Aa
therapy
My last biopsy was 2 years ago and i was f2, since then my liver enzymes have increased and doc said i probably
advanced to F3 or early cirhosis,because my platelets have dropped some but are still at the low end of normal.
I am very versed on the disease and being in the medical field does not make it any easier to treat or not to treat.
I am very aware that the disease marches over decades and i have had hep c for about 30 years. Thanks for
all the input.
advanced to F3 or early cirhosis,because my platelets have dropped some but are still at the low end of normal.
I am very versed on the disease and being in the medical field does not make it any easier to treat or not to treat.
I am very aware that the disease marches over decades and i have had hep c for about 30 years. Thanks for
all the input.
Here is some info on progression of hepatitis C induced liver disease.
"Fibrosis and Disease Progression in Hepatitis C"
http://www.hawaii.edu/hivandaids/Fibrosis%20And%20Disease%20Progression%20In%20Hepatitis%20C.pdf
"In the majority of patients with chronic hepatitis C, the progression of fibrosis is insidious and slow. Only a minority of patients has rapid progression of fibrosis with early development of cirrhosis. Current knowledge on the factors that are responsible and that correlate with more
rapid progression of fibrosis is limited, because it is based largely on cross-sectional studies using mathematical modeling and on a few, small scale prospective or retrospective longitudinal studies of changes in hepatic fibrosis. Carefully conducted prospective studies on untreated
patients, mainly patients with mild disease in whom therapy is not indicated, are needed to validate the current hypothesis on the progression of fibrosis. The mechanisms and factors associated with progression of fibrosis are poorly understood. Older age, male gender, excessive alcohol consumption, overweight, and immune deficiency are associated with more rapid progression of fibrosis. Therefore, counseling of patients should include abstinence from alcohol or minimal, occasional
consumption and dietary measures to reduce overweight and metabolic disorders.
The progression of fibrosis is difficult to predict in the individual patient particularly based on assessment at one point in time. Serial serum ALT levels, grade of activity, and stage of fibrosis are the main predictors of progression of fibrosis. However, the overall predictive value of these
characteristics is relatively weak and the progression of fibrosis is difficult to predict in the individual patient. The liver biopsy remains the best method to assess fibrosis and is valuable in determining prognosis and aiding in the decision for or against therapy. In untreated patients, regular
ALT measurements are useful, and repeat liver biopsy is the only reliable means of assessing the progression of fibrosis and is commonly recommended every 3 to 5 years in untreated patients. A second liver biopsy can distinguish patients with rapidly progressive fibrosis, but may
also merely indicate that the initial biopsy underestimated the degree of fibrosis. Overall, the risk of progression of fibrosis of more than 1 point in a 3- to 5-year period is low. In patients with factors associated with a higher risk of progression, such as age above 50 years, excessive alcohol
consumption, or high serum ALT levels, liver biopsy may be recommended more frequently (every 2 to 3 years); in contrast, in the younger patient with no other risk factor, the liver biopsies may be performed less frequently (every 5 to 10 years)."
--------------------------------------------------------------------------------------------------------
What factors predict hepatitis C disease progression?
* Excessive alcohol consumption (past and present) is strongly associated with a poor prognosis and progression to severe liver complications.
* Progression to cirrhosis is higher in people that continue to drink regularly.
* Past heavy consumption (more than 50 units per week for more than 5 years) is associated with faster progression to cirrhosis.
* Age at infection. People who are infected at an older age have a more rapidly progressing disease and reduced time from infection to cirrhosis.
* Gender. Men are more likely to progress to cirrhosis than women.
* Ethnicity may affect prognosis.
- Progression of chronic disease may be less rapid in black people.
- Asian people may have more rapid progression to cirrhosis.
* Co-infection with HIV, hepatitis B, and/or hepatitis A causes a more rapid progression to serious disease.
* Weight. Body mass index greater than 25 kg/m2 is associated with an increased risk of hepatic steatosis and disease progression.
Smoking is an independent risk factor for hepatic inflammation.
Hector
"Fibrosis and Disease Progression in Hepatitis C"
http://www.hawaii.edu/hivandaids/Fibrosis%20And%20Disease%20Progression%20In%20Hepatitis%20C.pdf
"In the majority of patients with chronic hepatitis C, the progression of fibrosis is insidious and slow. Only a minority of patients has rapid progression of fibrosis with early development of cirrhosis. Current knowledge on the factors that are responsible and that correlate with more
rapid progression of fibrosis is limited, because it is based largely on cross-sectional studies using mathematical modeling and on a few, small scale prospective or retrospective longitudinal studies of changes in hepatic fibrosis. Carefully conducted prospective studies on untreated
patients, mainly patients with mild disease in whom therapy is not indicated, are needed to validate the current hypothesis on the progression of fibrosis. The mechanisms and factors associated with progression of fibrosis are poorly understood. Older age, male gender, excessive alcohol consumption, overweight, and immune deficiency are associated with more rapid progression of fibrosis. Therefore, counseling of patients should include abstinence from alcohol or minimal, occasional
consumption and dietary measures to reduce overweight and metabolic disorders.
The progression of fibrosis is difficult to predict in the individual patient particularly based on assessment at one point in time. Serial serum ALT levels, grade of activity, and stage of fibrosis are the main predictors of progression of fibrosis. However, the overall predictive value of these
characteristics is relatively weak and the progression of fibrosis is difficult to predict in the individual patient. The liver biopsy remains the best method to assess fibrosis and is valuable in determining prognosis and aiding in the decision for or against therapy. In untreated patients, regular
ALT measurements are useful, and repeat liver biopsy is the only reliable means of assessing the progression of fibrosis and is commonly recommended every 3 to 5 years in untreated patients. A second liver biopsy can distinguish patients with rapidly progressive fibrosis, but may
also merely indicate that the initial biopsy underestimated the degree of fibrosis. Overall, the risk of progression of fibrosis of more than 1 point in a 3- to 5-year period is low. In patients with factors associated with a higher risk of progression, such as age above 50 years, excessive alcohol
consumption, or high serum ALT levels, liver biopsy may be recommended more frequently (every 2 to 3 years); in contrast, in the younger patient with no other risk factor, the liver biopsies may be performed less frequently (every 5 to 10 years)."
--------------------------------------------------------------------------------------------------------
What factors predict hepatitis C disease progression?
* Excessive alcohol consumption (past and present) is strongly associated with a poor prognosis and progression to severe liver complications.
* Progression to cirrhosis is higher in people that continue to drink regularly.
* Past heavy consumption (more than 50 units per week for more than 5 years) is associated with faster progression to cirrhosis.
* Age at infection. People who are infected at an older age have a more rapidly progressing disease and reduced time from infection to cirrhosis.
* Gender. Men are more likely to progress to cirrhosis than women.
* Ethnicity may affect prognosis.
- Progression of chronic disease may be less rapid in black people.
- Asian people may have more rapid progression to cirrhosis.
* Co-infection with HIV, hepatitis B, and/or hepatitis A causes a more rapid progression to serious disease.
* Weight. Body mass index greater than 25 kg/m2 is associated with an increased risk of hepatic steatosis and disease progression.
Smoking is an independent risk factor for hepatic inflammation.
Hector
Try this and if it doesnt work I will try another way.. Don"t think you need to register,however been so long maybe I did ;)
http://www.ncbi.nlm.nih.gov/pubmed/9121257
http://www.ncbi.nlm.nih.gov/pubmed/9121257
thank you...is this something I need to sign up for or register for? I went to the link, but it brought me to a home page, i don't see a login or anything...
There really is no definitive way to tell who will progress faster or slower and yes, everyone seems to react individually.
The age of 50... ,although it may be that if one was infected when young it seems progression can be very slow for many for decades then may speed up as we age,however that also is subjective.
By the looks of the study below if you were infected say at 40 then the mean time to cirrhosis on average was 13 years ..so by 53 the avg. person in that group may be chirrotic. It is also true that it seems approx. 30 % of "ALL" people never develop cirrhosis.
Point being,,no one can tell you for sure.
A good diet , optimum weight ,no alcohol,no smoking exercise and minimum stress.are all good life habits and one may be rewarded for that somewhat,however as long as there is virus present ,it is doing it"s dirty work to some degree.
There are different factors that have been looked at in the past ,if you are interested(below) however keep in mind though, you never can tell which of these parameters you may fall into with any certainty.
Best..
Will
http://www.ncbi.nlm.nih.gov/pubmed/9121257ptimum
The age of 50... ,although it may be that if one was infected when young it seems progression can be very slow for many for decades then may speed up as we age,however that also is subjective.
By the looks of the study below if you were infected say at 40 then the mean time to cirrhosis on average was 13 years ..so by 53 the avg. person in that group may be chirrotic. It is also true that it seems approx. 30 % of "ALL" people never develop cirrhosis.
Point being,,no one can tell you for sure.
A good diet , optimum weight ,no alcohol,no smoking exercise and minimum stress.are all good life habits and one may be rewarded for that somewhat,however as long as there is virus present ,it is doing it"s dirty work to some degree.
There are different factors that have been looked at in the past ,if you are interested(below) however keep in mind though, you never can tell which of these parameters you may fall into with any certainty.
Best..
Will
http://www.ncbi.nlm.nih.gov/pubmed/9121257ptimum
Hector, is there any study that says how much faster after 50 liver disease progress's? I am over 50 now, but only at 0-1 fibrosis...never drank much, but have stopped all together...excercise...eat pretty well...not over weight...
I will do treatment as soon as all the required approvals come through, cause I don't trust this disease to act the way I want it to...which sould be to stay like it is for the next 40 years and not progress!
There just doesn't seem to be a whole lot of rhyme or reason as to why or when this disease decides to progress, it's so different for each person...i wish it was more predictable...but i guess the scientist wish that too, ha...
Sorry linda, didn't mean to thread jack...:)
I will do treatment as soon as all the required approvals come through, cause I don't trust this disease to act the way I want it to...which sould be to stay like it is for the next 40 years and not progress!
There just doesn't seem to be a whole lot of rhyme or reason as to why or when this disease decides to progress, it's so different for each person...i wish it was more predictable...but i guess the scientist wish that too, ha...
Sorry linda, didn't mean to thread jack...:)
Linda, my first biopsy was 10 yrs ago, in all I have had 4 of them. My enzymes and viral load was all over the place, but my biopsy results never changed. 2/2 so don't be real sure of whats going on by those numbers alone. They can and usually do change at random. Dose not always mean your liver is getting way worse.
Assuming the information you posted is accurate and you didn't leave out any other causes of your liver disease...It took you 30 years to progress to stage 2. Your latest biopsy was only two years ago. That is not that long of time. Biopsies are only needed every 3-4 years at your stage of liver disease.
For a doctor to "speculate" progression to "F3 or early cirrhosis" is not something any knowledgeable doctor should or would say. Doctors create a diagnosis based on facts not speculation. Platelet counts vary all the time what are you or your doctor comparing it to yearly? monthly? results. Your platelet count indicates that you do not have portal hypertension which usually accompanies cirrhosis so how can your doctor speculate "early cirrhosis".
Is he/she a hepatologist? If not, they they are not qualified to even access your liver disease.
While after the age of 50 liver disease does progress more rapidly you still have time on your side to treat and cure your hep C.
If you are thinking about treating or getting a accurate diagnosis of your illness find a doctor who is experienced in treating hepatitis C patients and understands its implications on liver disease. A qualified gastro or a hepatologist.
Good luck.
Hector
For a doctor to "speculate" progression to "F3 or early cirrhosis" is not something any knowledgeable doctor should or would say. Doctors create a diagnosis based on facts not speculation. Platelet counts vary all the time what are you or your doctor comparing it to yearly? monthly? results. Your platelet count indicates that you do not have portal hypertension which usually accompanies cirrhosis so how can your doctor speculate "early cirrhosis".
Is he/she a hepatologist? If not, they they are not qualified to even access your liver disease.
While after the age of 50 liver disease does progress more rapidly you still have time on your side to treat and cure your hep C.
If you are thinking about treating or getting a accurate diagnosis of your illness find a doctor who is experienced in treating hepatitis C patients and understands its implications on liver disease. A qualified gastro or a hepatologist.
Good luck.
Hector
has your doctor suggested maybe a the fibro blood test or fibroscan to verify his diagnosis?
Over the last 2 years, how have you been treating yourself? No drinking? healthy food? Excercise?
I am always interested in how this disease progresses vs how people take care of them selves...I know a lot of people take a wait and see approach to treatment, and the above metnioned things are suggested to take of ourselves in the mean time, just wondering if it really helps that much...
what type are you?
Over the last 2 years, how have you been treating yourself? No drinking? healthy food? Excercise?
I am always interested in how this disease progresses vs how people take care of them selves...I know a lot of people take a wait and see approach to treatment, and the above metnioned things are suggested to take of ourselves in the mean time, just wondering if it really helps that much...
what type are you?
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