Is it possible to improve liver fibrosis without HCV treatment?

[Serg67]

Hi all!

I think this is interesting question. If I correctly understand, two studies have found that liver fibrosis is improved spontaneously in a nearly one quarter of HCV-infected patients (http://www.cghjournal.org/article/S1542-3565(06)00497-6/fulltext and http://www.gastrojournal.org/article/S0016-5085(03)50023-3/fulltext).

Furthermore, three month weight reduction programm improved liver fibrosis by 1-3 stage in 5 of 10 HCV-infected patients in this small study - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773265/

What do you think about this?

Best to all,
Serg.

[Serg67]

Yes, if we have cirrhosis or fibrosis 3 and we have not contraindications - it seems, it is better to recieve modern interferon-free therapy (with Harvoni e t.c.). In cases with fibrosis 0-2, in my opinion, it is not so obvious.

Good luck in your HCV therapy!

[Serg67]

If i correctly understand, if we achieve SVR using treatment, this doesn't automatically mean that we "completely free from virus". Some studies found that up to 80% of patients with interferon-induced SVR still have HCV virus in small concentrations, detectable by very sensitive analysis. But, undoubtedly, SVR is a good prognostic sign and SVR is repeatedly associated with prolonged survival.

Modern interferon-free treatments looks much safer with high SVR percent, and, it seems, it is good option for cases with cirrhosis and fibrosis 3, but these treatments still not accessible for people in many countries due to high price.

For people with fibrosis 0-2, taking in account noncomplete evidence base of antiviral therapy and relatively small expirience with these therapy, in my opinion, at this moment, the decision is not so obvious, especially if interferon-free treatment does not covered by insurance.

Good luck, hope you will achieve SVR!

[Serg67]

I agree. If you have cirrhosis with portal hypertension, it seems, interferon-free modern antiviral therapy is the best option. Whether weight reduction may be useful in such serious case - this requires opinions of good hepatologists...

Good luck with Harvoni therapy!

[hepcandme]

The damage done to my liver was caused by Hep C. People like me with cirrhosis face a shorter lifespan without treatment and lots of side effects. So many, in fact, that it is difficult to discern whether the virus or the cirrhosis is causing them

And the symptoms of cirrhosis are very difficult to live with - especially as the virus continues it attack on one's liver and other vital organs

So, I would treat even if I did not have advanced liver disease because once the virus kicks in - sometimes decades later - it just continues its relentless attack

Better to not count on a spontaneous remission, in my opinion

[patra_]

And they would still have hepc.  Treatments now, without interferon, surley are worth the time and trouble.  Take those, eat a liver friendly diet, and lose weight and, hopefully,  we are talking a win-win-win situation!  

At any rate we are talking improvement!  Also, don't forget exercise, in the mixture.

[flyinlynn]

I doubt as I have cirrhosis this would apply in my case

[Serg67]

The doctors sometimes tell us, something like that: "if you have HCV, your liver fibrosis may only progress, and the оnly way to improve fibrosis (or to stop progression of fibrosis) - to achieve SVR using antiviral treatment." I think, if fibrosis may improve spontaneously (as well as after weight reduction) - this is not completely true.

Moreover, for many people, perhaps, fibrosis improvement after therapy may be attributable to their weight reduction on anti-HCV therapy instead of antiviral effect (people often lose their weight on therapy).

If weight reduction works in terms of improving fibrosis, possibly, some people may replace expensive, not safest, and not well-studied anti-HCV therapy by well-balanced weight reduction program.

[AWorriedMom]

I didn't read the studies but can see where fibrosis may improve without treatment if there are other reasons for the scar tissue along with the virus. For example if the person has fatty liver and improves his eating habits, he may get an improvement. The problem is that it is hard to prove because none of the fibrosis measures, including biopsy, are perfect. But, it is an interesting point. What do you think?