Is InterferonTx. needful at any stage?

[AuntieD56]

I just had my physical and my labs are fantastic! Liver function is high normal, I've had Hep C for 7 years and only in the last year did my viral load increase from 40,000 to 1,000,000. Hwy? I don't drink smoke, take drugs, my diet is mostly organic vegetarian w very occasion fish or chicken. Hate eating flesh! My cholesteral is 137. 95 Hdl ,ldl 35, trigly. 35 vit D 39. All good. Is it really in my best interest to have the Interferon/ribavirin now? My husband had a kidney transplant this year & is finally off dialysis. That took a huge physical & emotional toll on me, but I'm recovering. But knowing his transplant will only be good for 5-7 yrs. I guess I should treat myself before he gets sick again. I'm also a caregiver to 2 seniors, with serious health health pboblems and they urge me to treat now before they get too sick also. Feedback please??? I'm so scared of being sick from the interferon. I know I'm lucky to have type 3. I feel so healthy! I', 56 years old 122 lbs. Been losing weight but I think it's because often I can't eat because I get so constipated.I'm so sorry for the many non-responders. I feel like a wimp just crying because I'm scared when my type has such a good response rate.I've always had such bad experiences with traditional healthcate txs and all my husband horrible health problems, some created by drugs that were supposed to help. I read Roches info on Interferon and it's not w/out risk. It's carcinogenic -I know so can hep C. They didn't do a biopsy given my numbers & history. Thought it unneccesary. Help please? Any opinions?

[Advocate1955]

I think the liver biopsies were more stressful for me than for my husband.  He had one in 2007, and I was able to be in the procedure room and watch.  It was an ultrasound guided procedure with a small incision in the upper abdominal area.  It was painless for him, and he was somewhat sedated because he was snoring through it, but could answer questions when they asked him questions.  The second one, I stayed in the hospital room, they whisked him out and whisked him back in less than 20 min, and he slept on one side for the next 4 hours or so.  He may have had some mild shoulder pain after the second one, but nothing major.  Every procedure has risks, but not getting a liver biopsy and not knowing how much damage the virus is causing is a bigger risk, in my humble opinion.
Advocate1955

[screaming48]

The biopsy was the easy part the worrying before was the killer. I wasn't even sore after the procedure, and I gained 10 lbs so far on treatment I don't know if its the fried thyroid or what but everyone responds differently. good luck

[curiouslady1]

There are other options to biopsy and one of them is a fibrotest using lab values from other tests.  I would say, given your age and circumstances, you will want to follow your physician's advice on the best course to take with assessment and treatment.

We are at a crossroads in the field of HepC research.  New treatments have just been beginning to appear on the market and newer still treatments are appearing in trials.  Those with GT 3 are having tremendous success with very mild oral drugs which have few if any side effects.  But these are still investigational drugs which are not approved for public use at this time.  The trials should be completing in another couple years with the likelhood of approval soon after.  Given your advanced age (I am 64 and in an oral trial at this time) you may want to discuss with your doctor the pros and cons of waiting for approved treatments which are easier on your system than interferon might be.   I waited for 40 years.  

[jules2551]

As all of the above said you need to get a liver biopsy to find out what condition your liver really is.  I had one before Xmas and it didn't hurt.  They give you medication and it's over before you know it.  The next day I wasn't even really sore.  Just the waiting for test results was the worst part.  Mine was Grade 2 Stage 3.  So basically I need to treat sooner than later.  You are probably in a totally different situation.  Dr told me I have probably had Hep C for 30 yrs.  I am 49 now.  Also G1B.

So call your Hepa Dr and ask him for a biopsy.  Nothing to be afraid of.  I have always said that a mammogram is 100X worse!

Good luck to you!!!

Jules

[1oftheclub222]

My Biopsy was no big deal at all.  It is a needle biopsy, sometimes they go into the side of you by your liver, on mine they went in right under my ribcage on the front of my stomache.  they gave me something to mellow me out and something to numb me.  it was over in just a few minutes, all the prep took way longer!  After, I layed down for about 2 or 3 hrs, then went home.  Just felt like I did a few to many situps.  didn't lift anything heavy for a few days, not a big deal at all, I was at work the next day.

As far as the weight, I only weigh about 120 myself, I hope I don't lose too much weight, can't really afford to...but I can see how I wouldn't want to eat after drinking all this water, ha....32 oz down...at least 32 more to go, but full already!

[pooh55811]

Here are a couple of sites that tell you more about the liver biopsy procedure:

http://www.uptodate.com/contents/patient-information-liver-biopsy?source=see_link

http://www.mayoclinic.com/health/liver-biopsy/MY00949/METHOD=print&DSECTION=all

http://www.gicare.com/endoscopy-center/liver-biopsy.aspx

[AuntieD56]

Thank you all for your really good advice and encouragement! It's much appreciated! Actually my hepatologist did at first recomend a biopsy and the second visit seemed to think it not so neccesay but didn't explain -probably in response to my reluctance, but I',m hearing all of you and it does seem best. What exactly do they do for the biopsy? Is it through the artey in the neck? What are the risks (i know all procedures have some)? I remember my husband having his, but his was special circumstances. I'm honored that you have shared your experiences! Thank you! I'm going to read the thread on the new oral drugs. I've heard that if you have a lower viral load you can have a better response rate. I'm taking Milk thistle, Alpha Lipoic acid, selenium, whey to boost glutathione levels, etc. Is it pretty common to lose 20 lbs or more during tx w/ Interferon? Am I doing right to try to gain some healthy weight so I'll have some to lose, do you guys think?( I do understand we're just sharing experiences here  and that's so great!?) I do have to think about being older in 2015 if I wait for the oral meds. and my "patients" getting sicker. Then where will I be? Tough call. i pray you will all find remission and great health and the ability to really enjoy your lives!!. Surely God created us all for wonderful things! Hippy Hal, God bless you, all these years living with this virus and you have a great attitude -AttaBoy!

[pooh55811]

I am not sure if you mean you contracted Hep C 7 years ago or if you were diagnosed 7 years ago. If you were diagnosed 7 years ago, you may have had Hep C a lot longer than 7 years. On the other hand, if you know for sure that you actually contracted Hep C  7 years ago, then you know how long you have had it.

Liver enzymes do not necessarily tell you how bad your Hep C is and how much liver damage you have. Granted, if the liver enzymes are up, something is wrong someplace, but the enzymes may be relatively normal even with significant liver damage and liver enzymes can elevate for other reasons.

My liver funtion tests have gone up and down for years although I was never diagnosed with Hep C until July 2011. Two years ago my liver function tests  (ALT) were only very, very slightly elevated. Last year the ALT was 90. My AST was high normal. I was diagnosed with Hep C after they did a Hep Panel. When I had a liver biopsy, the results showed Grade 2, Stage 2 (out of 4 stages). I believe I have read on the forum that the first sign a couple people have had were elevated liver enzymes and yet, by the time their enzymes were elevated, they had already progressed to cirrhosis. My point is, the liver enzymes may not be elevated even though the Hep C virus is busy doing damage to the liver and they are not necessarily a good indicator of  the severity of liver damage.

I think if I were you, I would ask to see a Gastroenterologist or Hepatologist (if your own doc is not a specialist) to help with diagnosis and treatment decisions. I would also ask your doctor (hopefully a GI or Hepatologist) to do more tests to get a better idea of how much liver damage you actually have. The liver biopsy is the gold standard for measuring liver damage. There are some other tests that may also help determine the extent of damage but are not as definitive as the biopsy. For instance, I had a liver ultrasound which was perfectly normal. Yet, you can see that I was already Grade 2, Stage 2. If you get more definitive tests, you will be able to make a more informed decision on whether to treat now or later. One thing to keep in mind, is tha it is easier to treat people with less liver damage than to treat those with more extensive liver damge.

Personally, if I had known I had Hep C many years ago (I have had it 30-35 years) and if there had been an effective treatment at the time, I would have treated years and years ago. Now I am 66 years old and have Grade 2, Stage 2 on the biopsy. I also have a high viral count and I am heavier in weight. The older age, the extra weight, and the high viral count all may negatively affect my chances of SVR. Had I treated in the 90s when I weighed 120 pounds and was 15 or so years younger, maybe my chances would have been better. In addition, Hep C is not benign even if the enzymes are normal. Hep C can cause other body ailments whether the liver is showing any signs of damage or not. (For instance, I had systemic vasculitis in 1994 and that was most probably from the Hep C although no one knew it then.) I am treating now (triple med therapy) and have been undetected since week 8. The Incivek was the worst of the drugs for side effects. Now that I am on Riba and Interferon, it is much easier.

There are some very knowledgeable people on the forum and hopefully they will post and give you more information.

In the end, it is your decision (along with your doctor who is hopefully a knowldgeable specialist in treating Hep C).

[orphanedhawk]

Unfortunately hep C can cause great liver damage to active people living a healthy lifestyle who have no idea they're sick.
It happened to me.

There are also people who can live their whole lives with hep C and have no liver problems.

Viral loads fluctuate and don't have anything to do with liver damage.

Only a biopsy can show how much of little damage is present.

If your liver is in good shape then there is no reason to rush into treatment.
There is strong reason to think less problematic, interferon free treatments will be available in the future.

[Advocate1955]

I agree with nowhine and 1oftheclub222.  I would recommend that you push for a liver biopsy, so that you know the health of your liver.  My husband progressed from f1-2 (mild fibrosis) to f4 (cirrhosis) in 3 years.  He had no symptoms.
Advocate1955

[fretboard]

You have to ask for a liver biopsy, it has never been offered to anyone I know of  It costs alot of money so doctor's just aren't gonna say, oh let's send you for a liver bx even though it is the gold standard.  Plus you may want to see a Gastro or Heptologist doctor, someone who specializes in the liver and HepC.  Most of the time when your ALT and AST is high and continues to be high then your body is being taken over by HepC and it's just a matter of time before the problems start.  Nobody here will come out and tell you to tx.  We are not doctors and I am merely sharing an opinion.  Get a liver biopsy, that's the only way to see how bad or how well your liver is doing against the HepC.  The HepC could be beating down your liver to death and you wouldn't even feel it.  Just being real here.  
good luck

[HippyHal]

I think only your Dr. should give you that kind of advise ultimately, and you mention a Hep C type with good response rate.. and maybe you will be one of the lucky short timers!.. but since you asked :) if I was in that good of shape physically, and they were monitoring my liver closely, I might be tempted to wait for some of the new "non interferon" treatments that appear to be on the horizon for approval (2015?)  Reference the Bristol Meyer Squibb thread..  Sounds like you have had a lot on your plate.. with more potentially on the way, so ultimately it is going to be your call..  I will say that having done interferon twice (once at 45, now at 60..) it was easier when I was younger!  (but what isn't?)

I am 60 and have lived fairly normally with HCV since I was 10 when I got a transfusion from a botched tonsillectomy..  I am much further down the trail than you, but if this triple I am on now is not successful, I will not do interferon again and will wait for the new treatments that are on the horizon (God willing)

Good luck, try not to stress..  enjoy life. It is the best reward!

[1oftheclub222]

Seems like a biopsy would really give you the best answer, cause then you will know for sure where your liver is at and how long you have to make a decision.  The thing about this disease is that most of the time a bad liver doesn't present any outward symptoms until it's too late.  You may feel the same if you have no liver damage or stage 3 liver damage.

[nowhine]

It would be difficult to give an opinion on whether to treat or not without a biopsy. It would appear your doc would have the same opinion. But assuming you have little or no fibrosis and g3 you may consider waiting for the new all oral meds as they are having much success with g3. Also no interferon and fewer sx. Best of luck.