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Avatar universal

stages of cirrhosis

My fiance was diagnosed with Hep C last year and cirrhosis stage 4. We have no medical insurance and the doctor's he has seen have done nothing for him. They don't offer any treatments and don't answer questions. We are very frustrated. He sees a new doctor next week.

My question is: What are the stages of cirrhosis? At what stage will he need a transplant?

My real question is: how much time does he have left?

I am scared and frustrated. Any help you can offer would be deeply appreciated.
21 Responses
29084 tn?1283659640
Sorry to hear your situation ... my advice to you is <b>definately</b> get a better doctor preferrably a dr that knows Hep-C ... He would quite possibly be suitable for Interferon + Ribavirin treatment .... I personaly know a woman who is 60 & has cirrosis she had geno 1b did 12 months of treatment & is now successfully cured of Hep-C, she's so happy. You are on a good site here hamie there is plenty of great people here that will offer you support, thats for sure ... good luck & maybe let us know on the forum here when he see's a decent dr....</font>
<br><hr><P><marquee direction="right"><Font face="Brush Script MT"size=+3<b>Steve</b></font></marquee><br>
Avatar universal
Hamie:

I just saw an excellent post on another message board that explains levels of cirrhosis.  The link is http://boards.health.msn.com/message.asp?message_id=5254829 (Can some one tell me how to create an actual hyperlink - do you just use regular html tags?)  I will also paste the information below because the person who posted this did such an excellent job:


When someone has hepatitis, and the doctor says that you're end stage (hepatitis)---------that's totally different than end stage cirrhosis.

Here's what I mean.

Hepatitis has four stages
(Stage 1, Stage 2, Stage 3, Stage 4).
The last stage of HEPATITIS (the 4th stage of hepatitis)......is cirrhosis.

THEN----Cirrhosis has three stages.
(Stage A, Stage B, Stage C.)

In other words-----You could look at it like this. Here's the order that the stages would go:

Stage 1 Hepatitis- is not cirrhosis

Stage 2 Hepatitis- is not cirrhosis

Stage 3 Hepatitis- is not cirrhosis yet

Stage 4 Hepatitis- is the beginning of cirrhosis

Stage A Cirrhosis- is compensated Cirrhosis (liver is still doing it's job)

Stage B Cirrhosis- is the start of decompensated cirrhosis ("decompensated" means that complications like ascites, encephalopathy, varices, are beginning to happen)

Stage C Cirrhosis- is decompensated, end stage cirrhosis

A person has to be at least Stage B or Stage C cirrhosis, to get "evaluated" for the liver transplant waiting list.

In other words------

Here's two very important things to keep in mind:

Hepatitis has 4 stages (stage 1, stage 2, stage 3, stage 4).......the 4th stage of hepatitis is "cirrhosis". Many people refer to stage 4 hepatitis as "end stage". (But you need to keep in mind that stage 4 hepatitis is just the BEGINNING of cirrhosis)

THEN

Cirrhosis has 3 stages (stage A, stage B, stage C)

stage A cirrhosis = compensated cirrhosis
stage B cirrhosis = beginning to decompensate
stage C cirrhosis = decompensated cirrhosis (end stage cirrhosis)


Stage A cirrhosis (compensated cirrhosis) means that the liver is still doing enough of it's job.....to keep you relatively well. No "complications" happening.

Stage B cirrhosis (beginning of decompensation) means that "complications" are beginning to appear. Examples of "complications" are ascites, or varices, or encephalopathy.

Stage C cirrhosis (decompensated cirrhosis) means that the liver is not able to do it's job......."complications" (ascites, varices, encephalopathy) are worsening.

Doctors use a CTP Scorecard to determine what stage of cirrhosis that a person is in. The CTP Score is based on 5 questions (and gives you a point value for each of your answers).
CTP scores range from 5 to 15.
A person must have at least a CTP score of 7 or higher, in order to get referred to a liver transplant center for an Evaluation.

The evaluation is a series of tests and interviews, to see if a person is a good candidate for transplant.

If a person passes their Evaluation, they are placed on the liver transplant waiting list.


Once a person is on the Waiting List......another scoring system is used (MELD score). The MELD Score is for donor liver allocation. (Used to see who gets the next available liver)
Avatar universal
Just thought I would drop in and say hi. Doing my no.3 today , feeling well,it's kinda wierd I notice myself looking forward to shot, like i'm on my way counting down ...yea! Also going to get my blood work, thats kinda exciting also. I am really happy I decided I started  my tx. it's not that bad, so far....and I just feel that I'm going to beat this evil dragon. I am geno type 1a , and I know the good Lord is right with me all the way .I hope every one is well today .I"M praying for all of us.       JILL
Avatar universal
Thank you so much for the information.  My husband will be starting Tx next week and we are both on overload learning everything we can to find out how to beat this.  

He is a 1a with 16 million viral load, ALT at 1096 and AST at 474.  His doctor said that he is a Stage 2 inflammation and Grade 3 fibrosis.  

Does this mean he is stage 2 or 3 regarding that chart you posted?  His doctor also said he noted scarring.  

Thank you,
Lori
Avatar universal
From the way I read the chart, and from my general understanding, it sounds like he is Stage 3, so he has considerable scarring, but he does not yet have cirrhosis; he is one step before cirrhosis.  Grade usually refers to amount of inflammation on a scale of 0 to 4, so he has moderate inflammation.  It seems to me like you are treating just in time so he doesn't progress to cirrhosis.  Hopefully the reports of fibrosis being reversable are true (maybe even cirrhosis), and your husband, and all of us, will beat this thing and our livers will heal themselves.  I wish you and your husband all the best with treatment!!
Avatar universal
Thank you G.  He's actually looking forward to starting Tx.  He's been a lurker here and reading everyone's posts and determined to slay the dragon.  He's usually a pretty pessimistic type person so I hope he rides this wave of enthusiasism till the end.  

But now that he's made up his mind he wants to start immediately.  I told him he should wait till after the holidays but...  Also, he doesn't know what he should tell our 14 year old son.  He thinks he got it from drug use about 35 years ago.  During a night of merriment, which he never did again.  But how do you tell a teenager???

Lori
Avatar universal
Once you make up your mind to start tx it's hard to wait. The anxiety is often worse than the actual start. It would be nice to wait until after the holidays but if that's going to make him too anxious it'll just be another problem. I couldn't wait to start then weanted to do a shot everyday. Many people just want to get it over with, the faster the better. I think I also got it experiencing with drugs as a teen but there are other ways that you can get this. Many in fact. I also was in the inocculatins lines in the Army when this was a issue and I've had surgery more than my share of times. I didn't tell my child I did heavy drugs I just explained the ways one could get it including as many ways as I could think of and said I just can't be sure exactly where it came from and there are many people who can't. I worried about it more that needed. There was never really any questions asked about that it was more questions if and when I will be ok. LL
Avatar universal
Thanks for the advice.  That's pretty smart.  Your right, I don't think our son will care how but when will Dad get better.  It's amazing how people want to "know" how you got it when you tell them.  Isn't it bad enough that you have it??  What does it matter.

I told my boss that my husband has HepC in case I need to run home or cover him in taking our son back and forth to school and that was the first thing he asked... "how did he get it?"  I should have said, "It doesn't matter.  He just has it."

Lori
Avatar universal
Your husband is lucky to have you working through this with him. Since you're reading this board, you'll have a much better idea of the things he might be experiencing.
My thought is that if you tell your 14-year old the whole variety of ways in which HVC can be caught, it might give you a chance to point out that this is yet another reason not to fool around with drugs... without revealing your suspicions about where your husband contracted it.   Maj Neni
Avatar universal
My mother has hepC the hospital she goes to she gets a new intern every 6 months.Recently she was told she is in the last stages of corrhosis.Last visit I ask if corrhosis turns in to cancer he seemed confused by the question and never did answer.Im not sure if he did understand me or he just didnt know. .....1) Any helpful tips on getting an answer 2) does anyone know the answer?
Avatar universal
Of every 100 persons infected with HCV about:

55%-85% of persons may develop long-term infection

70 persons may develop chronic liver disease

5-20 persons may develop cirrhosis over a period of 20 to 30 years

1%-5% of persons may die from the consequences of long term infection (liver cancer or cirrhosis)

Hepatitis C is a leading indication for liver transplants.

so you see cancer only develops in a small %. by the way did you know that this thread was from 2003? it might be better for you to start a new post for more up to date info.

229903 tn?1191086451
My husband was diagnosed with early cirrhosis - genotype 1 a.  He completed treatment last year and is SVR (which means cured).  He actually treated twice but didn't finish the first treatment.  The first time he didn't have prescription coverage and the drugs to treat hep c are very expensive.  I mention this because the drug companies have very generous plans where they will provide all your medicine for free.  We were afraid our income would be too high, but they had very lenient guidelines.  
If you go to a good hepatologist he could probably point you in the right direction.  By the way, I hope this new doctor deals with a lot of hep C patients.  Our first doctor was a gastroenterologist and I don't think he had a lot of experience with hep c patients and he ended up taking my husband off treatment for side effects that I have since learned are quite common.  He also never offered any treatment for any of the side effects.  If your fiance goes to a hepatologist he would probably get better treatment.  So, if you have any choice in the matter, I would choose a hepatologist if there are any in your area.  It's so worth it!
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