Re: early cirrhosis in Hepatitis C

Posted By HFHSM.D.-D.M. on December 23, 1998 at 17:12:29:

In Reply to: early cirrhosis in Hepatitis C posted by Karie on December 14, 1998 at 21:43:14:






I am a 42 year old female with Hep C.  I believe I have had it for 25 years.  I was diagnosed 5 years ago, and began a four month treatment of interferon, which I tolerated terribly, and was forced to stop, with no decrease of liver enzymes.  I recently had my second liver biopsy (last one was five years ago).  The results were early cirrhosis, with a score of 11 on the Burke-Knodell.  I have few, if any symptoms, but realize that this disease will progress to end-stage liver disease, and require a transplant.  I am positive, yet want to be realistic about my future.  I take good care of myself, but know that at some point I will become ill.  My questions, because I would like to travel before that time, are:
l.  Likely time to illness
2.  Likely time from illness to (hopefully) transplant
3.  I have O neg. blood:  does this significantly lower my    
    chances
    for a liver.
I realize that no one can give me exact times, but I would appreciate SOME idea, as to have some control over my life.



____
Dear Karie:
I really appreciated your letter because it allows me to comment on some very important issues pertaining to hepatitis C.  In addition, I feel that I can provide you with some reassuring news.
First of all, it is critical for me to point out that I cannot comment specifically on your case, because I am missing some critical information.  It would be extremely important to show what your first biopsy showed.  If there hasnt been that much change from your first biopsy to your second that would be encouraging even if your second biopsy shows early cirrhosis.  However, if there has been significantly worsening between the two biopsies that would be more concerning.  In addition, there are several lab tests (protime, platelet count, albumin and bilirubin) that give us a feel for an individuals liver disease and that information would be important as well.
Having said that, I would make a few general comments.  The overwhelming majority of individuals with early cirrhosis on biopsy should do well for at least five years and many will do well for ten years.  We would use this same time frame to determine when you will need a liver biopsy.  I always stress that the progression of hepatitis C can vary from individual to individual and this period can be longer or shorter.  
I would also stress to you that it not like your liver will fall off a cliff one day.  We liver specialists (hepatologists) can usually follow a patient a long and have a good feel for when things are getting worse and the rate at which things are getting worse.  Most patients have plenty of warning and you can use this information to have some control over your life.  We also use this information to figure out when to put someone on a transplant list so that we can make sure that someone becomes eligible for a donor liver as they need one.  And by the way having O negative blood should not be a problem.
Finally, I would stress Karie that new treatments for hepatitis C are coming up and you might just benefit from some of these treatments.  Pegylated interferon is a form of interferon that only has to be taken once a week.  Early studies suggest this form of interferon is more effective than regular interferon and is at least as well tolerated.  This medication might be something that could benefit you.  I would also stress that the one thing you can do to help your cause is to avoid alcohol.  I am sure you have been told this and are doing so, but I cannot stress how important it is.  
Good luck with your situation and dont despair.  I hope this information is helpful to you.  If you have additional information or questions, I would invite you to post the material to MEDHELP or to contact us directly at Henry Ford [phone]. We have an active group of liver specialists and we have a strong interest in and experience with hepatitis C and liver transplant.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation.  Always check with your personal physician when you have a question pertaining to your health.