This is the latst from CCO . based on patient profiles. In this case it is recommended he get frequent HCC screening,however I have never read anything about screening for St patiens if they had eradicated the virus sussefully..God to see you Eric.. all the best
Will
Patient Case: Posttreatment Monitoring of Patients
The patient is a 56-year-old white male with genotype 1a HCV infection. A previous liver biopsy in 2009 revealed stage 3 bridging fibrosis. Laboratory findings are as follows: AST is 56 U/L, ALT is 47 U/L, total bilirubin is 0.8 mg/dL, albumin is 3.9 g/dL, prothrombin time 7.8 seconds, white blood cell count of 3.4 x 103 cells/μL, hemoglobin is 11.6 g/dL, and platelet count is 112,000 cells/μL. He is treated with telaprevir-based therapy for 12 weeks followed by peginterferon/ribavirin to Week 24, at which point he declined further therapy. HCV RNA is undetectable at treatment cessation and remains undetectable 24 weeks later.
How will the patient need to be followed in the coming years?
Analysis by Donald M. Jensen, MD:
HCC surveillance should be performed every 6 months for the remainder of this patient’s life. It is likely that this patient has cirrhosis based on his AST:ALT ratio and the presence of thrombocytopenia. The 2009 biopsy probably underestimated his degree of fibrosis, which is not uncommon. According to AASLD guidelines,[2] he should have received 48 total weeks of treatment, but he did respond successfully to 24 weeks. Patients with cirrhosis require continued surveillance for HCC since the risk persists, albeit reduced.[19] The risk of hemorrhage from esophageal varices, however, is nonexistent following SVR, and endoscopic surveillance for these is not necessary.[37]
Thanks for the welcome! I guess we need the rain, so it's not all bad.
Sold the boat. It's too shallow for a cruising sailboat on the west coast. Some people do have them, but it's not great sailing and my wife is tired of it. Thanks for asking though. I hope all is well with you.
I have already been in a Telaprevir (which is Incivek), trial, back in 2007. At that time, I was exposed to the Telaprevir, but I was randomized into the "NO RIBA" group. So all I go was Telaprevir and Peg. I had a big drop in my viral load initially, but since there was no Riba in the mix, I had breakthrough and my viral load went back up, rebounded quickly at week 3. I was kicked out of the trial due to non-response by week 5. Since I've been exposed to Telaprevir, no other doctors (including Schiff), want me to do another treatment with any drugs in that same class. In other words that don't want me retreating with Telaprevir(Incivek) or Boceprevir(Victrelis), due to the previous exposure to Telap and resistance... None of the new trials for all orals have had a spot for a null responder/Telaprevir failure patient (who didn't get all 3 drugs). So, that why I'm not doing any treatments. I've already done 11 treatments in my HCV life (4 TX's were trials), 1 TX was a maintenance dosing regiment, all the rest of the 6 TX's were full scheduled TX's with normal dosing or double dosing. My last bio #5 showed about a stage 2 no bridging - which went along with that fibroscan that was done down there by Schiff last year. But, Bio#3 and Bio#4 showed bridging fibrosis. When I had a baseline upper endoscopy, my esophagus was free of varices (a good thing). I think my GI is just monitoring me for liver cancer-just to be safe. Susan400
Nothing to add to the good advice given above, but just wanted to welcome you to the Sunshine State. Think it should be renamed to the Rainy State with the amount of rain falling recently. Hope you're happy with your GI.
How nice to see you here.
How's the boat ?
After I get my 6 month SVR in September I will not be doing cancer screening.
My reasoning is that nobody in my close family has had cancer and even more important, despite being close to dying from ESLD, I never developed liver cancer. Genetically I believe I am not predisposed to the the big C.
Most doctors make decisions based on graphs and statistics, not on individuals. Our doctors are our guides. Ultimately our health decisions are ours to make.
I'm moving forward away from fretting over my health:)
Wishing you the best~
OH