Disease progression statistics

[mike716]

Does anyone know where I can get some statistics on how many people with hepatitis progress to end-stage liver disease, particularly with reference to genotype, age, ALT/AST, etc.?

Thanks!

Mike

[Andromedae]

I have no stats to contribute - just wanted to say thanks to all for an extremely informative discussion :) .  I've learned a lot.

Andromeda

[scoop49]

ill have to get back to you on some of the older blood counts
but i can tell you that platelets were not an issue until approx "04-'05 (approx 30 years after contracting hep c)
then platelets fell alarmingly down to 50 to 60 counts
they would not start me on tx so i was in the 'tween zone of not quite unhealthy enough for transplant.
platelets continued to vary but were up two months running to 75- 80 early this year and i started tx 4-18'08. since then platelets went from in the 60's to 50's then at week 7 to 29. now (staying on tx) there is at least a temporary hole at high 20's to mid 30's (they will now go slightly below 25 at this hospital.
reason? don't really know- have always been in good physical shape-jog etc. i did go from one glass of wine with dinner to no alcohol at all and stopped taking allergy pill and aleve daily.
alt #'s were never real high-(maybe mid 80's?) on combo tx are now mid 30's
just got your message today- good luck

[mike716]

Hi, Scoop. Sorry it's taken me so long to reply to your post, but I've been layed up with the flu for the past week.

Your story interested me a lot. I've got a coupla questions, okay?

First, what were your test scores (ALT, platelets, PCR, etc.) in 97 when they discovered you were HCV+?

Second, how low were your platelets in 2006?

Last, how did you get your platelets back up again so you could go on tx?

Glad to hear your holding up good with minimal sx. If I run into Duval at the tango salons, I'll say hi to him for ya.

Mike

[Rockerforlife]

Recent studies suggest that chronic infection with HCV will almost invariably result in cirrhosis. It is the time that this takes that varies. For those people who develop a chronic or long term infection (between 70-80% of those infected with HCV) around 20-30% will develop cirrhosis within 20 years. For some it may be quicker but for others it may take up to sixty years so they may well die of unrelated diseases beforeha

[scoop49]

everybody's got an opinion

me-contracted hepc in 1974 settled down-raised a wonderful family-worked hard-was not a stranger to the evening bottle

hep c discovered '97-quit drinking-stayed in very good physical shape-thought f-it the bad stuff only happens to people who ignore the wall scribblings.
2006- wham! i had known for a year or so that my platelet count was way down (result of hep c) and discovered i cannot go on treatment even if i chose to and i gained 20 bloated pounds, felt as if i'd faint walking up stairs and basically thought it was the beginning of the end. (this after at age 57 running 3-5 miles at a good clip and working construction full time and feeling fine)
i am now 59 in week 10 of treatment and as i hold my breath every week hoping my blood counts allow me to stay on tx. (for me the side effects are very tolerable-just bit of fatigue and headaches)

so-i guess -to quote yossarian- there's another country heard from
quantity/quality? who knows

i wish you well-say hi to duval
scoop49

[mike716]

These histories from Brent, somuchmore2, and others about a decision not to treat followed by more-or-less rapid progression are frightening. I'm going to translate them into Spanish and force my hep MD to listen and give me a reply, the next time I see him. I'm very concerned that he and the other hepatologists here in Buenos Aires are judging things by old, bad information.

Re biopsies, I've read a lot of articles that say they can't be trusted. It's not just that different people with different experience are analyzing the biopsy samples, but the very nature of a biopsy - a very small specimen of the liver - makes it untrustworthy. An article in the February issue of Hepatology on a new test, FibroTC, is especially interesting for the light it throws on this point, in regard to the often non-homogeneous nature of liver fibrosis, which makes biopsies appear seriously unreliable. Here's the URL: http://www.ncbi.nlm.nih.gov/pubmed/18098299?dopt=Abstract

By the way, got a copy of that article from the authors andI posted an image from it on my forum webpage, if anyone wants to look at it. It's the multi-colored graph. Click on it to make it bigger (or just go to http://www.medhelp.org/user_photos/show/8507). The image shows a FibroTC analysis of an HCV-infected liver that has four different stages of fibrosis in it. What good would a biopsy be on that person's liver? Depending on where the needle went in, anything from F2 to F4 could be diagnosed.

Re upbeat's post, I believe there is evidence that treating HCV runs the risk of powering up the virus if it isn't eliminated. It's the old "what doesn't kill you makes you stronger" idea, and it's as true for microbes as it is for humans, I believe. It's always dangerous to treat and not cure. That's why they tell you not to stop taking antibiotics before finishing the box, even if the infection you're taking them for has cleared up.

I don't really know how interferon and ribavirin work, on a molecular level, but the suppression of viral genotype breakouts is not the only concern. There's the problem of the drugs pushing the present genotype into a more virulent mode. Viruses have different virulences (power to cause cellular harm) just like bacteria do. Normally a microbe doesn't evolve a higher virulence than infection/transmission allows, on the principle that if it is so virulent that it kills its victim before he or she transmits the infection then it dies off with the victim. But taking drugs can alter that equilibrium. And the evolution of HCV is super fast. It has a huge reproduction rate.

I think a lot of interesting discussion has come out of this thread and the forum in general on these questions, particularly the treat/wait thing. It's too bad there isn't more being done by research to solve them, like coming up with a really good non-invasive liver damage test. As long as the medical community sticks to their age-old biopsy belief, we aren't going to make much progress.

Mike