Cirrhosis and normal liver enzymes

[see me]

I was dx last tuesday with hep c - going for liver bx in am.  I have had symptoms for 12 years - so obvious now.  But the past two months have been very bad- so, so, many symptoms.  I am concerned it may be cirrhosis but the last liver enzymes were normal. Can one have a normal liver panel with cirrhosis.

[can-do-man]

Well there is different opinions on that, at the least they should make it to where one can't respond but start a new thread.......... The date is below the title and next to the name.......... Good luck.:)

Cirrhosis and normal liver enzymes

By see me Sep 26, 2006

[8nickers8]

why don't they get rid of them?  I don't see any dates on them. I just joined a little while ago and I can't make heads or tails of alot of the site.
Thank you for letting us know.  I feel like a schmuck but hey, I do alot anyway :)

[can-do-man]

6 year old thread here folks.......

[8nickers8]

You know, it kind of makes me sick when alcoholics, folks who can't stop drinking, try to find rationalizations to justify so they can keep drinking.  Don't we have enough to worry about with Hep C?  I was never a drinker and had hep c from age 18 and found out when I was 49 years old.  I had 0 scarring and 0 inflammation and Dr. said it was because I did not drink- ever.  And I was able to wait until this past April to begin treatment and was able to do a very easy all oral and at 4 weeks post tx I am UND.  I am so grateful that I never drank. Oh, and my first husband, died at age 32 - he was a severe alcoholic.  

[8nickers8]

7977 trials won't let anyone on without a biopsy and that is for geno 2 and 3.

[Skidude]

Me.  No damage a few years ago at BX.   A beer now and then.  Now I have cirrhosis.  Wow.  I'm screwed.

[Kalio1]

Here's another one showing moderate drinking with hep c increases fibrosis progression. I could do this all day long thre is so much info showing it is a bad idea to drink at all with Hep C.
http://www.blackwell-synergy.com/links/doi/10.1046/j.1365-2893.2002.00356.x/abs/

[jmjm530]

On re-reading, the sixth paragraph of my previous post is confusing.

It should read:

"I should also add that I spoke to several nationally known hepatologists and all allowed me to drink in moderation after finishing treatment. In fact, I was allowed to drink prior to treatment as well. I was not allowed to drink during treatment."

[Kalio1]

Here is a good link about sulfasalazine I found helpful.
http://www.wellcome.ac.uk/doc_WTX033662.html

Here is a link that talks about caeolin-1 and it's influence on liver regeneration.

http://bio.com/newsfeatures/newsfeatures_research.jhtml;jsessionid=S31LSW40TRMBPR3FQLMCFEWHUWBNSIV0?cid=21900014

[Kalio1]

I knew Jm would show up on this thread. I am through on the subject, If people with compromised livers from being HCV positive or from established liver damage are determined to drink alcohol, nothing I say or anyone says will change that.

[jmjm530]

Jboyhk,

We used to have passionate discussions on both sides of this issue, but apparently most have gotten worn out on the topic. This is unfortunate because all side should be heard not just the last man (or woman) standing.

IMO you are absolutely correct.

A careful read of recent studies show that liver damage was only associated with *heavy* drinking -- like 4 or more drinks a day, and not light or social drinking.

Even the study cited above -- actually a questionaire review -- hedges on what the headline writer suggests: "The damage was less than with heavy drinking, (caps mine) AND MAY HGAVE MINIMAL OR NO EFFECT -- but the chance of damage was there." In fact, most of the "warnings" against drinking can be traced back to older studies in the late 90's that only collected data on heavy drinking.

Here are some recent studies that suggest light or moderate drinking has no effect on either the progression of fibrosis or viral replication.

I should also add that I spoke to several nationally known hepatologists and all allowed me to drink in moderation after finishing treatment. In fact, I was allowed to drink prior to treatment as well, not just during treatment.

CITATION 1 (From esteemed Cleaveland Clinc -- Fifth article down) http://www.clevelandclinicmeded.com/hcv/litreview1.htm

"...What does this mean for our patients with HCV? It seems to this reviewer that the stern warnings we have previously given about the possible dire consequences of even modest alcohol intake now must be tempered. Alcohol abstinence may be the safest course of action, but an occasional drink appears not to harm the liver in those infected with HCV"

CITATION 2: http://tinyurl.com/l7c8h

CITATION 3: http://gut.bmjjournals.com/cgi/content/abstract/54/10/1468

As I've said previously, statements like "I get so tired of people trying to justify drinking with hep c, it is like a person with emphesema saying a few cigs are ok." are the worst kind of propaganda because they play emotions and personal bias against studies and facts, with the inference being that anyone who thinks it's OK to engage in light social drinking with HCV somehow has a drinking problem.

I personally find the insinuation insulting, others have as well, I have so mentioned it the past, as have others,  but so be it, one of those topics :)

Jboyhk,

I'm not posting much these days and will not post more in this thread, but please feel free to use these studies in any future discussions on the matter.

All the best.

-- Jim

[Kalio1]

and another one - http://www.drugabuse.gov/HepatitisAlert/HepatitisAlert.html



here is the conclusion:
"Persons who test positive for HCV should be given information regarding the need for preventing further harm to the liver, reducing risks for transmitting HCV to others, and obtaining medical evaluation and followup for chronic liver disease and possible treatment. It is important that physicians know if a person is infected with HCV so that medications that may have side effects involving the liver can be avoided. To protect the liver from further harm, HCV-infected persons should be vaccinated against hepatitis A and B, if susceptible, and should be strongly advised that even moderate alcohol consumption may adversely affect disease progression. All persons should be advised not to use illicit drugs."

[Kalio1]

Comprehensive detailing of the many dangers of ANY alcohol to the HCV positive patient.
http://www.medscape.com/viewarticle/488940_2

[jboyhk]

Kalio,

I have read that study you posted already a while a go.

It would be considered garbage in the world of statistics and scientific research.

Any study that is dependant on soley patients reporting in flawed and useless.

I can post you thousands of links why. The main reason is that people LIE.

People that say that they are 'moderate' drinkers may be ashamed to admit they are 'heavy' drinkers and hence the outcome is meaningless.


The researcher even admits it in the last paragraph "His results may be somewhat skewed, since each patient reported his or her own medical history and drinking habits, he says."

[Kalio1]

Inotice the site of the link I posted i down at the moment, but it is a good link. They must b doing maintenance.
Here is another link that shows the dangers of even moderate drinking and Hep C.
http://www.webmd.com/content/article/83/97883.htm?lastselectedguid=%7B5FE84E90-BC77-4056-A91C-9531713CA348%7D

[Kalio1]

You said one study, so here is one but there are plenty more where this came from. Again, anyone who needs "proof" to justify drinking with hep c is too concerned with continuing drinking in my view and willing to ignore ALL the top docs in the field who say to stay away from it. You accused me of "yelling" and I didn't yell at all I just voiced my opinion like you. YELLING LOOKS LIKE THIS ONLINE. Because a person states their position doesn't mean they are yelling. I get so tired of people trying to justify drinking with hep c, it is like a person with emphesema saying a few cigs are ok.
I don't think it is a good idea to suggest moderate drinking with Hep C is ok as you are doing particularly in a Hep C forum, stating there is no "proof" it isn't ok when there is. It can give the ok to people who are having a hard time stopping alcohol a green light when the facts DO support stopping alcohol if you are Hep C positive. I was going to give you a list of references but it's late and Im going to bed, plue I dont think any anount of info will convince you, your mind seems made up already to me. If you really wanted to find this info, it is easy to find.

http://cat.inist.fr/?aModele=afficheN&cpsidt=14954579

[Kalio1]

People will convince themselves of anything to justify continuing to drink alcohol. They search for "evidence" to back up their need to continue to drink even a little in spite of being diagnosed with a liver disease such as HCV. If alcohol isnt a problem for then why is it SO important to continue to drink? I'd say having a liver disease is reason enough to not even have a desire to drink and risk your liver by drinking any alcohol. I was told by several doctors personally and have read TONS of top heptologists' opinions on the subject and they all say alcohol accelerates the HCV virus and should not be consumed. Nothing that can potentially harm your liver should be consumed. It's your liver and your life. If alcohol was a take it or leave it thing to you indicating you dont have a problem with stopping it then you wouldnt have asked about how much a person with HCV can drink safely. The answer is no alcohol is the safe way to go. ALL the top hep docs say NO alcohol if you are HCV positive.

[pvk]

Thanks for your responses.  I'm anxiously waiting for the results of my biopsy.  I expect that despite my lack of other symptoms the news isn't going to be great.  30 years with the virus and many of them spent as a "moderate" drinker don't put me in a good position.  I'm pretty sure I'm headed for treatment.  Do you guys have any advice on how to go about finding a good doctor?  I've seen a hepologist but have no idea whether he's good, bad, or indifferent.  Thanks.

[Kalio1]

Many of us were moderate drinkers and had no idea we had this virus, that is a very common situation. Try not to worry about damage being great, you just might be pleasantly suprised and have very little. Even though I didn't discover I had HCV until I had early cirrhosis I am still very grateful I caught it before my liver failed. There are some excellent options being tested as I type that show promise in reversing liver scarring even in cirrhotic patients so don't despair. The sneaky, insidious nature of this disease will be lessened if we can educate the public and work to have EVERYONE tested as a matter of course. We can't do anything about the things we don't know we even have! I too have had regrets over by glasses of wine in hindsight but there was no way for me to know I had a deadly virus that was being fed by the wine and neither did you. What is your doctors name and where are you located?

[pvk]

I'm in Los Angeles and I was referred to the Pfleger Liver Institute at UCLA, where I saw Dr. Sammy Saab.

[jboyhk]

Again I am in know way promoting alcohol use with Hep B or C. I am just stating the known risks. If you read very carefully any of the studies they all say 'may' increase the risk with moderate alcohol use. That means from a statistical point of view the correlation is not strong enough. You never see 'may' increase the risk with heavy alcohol use since there is a statistically significant risk.

Just look at his site


http://www.aidsmeds.com/lessons/Hepatotoxicity.htm


What's the deal with alcohol?

There's no shortage of information concluding that heavy alcohol use

[Kalio1]

Hey we are practically neighbors, I live in Santa Barbara. Your doctor sounds great. Google him, he looks like a fine doctor.Plus he must be pretty young and that is a good thing, they are learning a lot about Hep C in med school these days. My Primary is young too( and also a UCLA grad) and he was very on top of HCV, suprisingly so and he told me they were educated extensively on HCV. I'd say you are in good hands, that is if you like the guy and he seems to be well informed. It's hard to say by reading their Cv's what they are like as doctors and if they are good communicators or not but from the looks of his credentials you have a good doctor and a good facility in my opinion. So many doctors are no longer taking Hep C patients on as they already have so many be glad you have a good doctor and secured a spot! My doctor said they can't take on any more and I hear that a lot lately.

[tbag]

i'm 63 yo. i had hep c type 2, took the treatment and am now undetectble. however, i've been told that i have compensated cirrhoses. yesterday, i read about sulphasalazine a drug that is supposed to reverse liver scarring.  does anybody know anything it. i would appreciate any info.

[jboyhk]

I am not 'convincing' myself of anything. I just want the facts.

Instead of yelling at me, please show me a study that has a positive correlation between moderate drinking and increased risk. Not a 'maybe', because in statistics that means 'insignificant'.

Let me give you an example. Heavy drinkers die earlier than moderate drinkers. This is a statistical fact.

From this, you would make the conclusion that moderate drinkers die earlier than non drinkers.

In fact, it is wrong. Statistically (not 'maybe'), moderate drinkers live longer than both non drinkers and heavy drinkers.

You cannot just 'extrapolate'.

All I ask if for you to show me ONE study that shows a 'definite' increase in risk, one that is statistically significant.

Dr's say many generic things all the time just to be on the safe side. Of course you shouldn't drink if you have a liver disease if you want to be super safe, but the research and studies I have seen don't support it.