What does this mean?

[hcvJames]

This is a quote pulled from some web site .. " In patients with hepatitis B or C, the five-year survival rate after a diagnosis of cirrhosis ranges between 71% to 85%." What happens after 5 years? This is kinda dumb but I badly misinterpreted a quote about the seriousness of Hep C a year before starting treatment. Assuming eventual SVR with all other things being equal ..

Once UND does cirrhosis stop? slowdown? Guess I'm asking, we know HCV causes cirrhosis but once created does it become a separate entity?

Does cirrhosis stop after SVR?

With liver damage just short of decompensation how does it affect longevity even if cirrhosis stopped?  Simpler, with little left to do all the work will it wear out faster than otherwise?

Thanks you guys are great.

[eureka254]

PS:  When my husband first started treatment he was considered a well-compensated cirrhotic, and I had held out hope that he might be one who could improve stage if he were to SVR.  Although he HAS reached undetected, it has not kept him well-compensated. I've resigned myself to the fact that for him, if he WERE to svr, it may jelp to slow down or halt further decompensation, but perhaps not much more; and though miracles do happen, I do not have high expectations for reversal of stage at this point.

[Trinity4]

Exactly what I was trying to say eureka254.  Thank you for keeping it real.  

[eureka254]

As SVR rates improve and larger hcv-undetected post-treatment populations can be observed, more and more evidence seems to bear out that cirrhosis can be a reversible condition in those who SVR.  The unfortunate flip side of the that data is that 1/4 to 1/5 of cirrhotics will not make it to that 5-year mark after diagnosis, hcv or svr not withstanding.

My belief is that there comes a point in cirrhosis when liver damage hits "critical mass."  Decompensation is one of those points, but there appears to be some other earlier 'point of no return.'  There is apparently a population of folks with compensated cirrhosis who do not improve in Stage even after SVR.  Furthermore, research over the years on maintenance therapy and achieving undetected status in the non-SVR group seems to indicate that undetected viral load in blood has little significant impact, if any, on liver disease progression.   All of which I feel is compelling information for hcv folks with progressing liver damage to treat sooner rather than later (and for Stage 4 folks to go all out if possible).  ~eureka

[portann]

Good stuff about Schiffman's recent study AND your biopsy results. :):):):):):)

Experiences like yours make it real that others may go that route, too.

Susan

[Trinity4]

There are studies that also indicate even with SVR some will not experience improved liver histology and in some cases advancement to cirrhosis has occured.  It's not common, but it does happen.

[newleaf10]

There was a study published last year that gave figures on regression of fibrosis after SVR.  It was presented by Mitchell Schiffman.  It found that while a few cirrhotics remained unchanged, most patients (all stages of damage) regress about 2 stages within 4-5 yrs (that was the time span between the biopsies they did).  10% of cirrhotics regressed to 0 damage.  Of course this is assuming that the HCV was the only thing damaging the liver and you don't add something else like overuse of alcohol or other toxins after SVR to keep the damage occurring.  
I started TX at 3/4 (compensated cirrhosis), SVR'd, had a biopsy 12 mos. after stopping the TX meds and was rated 1/2 with a few features of 3.  Looks like I will be one of the lucky 10% and I expect to have a completely normal liver within the next year or 2.

[hcvJames]

It certainly does help. Thank you so much.

[HectorSF]

In patients with hepatitis B or C, the five-year survival rate after a diagnosis of cirrhosis ranges between 71% to 85%. What happens after 5 years?

For the patients who remain stable they remain so. While the percent that decompensates has a limited life expectancy.
Survival rates for patients with compensated liver function and HCV remain quite high over a 10‑year period. By contrast, once a complication occurrs, the survival dropped off dramatically, such that the survival rate is only 50% at 5 years. Therefore, the onset of any decompensating event is clearly an ominous sign for patients with HCV‑related cirrhosis.

Once UND AND SVR does cirrhosis stop?
The progression usually stops. There is nothing left to cause progression of the disease at that point.

Does cirrhosis stop after SVR?
Progression stops.

With liver damage just short of decompensation how does it affect longevity even if cirrhosis stopped?  

Once cure has occurred, the liver has the potential to return to completely normal functioning, which happens in a majority of patients. You don't need all of your liver for it to maintain its functioning. Compensated cirrhotics may have have no symptoms at all. That is way a biopsy is needed to access the true condition of the liver. Even in people with pretty severe cirrhosis, if the medications cure the HCV, the liver scarring improves and the risk of future liver failure is reduced.

But the increase chance of HCC (liver cancer) continue. So monitoring for HCC must continue for the rest of a cirrhotic's life.

Hope this helps.
Hectorsf