Pegiterferon therapy in early cirrhosis

Question

Dear sir, i am Dr aftab , i have a querry about my elder sisters medical condition, she is aged 54 years with 74 kg wt. she is diagnosed with chronic active hepatitis C one month back , her UGI endoscopy showed grade one esophageal varices , her clinical & biochemical indicators put her in CHILD-POUGH class A of liver cirrhosis. Now I am indecisive about putting her on peginterferon & ribavirin therapy. I have consulted so many of my seniors and consultants but there is a big difference of opinion regarding initiation of peg inf therapy. now i am referring my case in front of you expert doctors to guide me through as time is not on our side i m expecting a brisk response from u people. thank u sir.

This discussion is related to Help understanding Hep C treatment.

alagirl · Answer

I would find the teaching hospital closest to you that has the largest liver center.  I would take your sister to a hepatologist, not just a gastro.  

Here's a link to some clinical information regarding combo tx with interferon/ribabvirin for patients with compensated cirrhosis.  (It appears to have more success in genotypes 2 & 3, but does have some success with genotypes 1 & 4.

http://www.hivandhepatitis.com/hep_c/news/2006/120806_b.html

Here's info from a study published in 2008 talking about regression in cirrhosis from tx:

Regression of Cirrhosis in HCV
Study findings suggest that HCV treatment can lead to regression of cirrhosis.
— Atif Zaman, MD, MPH

Published in Journal Watch Gastroenterology November 21, 2008
Covering Ann Intern Med 2008 Sep 16; 149:399

http://gastroenterology.jwatch.org/cgi/content/citation/2008/1121/2

Good luck to you and your sister.

newleaf09 · Answer

No doctors here, but the experience of many of us patients is that early, compensated cirrhosis patients can be successfully treated with peginterferon therapy to kill the hepatitis C virus.  Successful resolution of the virus usually causes a regression of fibrosis (scarring of the liver) and allows the patient to back away from end stage liver disease and lead a normal life.  Please take your sister to a gastroenterologist with experience in treating liver disease.  He will assist your sister in making the proper treatment decisions.