what is stage 4 cirrhosis of liver

[cafatero8]

i have chronic hepetitis c with stage 4 cirrhosis. what does it mean??

[ceanothus]

It means your liver is very sick, that you need to be under the care of a good hepatologist at a liver transplant center, and that you need to learn a lot about liver disease and what you should and should not do to keep as healthy as possible. Stage 4 cirrhosis means that much of the normal tissue in your liver has been damaged by the virus and been replaced by scar tissue instead of normal liver tissue. Scar tissue doesn't function like normal liver tissue and it can impede the normal blood flow through the liver. The liver can compensate for quite a bit of damage and if your doctor says you have compensated cirrhosis then your liver still has the ability to perform all of its basic required functions. In this case the main thing you need to worry about is not adding any more damage to your liver, as you don't have much leeway left to you. You need to avoid ALL alcohol, stick to a low-sodium diet, treat to eliminate the Hepatitis C as soon as possible, and stick religiously to having a full check up by a good hepatologist at least every six months. They will need to re-evaluate your liver that often and will also need to do an ultrasound every six months to rule out liver cancer (you are now at a much increased risk for liver cancer) and to look for signs of possible decompensation. If your liver is damaged a little more and it decompensates you will have many more concerns and will need to start considering getting on a liver transplant list. Don't panic yet however, as most people with Hepatitis C and cirrhosis are still able to function fine and have pretty good chances of never decompensating. I'm an example of that. I acquired Hepatitis C in 1984 and was diagnosed with cirrhosis in 2004. I treated the Hepatitis C three times over the years and the last treatment finally worked. I achieved SVR (cure) in March of 2013 and my liver stayed compensated throughout. All of my risks are substantially lower now that the virus is no longer adding new damage. I still have to avoid new sources of damage and get checked every six months to make sure it is still compensated and has not developed HCC (liver cancer), but my doctor assures me that with the virus gone it is much less likely that either of those will ever happen.

Good places to educate yourself include the forums here at medhelp and my other favorite, http://www.hcvadvocate.org. Feel free to ask more specific questions, but you might find more people (but probably not doctors) around to talk to you at either the Hepatitis C forum (http://www.medhelp.org/forums/Hepatitis-C/show/75) or the Cirrhosis forum (http://www.medhelp.org/forums/Cirrhosis-of-the-Liver/show/1390). Best wishes for getting healthy!

[Thomas D Schiano, MD]

stage 4 means cirrhosis and the amount of scarring seen in it