Does Smoking effect Treatment?

[Trinity4]

Yes, I smoke about 1 pk every 4 days.  I know it's a nasty, vile habit.  I've smoked since I was 25 years old so that's over 25 years of smoking.  I've never been a heavy smoker and quit with both pregnancies and a couple of times through out the years. Never smoke in my house, car, or at work.  It's after dinner, and during the evening hours.  As a matter of fact, I had quit for a year prior to dx of hepc. Cold turkey - no patches, no pills.  The logic is why am I even bothering with tx when the smoking is going to kill me anyway?  True that, and I know every reason in the world why I should quit right now, this minute.  I've mentioned coping mechanisms in the past that help us to keep ourselves in check when the sx get overwhelming.  I've tried AD's before - the sx from them are worse for me than the actual depression.  I don't get the benefit from them that most do and I really gave it an honest try.  So, when I get to the boiling point, I smoke a nasty cig and life becomes tolerable again for a while.  My question is, does smoking effect the chances of SVR?  If I was not a smoker, would I have possibly gotten UND at 12 wks instead of the 793 IU/ml?  I haven't seen any studies on this but I haven't made a great effort to find any either.  What are your thoughts on this -  BTW -  I already know what a knucklehead I am for smoking so please don't give me to much grief about that.  :)
Trin  

[Rockerforlife]

Smoking is the worst smell in the world to me now...i quit smoking when i was 18...but ive dabbled in between my 18-50 years of age....i say quit before you TX...expensive dirty stupid nasty habit........sorry but it is.....

[Xenigma]

I gotta tell you that I quit smoking with Chantix b4 I started tx.  When I finally started tx, I started smoking again.  Somehow I needed my old friend back.  
Soon I will get back on the Chantix and quit again.  The stuff works well, my problem with the sx was that I constantly felt like I had morning sickness--all day!  You never have a nicotine fit with the Chantix and if you sneak one, it's really not what you want and wind up putting it out after a puff or two.
Very strange how it works---on me anyway.
I know how hard it is to quit-I do believe during tx is not the time.
Cut down if you can not that you smoke a lot and wait til your done to quit.
enigma

[rita863]

Trin,

I also smoke.  I know i should not but when i spoke to my doc before i started to tx, he said he would not give me Chantrix or advise that i use the patch while tx.  the only way to do it  while tx is cold turkey,  He doesnt like that i smoke and neither does anyone else, but until tx is done, i cant do anything else that will make me think i am loosing my mind, or make me want to ram my car into every person that cuts me off while driving.

I know its not good, but i think once tx is done, and these meds are out of my system, they i can really work on getting healthy.
And you wont get any grief from me....


Peace

Rita

[CoWriter]

Actually, there are quite a few studies that showed that smoking lowers SVR.  That it  affects immune response (even on children from second-hand smoke), increases inflammation and fibrosis, contributes to the development of iron overload, is associated with the metabolic syndrome/insulin resistance and increases purine catabolism which promotes excessive production of uric acid.  All things that are known to lower SVR.
  

"There is one thing that smoking might be good for and that is it might help reduce the sides of Tx."

You're basically telling people that smoking reduces depression during HCV treatment. Based on a HIGH DOSE Interferon study done on MELANOMA patients which used doses of 10 and 20 million units SC or IV several times a week....doses that are never used to treat hepatitis C.  Forgive me if I find your data slightly....innacurate.


World J Gastroenterol. 2006 Oct 14;12(38):6098-101.
Heavy smoking and liver.

Smoking causes a variety of adverse effects on organs that have no direct contact with the smoke itself such as the liver. It induces three major adverse effects on the liver: direct or indirect toxic effects, immunological effects and oncogenic effects. Smoking yields chemical substances with cytotoxic potential which increase necro-inflammation and fibrosis. In addition, smoking increases the production of pro-inflammatory cytokines (IL-1, IL-6 and TNF- alpha) that would be involved in liver cell injury. It contributes to the development of secondary polycythemia and in turn to increased red cell mass and turnover which might be a contributing factor to secondary IRON OVERLOAD disease promoting oxidative stress of hepatocytes. Increased red cell mass and turnover are associated with increased purine catabolism which promotes excessive production of URIC ACID. Smoking affects both cell-mediated and humoral immune responses by blocking lymphocyte proliferation and inducing apoptosis of lymphocytes. Smoking also INCREASES SERUM AND HEPATIC IRON which induce oxidative stress and lipid peroxidation that lead to activation of stellate cells and development of fibrosis. Smoking yields chemicals with oncogenic potential that increase the risk of hepatocellular carcinoma (HCC) in patients with viral hepatitis and are independent of viral infection as well. Tobacco smoking has been associated with suppression of p53 (tumour suppressor gene). In addition, smoking causes suppression of T-cell responses and is associated with decreased surveillance for tumour cells. Moreover, it has been reported that heavy smoking AFFECTS THE SUSTAINED VIROLOGICAL RESPONSE TO interferon (IFN) therapy in hepatitis C patients which can be improved by repeated phlebotomy. Smoker's syndrome is a clinico-pathological condition where patients complain of episodes of facial flushing, warmth of the palms and soles of feet, throbbing headache, fullness in the head, dizziness, lethargy, prickling sensation, pruritus and arthralgia.

http://www.ncbi.nlm.nih.gov/pubmed/17036378?ordinalpos=14&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


"Serum URIC ACID level >/=5.8 mg/dl is predictive of poor response to HCV treatment."

http://www.ncbi.nlm.nih.gov/pubmed/18297716?ordinalpos=118&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


"Impact of cigarette smoking on response to interferon therapy in chronic hepatitis C Egyptian patients.
CONCLUSION: Smokers suffering from chronic hepatitis C tend to have a lower response rate to interferon-alpha compared to non-smokers."

http://www.ncbi.nlm.nih.gov/pubmed/15378774?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


"Association among cigarette smoking, metabolic syndrome, and its individual components: the metabolic syndrome study in Taiwan.  
In conclusion, this community-based study supports the view that smoking is associated with the metabolic syndrome and its individual components. Smoking cessation is beneficial to metabolic syndrome and its individual components."

http://www.ncbi.nlm.nih.gov/pubmed/18328358?ordinalpos=6&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


"Low leptin but high insulin resistance of smokers in Japanese men.
CONCLUSIONS: The present finding may explain in part an association among smoking, leptin levels and diabetes. SMOKING is one of the important modifiable risk factors for the prevention of diabetes."

http://www.ncbi.nlm.nih.gov/pubmed/18579252?ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


J Hepatol. 2008 Apr;48(4):657-65.
Environmental factors as disease accelerators during chronic hepatitis C.
"It has also been suggested that cigarette SMOKING may enhance activity grade in patients with chronic hepatitis C, thereby increasing progression of fibrosis."

http://www.ncbi.nlm.nih.gov/pubmed/18279998?ordinalpos=13&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


Gastroenterology. 2008 May;134(6):1699-714.
"Disease progression in chronic hepatitis C: modifiable and nonmodifiable factors.

Of greater immediate relevance to patients and their clinicians are the potentially modifiable factors, which include excessive alcohol consumption; SMOKING (tobacco and marijuana); insulin resistance; and coinfection with hepatitis B virus, human immunodeficiency virus type 1, or schistosomiasis."

http://www.ncbi.nlm.nih.gov/pubmed/18471548?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


"Effects of parental smoking on interferon gamma production in children."
http://www.ncbi.nlm.nih.gov/pubmed/18519461?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


"Parental smoking impairs vaccine responses in children with atopic genotypes."
http://www.ncbi.nlm.nih.gov/pubmed/17291854?ordinalpos=13&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


"Hydroquinone, a major component in cigarette smoke, reduces IFN-gamma production in antigen-primed lymphocytes."
http://www.ncbi.nlm.nih.gov/pubmed/18409047?ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


"Impairment of human NK cell cytotoxic activity and cytokine release by cigarette smoke."
http://www.ncbi.nlm.nih.gov/pubmed/18055568?ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

[CoWriter]

"It would be refereshing if some of the energy here directed against social drinking would find its way into an anti-smoking message for those with Hep C."

Great idea!

[Trinity4]

Thank you for the studies - I am actually the one who does the smoking and I must say CS is exactly right - in my case if I did not have an occassional cigarette, the sx of tx would be overwhelming at times.  I'll stick to a puff every now and then as opposed to raging and depression.  Not justifing smoking, but better than the alternative.  If you are saying that yes, definitely smoking reduces the chance of becoming UND -  Take into consideration I had 2 dose reductions at weeks 7 & 8.  
Already had 13 phlebotomies - Guess I don't have to worry about that.  I have PCT and that is the only effective method of reducing ferritin in those with Hepc.
Maybe I should try pot -  that way I could get the munchies and blow up like a balloon, adding extra stress to my heart.  I think it's what whatever works on tx - afterwards, deal with the fallout.  Again, thanks for the findings.
Trin