new doctor. BTW hope it's OK that re-posted your comment on the other side to help make a point.

-- Jim

[Gladitsnotworse]

Your comment was exactly the thing I needed to hear today. It has helped me make my decison to  find another md. I treated with my GI and he did not want to give me procrit or neupogen. He felt it best to reduce the Ribaviron. I am a 1a, biopsy stage 1, 40's female, with 8million vl. I cleared at 12 weeks, then it showed back up 3 months post treatment on pegintron. I am considering retreating and my GI says this time he will give me the extra meds I need. I wanted to wring his neck. I wasted a year of my life going thru treatment. I found a hepatologist in Charlotte just now with my insurance company. Its 100 miles away but if it even gives me a small edge in reaching permanent svr it will  be worth it.

Thank you