concerning tx

[shamus8]

i am about to start program for hep c. i am 56, have hepc,cirhosis of the liver, 4th stage, neurapathy, diverticulitis. what am i to expect  

[HectorSF]

Hi. Welcome.

I assuming you are still compensated? No bloating of the abdomen, no vomiting blood or defecating blood. No confusion or stupor or coma due to hepatic encephalopathy. These are all complications of decompensated cirrhosis or what is called End-Stage Liver Disease. Are you being treated by a hepatologist? If you live in Foster City I would recommend you go to the liver transplant centers at either Stanford or here in San Francisco at UCSF. These doctor work every day with patients with degrees of cirrhosis caused by hepatitis.

Having cirrhosis makes treatment much more difficult. And the odds of success are much lower than for other people with less liver damage. You should have the best medical care available as treatment can be especially difficult for people with cirrhosis. You could have problems with not having enough platelets to get through treatment. You could suffer from severe anemia. Both of these condition may require helper drugs or transfusions in order for you to continue treatment. Only in a hospital setting do they has the resources to manage some of the complications you may experience. Some of these complications can cause treatment to be stopped short and you don't want that to happen if it can be avoided.  Plus you have other conditions and my be taking meds that will interact with the treatment drugs. So you case is more complicated then for many people. Since you have beginning cirrhosis you want to give yourself the best chance possible for curing the virus as possible. Once you do treatment with these drugs (NS3/4A protease inhibitors) you won't be able to repeat treatment due to resistance and will have to wait possibly a few years for new, different antiviral drugs to be available. During that time your cirrhosis could advance to the point where you will not be able to treat again with any drugs. Then you only option will be to wait for a transplant. So again I want to be clear that it is very important to give yourself the best care possible since you will need to treat for 48 weeks. That is a long term commitment. The best treatment available is from hepatologists that work at the transplant centers at Stanford and UCSF. (I have had my cirrhosis managed at UCSF for 4 years now and am now list for liver transplant there).

I have been in your position in 2008 and failed treatment. Since that time I have developed End-Stage Liver Disease (ESLD) and liver cancer (HCC) and will need a transplant within the next year or two to continue living. You DON"T want this to happen to you! You still have the option to cure your hepatitis C and prevent further damage to your liver. You should understand the the decision you make about treatment could have life long consequences. Please don't make this choice without a lot of though before hand.

Best of luck to you!
Hector

[pooh55811]

Welcom to the forum.

Can you tell us what Genotype you have and what type of treatment you will be doing (triple med treatment or Interferon and Ribavirin). The meds have different side effects so it helps to know which meds you will be taking. Also, the side effects affect people differently.

I don't know much about cirrhosis and how treatment affects people with cirrhosis, but there are several people on this forum who have cirrhosis and who will probably respond to your post.

[flcyclist]

A few additional factors that will affect the predicted outcome of trt such as the viral genotype and your IL28B genotype would be helpful to know if you are asking about the predicted % SVR.  

Or are you asking about what to expect in general regarding side effects, etc.?