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1473047 tn?1286961232

Any Good News ?? Cirrhosis stage 4

Hi All !   Got D bad News am now a member of your clan , Think I got it in way back in 1982 a long time ago. Have not started treatment yet. My biopsy says I'm at stage 4 ,I'm gutted.   finished my hep A and hep B shots, hope to start treatment early next year. The only good news seems to be my genotype 3, but because I'm the wrong side of 40 & stage 4 cirrhosis my chances are much lower ??  Any success stories out there and if so what do you believe you secret to be, Do cured people go away from these posts, or should I fear the worst.
Best Answer
446474 tn?1446347682
I couldn't  tell if you are still compensated or not. It is best to do treatment while compensated. If you are decompensated, depending on how ill you are, the risk of treatment may be to great. Treating while decompensated risks acute liver failure and only should be undertaken by working with a hepatologist who has successfully treated decompensated patients. The only place one will find this doc is at a liver transplant center at a hospital. Best practice calls for being listed at the transplant center should you have acute liver failure. Should your liver fail, you will only have a very short time to live without a transplant.

As far as your chances of treatment working for you... Here is a recent study that confirms the basic premise that the more the liver is damaged the more difficult it is to successfully treat. But the benefits outweigh the risks as your only other option is a liver transplant which is a major life changing event. And everyone responses differently. So the only way to know if treatment will work is to try it.
February 2010 issue of Hepatology

Savino Bruno and colleagues from Italy conducted a study to assess the safety and efficacy of pegylated interferon alfa-2a (Pegasys) plus ribavirin in people with advanced fibrosis enrolled in 3 international randomized clinical trials.

Results
SVR rates progressively decreased as degree of liver damage increased:
  
Genotype 1 or 4 patients:
   60% SVR without advanced fibrosis;
51% SVR with bridging fibrosis;
33% SVR with cirrhosis (P = 0.0028 for trend).
  
Genotype 2 or 3 treated for 24 weeks:
   76% SVR without advanced fibrosis;
61% SVR with bridging fibrosis;
57% SVR with cirrhosis (P < 0.0001 for trend).

Regardless of genotype, participants without advanced fibrosis were more likely to experience early response to treatment.
Earlier treatment response was associated with higher SVR rates and lower relapse rates during post-treatment follow-up.
* Patients with similar responses during the first 12 weeks of treatment had similar SVR and relapse rates, regardless of degree of fibrosis/cirrhosis.

Based on these findings, the study authors concluded, "Compared with patients with less severe disease, SVR rates are significantly lower in patients with advanced fibrosis."

* However, they added, "irrespective of genotype and degree of fibrosis, the time to become hepatitis C virus (HCV) RNA undetectable was the strongest predictor of SVR."

In conclusion: Each person responses differently to treatment due to many factors. The only way you will know if the treatment will work is to do it and then monitor your response to treatment. The quicker your viral load becomes undetectable the better your chances of SRV.

FYI: I trust that you are being screened for liver cancer (HCC) every 6 months? This is important as you are at an increased risk for liver cancer once you have progressed to cirrhosis.
Had an endoscopy to detect esophageal varices and should be done every two years. Varices should be treated with a nonselective beta-blocker such as nadolol or propranolol.

Best of luck to you. I hope this is helpful in some way.
Hectorsf
3 Responses
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1118724 tn?1357010591
I am 59, M, have type 1b, the hardest of types to cure, have had Hep C since early 70's, and have cirrhosis. Treatment is at shot 41, I have been UND since first test at week 10. Side effects have been mild. Treatment is scheduled to stop at years end. Then a wait of 6 mths to a yr. to confirm SVR. Not cured yet but optimistic.
If you drink, STOP now. Period. End of story. Never again. Alcohol is gas to a raging fire. Quit salt. Certainly don't add it to what you eat and look for low sodium food. Salt retains fluid. Your liver can't deal with it well and shunts water to the legs, and tissue between organs. Not a good thing. I don't know if it applies to everyone ... but Iron isn't a good thing either. I'm paranoid enough to quit eating beef and pork over it, even though test show no sign of iron buildup. I only eat small amounts of skinless, boiled/baked, chicken. Fat, is hard to process, another reason to not eat meat. Sugar is supposed to be something of a no-no but I couldn't stop, only cut back. Treatment makes diabetes easier to develop.
The one absolute is no alcohol. Make a real effort to cut back on the others.
All the best, you'll make it.
Helpful - 0
179856 tn?1333547362
Sorry Casper that you joinned our clan, totally not something we'd wish on anybody and we all understand that feeling of finding out.

Lots of cured people are still around here years later just trying to help new guys like you who get that bad call.  

Your geno 3 is a good thing but cirrhosis makes it more difficult but not impossible that is for sure.  If you can beat the virus you can hopefully reverse some of that liver damage and live a nice long healthy life.

Ask all the questions you can and learn every single thing you can about this disease - it will help you to beat  it.

PS I've been cured over three years :)
Helpful - 0
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