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Hep C treatment, Where Do I Start?

I was diagnosed with Hep C in 1986.  Back then there was no treatment.  I was told to keep my liver enzyems checked yearly and lead a healthy lifestyle.  Well I have reached 47 this year and I've always been concerned when this disease would start effecting my life.  I have now just found out after 20 + years I have Genotype 2b and my viral load is 2,998,290.  I have a appt soon with a Gastro.  What happens next?  What are my options?
Can I be cured?  
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Avatar universal
Sorry ..I forgot to add ..  In the last few years I too have developed some muscle pain ..that has been checked out thoroughly with no undo findings . My Hepas have suggested this is more than likely due to HCV.  

Best ..
Will
Helpful - 0
Avatar universal
Agree with OH about the fatigue and there is much new -data coming forth on "extrahepatic manifestations"(outside the liver) symptoms.(including muscle  & jont pain)
Best...
Will

http://www.google.ca/search?sourceid=navclient&aq=0&oq=cutaneous+manifestations+of+hepatitisc+medscape&hl=en-GB&ie=UTF-8&rlz=1T4DACA_en-GBCA302CA302&q=cutaneous+manifestations+of+hepatitisc+medscape&gs_upl=0l0l1l149444lllllllllll0&aqi=s23

Most patients with acute and chronic infection are asymptomatic. Patients and health care providers may detect no indications of the conditions for long periods; however, chronic hepatitis C infection and chronic active hepatitis are slowly progressive diseases and result in severe morbidity in 20-30% of infected persons. Astute observation and integration of findings of extrahepatic symptoms, signs, and disease are often the first clues to underlying HCV infection.

Cutaneous symptoms or findings relevant to HCV infection manifest in 20-40% of patients presenting to dermatologists and in a significant percentage (15-20%) of general patients. HCV is suggested and must appear in the differential diagnosis of these patients to avoid missing this important but occult factor in clinical disease in the appropriate setting.

Extrahepatic manifestations of hepatitis C virus are numerous.[1] The most prevalent and most closely linked with HCV is essential mixed cryoglobulins with dermatologic, neurologic, renal, and rheumatologic complications. A less definite relationship to HCV is observed with systemic vasculitis, porphyria cutanea tarda, and the sicca syndromes.

HCV is a major public health problem because it causes chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC). HCV also induces extrahepatic manifestations such as mixed cryoglobulinemia, porphyria cutanea tarda, leukocytoclastic vasculitis, lichen planus (LP), and sicca syndrome, all of which should be regarded as early markers of a potentially fatal chronic liver disease.[2]

Next Section: Pathophysiology Pathophysiology
Chronic hepatitis C infection is associated with many extrahepatic manifestations in joints, muscles, neural and gastrointestinal tissues, and skin. In this article, the many dermatologic manifestations of hepatitis C virus (HCV) are classified according to diseases with proven or suspected etiology or causation.

Helpful - 0
Avatar universal
Thanks
I will speak with GI and guess wait on next steps.
Maybe its just arthritis and just getting more mature...LOL
Helpful - 0
163305 tn?1333668571
Other than leg cramps that were associated with cirrhosis, I've never had those problems.
Most people with little to no liver damage also have little to no symptoms of the virus.
The most common symptom is fatigue.


You should talk to your doctor. You could have something else going on.
Helpful - 0
Avatar universal
Just wondering?
Hep C symptoms?
Does any one have pain in thier lower limbs... ?
I have sever pain in my lower legs and lower arms, exspecially in my feet they hurt so bad at night.  It so deep down like in the bone.
Any one else?
Helpful - 0
Avatar universal
Thanks everyone! I'm starting to understand now a little more. Now I know what questions to ask the GI doc when I go in a couple of weeks.
Helpful - 0
163305 tn?1333668571
Actually, Will has a point. People with little or no damage tend to do well with tx.

If it were me, and I had no or little damage to my liver, I'd wait for the new interferon free oral meds which won't be available outside of the trial setting, for several years.
That's what I would do, but I am not you.
Helpful - 0
Avatar universal
am wondering about the reactions to these medications.  What are they?
-----------------------------------------------
As orphanedhawk has mentioned above ,the side effects vary between everyone differently. Some people doing Peg/Riba experince only mild flu -like symptoms and others have more severe side effects. Most of these can be managed by your care giver however.

I would have a slightly different opinion than my friend orphanedhawk above "if no liver damage there is no reason to treat"

When and if one treats HCV is always a personal choice and always to be discussed with a doctor knowledgeable about HCV and it's treatments,and if there is currently minimal liver damage(fibrosis) then there certainly is no panic or rush to treat,however the virus,as well as causing some degree of liver damage in most people it  often causes extrahepatic problems,,meaning outside the liver for many ,especially the older  a person is.

Also it has been proven that patients treating with less liver fibrosis vs. more  do somewhat better in therapy as far as side effects and success.

Always to be discussed with your doctor on the right approach though....

Best..

Will

  
Helpful - 0
163305 tn?1333668571
f you do not already have cirrhosis, then doing interferon treatment which actually help your liver improve once you are undetected.

There are many possible side effects to the medications, not all experienced by everyone.

The truth is how long you've had hep C, genotype, viral load, have nothing whatsoever to do with whether or not you have liver damage. It is not a logical virus, affecting different people differently.
If you have no liver damage, there is no reason to do treatment.
Personally, I've found a liver specialist, hepatologist is preferable to a GI.

Good luck.
Helpful - 0
Avatar universal
Thank you, for the quick responses.  I am wondering about the reactions to these medications.  What are they?  
Im sure none of them outway cirrhosis.
Im looking forward to the support that seems to be here.
Helpful - 0
Avatar universal
Will is right, they don't always do a biopsy for 2B's, I think it is because they have such a good chance of reaching SVR, but don't really know why, just gussing on that.  My doctor told me I didn't have to have a biopsy, but I asked if i could so I could be armed with all the info I needed to make the best decision I could.
Helpful - 0
Avatar universal
You are off to a good start.  Getting a biopsy will most likely be one of the next steps.  I am also a 2b I am on Peg/Rib combo therapy for about 8 weeks now.  If you get a biopsy, this will tell you what shape your liver is in.  This will give you a better idea what your options are.

For 2 B's combo therapy is the Standard of Care (SOC) right now.  Combo therapy is Interferon and ribivarin.  Therapy is for 24 weeks.  If you do not have cirrhosis, your chances are pretty good of reaching Sustained Viral Response (SVR) which means they can't detect any viral count for 6 months after you complete treatment and this is considered a cure.  It's about 80% chance of reaching SVR for 2B's.   Even if you have cirrhosis, but it is still in the beginning stages of it (your liver is still functioning), you can still be cured, I think it just lowers your chances a bit, but not sure how much.

there are also other promising things most likely coming down the pipeline in a few years if you and your doctor decide you want to wait on treatment....although there are no promises on those things, they are still in clinical trials.

There are also clinical trials you could also try to get in, although clinical trials are kind of iffy, they haven't ironed out all the bugs yet, or can't guarentee any results, they are still collecting data on those who join the trials.
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Avatar universal
Can I be cured?  
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Yes.....Geno type 2 has excellent cure rates  (approx 80%) with the drug combo of Interferon & Ribavirin

The gastro may or may not decide to do a biopsy to ascertain how much liver damage (fibrosis) has occurred due to HCV and then a discussion with you about treating would be warranted.

Welcome to the group...
Will
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