Should I wait for new drugs?

[denigreg]

Hello all. I am so confused. Have hepc geno3. Had biopsy in 2002 stage 3 grade.01 had biopsy in 2007 not sure of results. Had another biopsy last week going to doc tomorrow. I tried treatment back in 02 but quit after only a month. I have had hepc since 84. I have been a social drinker all these years. I partyed alot. Is there a new drug coming out? Or should I do treatment now. My liver enzymes since diagnosed w/ hepc in the 90's have been around 200's. In Dec at my 6 mnth blood work they were up to 400's. Now back to 200''s. I quit smoking and drinking 2004 while I was pregnant and they were lower but 1 month after my son was born I went back to smoking and drinking. I will be 47 in May and want to be around for my 6 yr old son and 26 yr old daughter. Afraid to see doc tomorrow. p.s. my gastro doc let me have it when I told him I was still drinking. I haven't drank since I saw him last month.

[desrt]

By the way, as stated by other members, the new drugs (if approved) do little if anything for geno 3s and will add more side effects (though they will shorten tx times for some geno 1s). I would suggest txing sooner rather than later. Whatever your reasons for discontinuing in '02, someone here has run up against the same problem and has figured out a way around it. Good luck.

[willbb]

Hi there...Basically your labs state you have Stage3 fibrosis  with mild to moderate inflammation going on  with no signs of liver cancer.

With having Geno type 3 there is no benefit to waiting for the new meds as they do not have a greater efficacy rate on geno type 3.

It would seem prudent as your Dr. has advised to start tx. and your Gastro will probably concur with  that on the 28 th.

Hope you have been able to stop  drinking as it will hasten your degree of fibrosis.

Hope that helps some

WILL

[desrt]

Fibrosis is staged from 0-4. At stage 4 it becomes cirrhosis, or irrepairable damage. Your progression from 2002 to today is unremarkable, given that you "partyed alot". "

- no hepatocellular inclusions
- no evidence of malignancy" means no signs of liver cancer.

"patchy mild steatosis" Steatosis is fatty liver disease. We geno 3s are more prone to this.

Others on this site are better at reading bx results, but basically it says your liver is in pretty bad shape but not the worst and you should plan on staying clean and sober even after treating successfully.
Why did you stop tx in 2002 and how do you plan on staying the course this time?

[denigreg]

cont...
- portal tract, periportal, pericellular & bridging fibrosis w/ architectural distortion and areas of micronodule formation consistent with incomplete ccirrhosis (stage 3)
Trichrome stain performed..
- no stainable iron
- no hepatocellular inclusions
- no evidence of malignancy
Please help me understand. Thanks so much to all for your input and support. Love and Health to all.
Deni

[denigreg]

Well I got results... No clue what it all means. Surgeon didn't have many answers. So I have app w/gastro doc on 2/28. He just called me yesterday on my cell and said it didn't look good but could be worse and he's ready to start treatment and wanted to know if I was ready and of course I said yes. then I lost service before I could ask ????'s called back at it was his answering service so I'm going to call his office today.But I am so concerned and confused don't understand any of this. I got the results from surgeon on my '07 and I looked closer at the notes from my '02 biopsy - read 02 wrong it was
2002 stage 1 grade 3, 2007 stage 2 grade 2 now stage 3 grade 2??
Does any one understand any of this...- portal tract& lobular non-spec mild - mod chronic & mild acute inflmation with piecemeal necrosis, patchy mild steatosis, ballooning degeneration of hepatocytes, focal Mallory's hyaline & occasnl acidophilic bodies (grd 3)
-

[denigreg]

Thank you for the posts. I agree and am giving it my all. I quit drinking and smoking twice in my life - when I was pregnant with my children. So my mind set is for them. No more drinking just have to work on the smoking. I know I can do it. :-)  Power of positive thinking and prayer will help. Just alittle tough without my Mom who passed away Aug 2009. She always prayed with me and did so much research on Hepc and drinking/smoking. I have a whole file on it. So I have plenty of reading material. Going go doc's in a bit. Post more later. Thank you again to all. You are all very helpful. It's good to know I am not alone in this. Health and love to all. Denise

[RobertBeWell]

Single best thing you can do for your liver and your lifespan:

Cease ingesting the poisons found in tobacco smoke and liquor.

The importance of this can't be overstated.

As an alcoholic and ex-smoker myself (in remission for almost 10 years now) I know it can be tough. It took me damn near seven years to where I truly felt normal and had no desire to alter my conciousness anymore. BUT YOU HAVE TO DO IT.

Best of luck,

RBW

[denigreg]

Thank you all for your input and info. Very helpful! I'll let ya all know what happens tomorrow. Hope all are doing well. :-)
Denise

[Willy50]

The newer drugs nearing approval will NOT help with genotype 3.

Most treatments become longer, more difficult and less successful as staging/liver damage increases...... with a possible outcome of not being able to treat if you wait too long.

Alcohol use will generally cause liver damage to accelerate for most folks.
Alcohol use will generally make treatments less successful if you drink during treatments.

Willy

[paen53]

See what your Dr. says tomorrow with the bx results - also see if you can get copies of the one from 2007. They're important records to have. The best thing to do until any decision is made about tx is to stay alcohol-free - completely. With liver damage, we need to eliminate anything that causes more inflammation, and alcohol is on the top of the list as well as many OTC drugs.

Once you get your bx results, find out what the Dr. recommends for you. My thoughts would be sooner rather than later regarding tx. Keep your focus on getting healthy and being there for your kids. Best of luck tomorrow - Pam

[Bill1954]

The new drugs Telaprevir and Boceprevir are both in a class known as ‘protease inhibitors’. The data from clinical trials suggest they aren’t particularly effective on patients with genotype 3 infection; here is some specific info on this subject:
~~~~~~~~~~~~~
http://www.natap.org/2009/EASL/EASL_13.htm

Telaprevir Effective for Genotype 2 But Not For Genotype 3


EASL April 23-26 2009
Copenhagen, Denmark
Reported by Jules Levin

In phase IIb studies in treatment-naives, mostly caucasians, telaprevir in combination with peg/RBV improved SVR rates in half the time of treatment compared with standard of care:

--PROVE1: 61% vs 41% (p=0.02)
--PROVE2: 69% vs 46% (p=.004)

In this study genotype 2 treatment naive patients achieved a mean 4 log reduction in viral load after 6 days on monotherapy with telaprevir. The triple combination of telaprevir + peg/RBV achieved a mean 5.3 log reduction in viral load at day 16. But genotype 3 patients only achieved a -.80 reduction in viral load so therapy for genotype 3 won't be pursued….

(much more info in study link)
~~~~~~~~~~~~~~

Based on this info, it seems that with stage 3 damage per biopsy in 2002, I’d want to get right into treatment.

You might open that link, print a copy and use it as a talking point with your doctor at tomorrow’s appointment.

Good luck, and take care-

--Bill