Can cirrhosis heal?

[GP7852]

I have stage 4 cirrhosis.Just started treatment for 24 weeks with Harvoni.If I clear and stay clear after treatment can the cirrhosis heal?Can I ever get back to having a normal liver without the worry of tumors?
                                                     Glen

[Dee1956]

Hello!  I think it all depends on how far along the cirhosis is and it depends on the person
I was dx with the possible transitioning to cirrhosis due to wisps of collagen seen in my biopsy.  My ultrasound showed a rough echotexture.
It has been 3 years since I finished tx.  In June I had an ultrasound that for the first time said smooth texture, no sign of cirrhosis.  I was shocked as I assumed that I would always have the rough echotexture that had been seen since 2008
There have been two members who have come back several years later to tell us that the stage of scarring and fibrosis had reduced a level or two since they finished treating. (Andiamo1 and JimJim)
I know another person who had a high meld score who treated and is now cured and his/her meld score has reduced quite a bit.
I hope the same happens for you.
My doctor explained that once the virus is not attacking your body, healing can occur.  Of course that includes eating well, not drinking etc.
Take Care, Dee

[HectorSF]

Regarding the development of liver cancer (HCC) after achieving SVR in patients with either F3 or F4 liver disease. There still exists an increased risk in these patients. A higher risk than in someone who has never developed advanced fibrosis or cirrhosis.

The current recommendations are that doctors should monitor patients (ultrasound + AFP blood test) for a number of years after achieving SVR. This is a case of "a ounce of prevention is worth a pound of cure". Since liver cancer (HCC) has no symptoms until its final and fatal stage, surveillance with imaging and tumor marker blood levels are the only way to catch the cancer early when it is still treatable.

Since we are now in a new era in regards to advanced liver disease caused by hepatitis C where now most people even with advanced liver disease can be cured and the progression of their liver disease stopped, further studies are being done to clarify the ongoing cancer risk post SVR.

Here is the current recommendations for HCC risk in post SRV patients.

From the AASLD/ ISDA Hepatitis C guidelines.
THE source for all of the latest information on hepatitis C.
"Recommendations for Testing, Managing, and Treating Hepatitis C"

MONITORING PATIENTS WHO ARE STARTING HEPATITIS C TREATMENT, ARE ON TREATMENT, OR HAVE COMPLETED THERAPY
....
"Patients who have advanced fibrosis or cirrhosis continue to be at risk for development of hepatocellular carcinoma after achieving an SVR, although the risk in these patients is lower than the risk in persistently viremic patients. (Morisco, 2013); (Morgan, 2010); (George, 2009); (Morgan, 2013); (Singal, 2010) Patients with cirrhosis who achieve SVR experience increased survival (compared with patients with cirrhosis who are untreated or in whom treatment fails), but still may be at some risk for hepatocellular carcinoma; thus, they should continue to undergo regular surveillance for hepatocellular carcinoma despite the lowered risk that results after viral eradication. (Bruix, 2011) The risk of hepatocellular carcinoma among patients with advanced fibrosis prior to treatment but who have regression to minimal fibrosis after treatment is not known. In the absence of data to the contrary, such patients remain at some risk for hepatocellular carcinoma and should be monitored at regular intervals for hepatocellular carcinoma."

Good luck with your treatment!
Hector

[Dee1956]

Thank you so much for the invaluable information.
I am getting checked yearly.  It was every 6 months before I got to SVR.  Now he said once a year for US, blood work and to see the doctor, unless I have a problem. i.e. I have a huge gallstone.
I think I remember at one time it was said this should continue for 8 years after getting to SVR.

Thank you again, really happy to see you posting. :)  I hope this means you are feeling a little better
My best to you
Dee

[GP7852]

You made my day Dee,your reply was great to hear

                                                Glen

[GP7852]

Thank you Hector
       Glen

[Dee1956]

Thanks Glenn, I was told back in 2007/8 that it would not heal.  Over time with research they are starting to find different.
I was shocked when I had my US in June and they stated "no sign of cirrhosis" That is not to say that I don't have scarring and fibrosis.  I do.  I do think that once getting to SVR you have to be diligent in watching the diet no drinking.  I don't eat red meat, haven't in many many years when I found out how long it takes to digest.
My sons taught me that :)

[GP7852]

Thanks Dee
I stopped the drinking a long time ago and have no desire for it at all.I find a vanilla milkshake a lot more enjoyable.I didn't know about the red meat but I hardly touch it due to family history.Guess I should cut it out completely even though it is just a filet mignon maybe once a month.My goal is to be at my twins weddings (they are 23) whenever that happens and since one of them is a girl I must be healthy enough to dance with her.I am 60 and would love to hang around for at least another 10 years.There is still so much to do if you know what I mean.
                                         Glen

[Dee1956]

I know what you mean...most definitely :)

[linda803]

Hi Glen, my husband also is on Harvoni, He is on it for 12 weeks, We were told that because he has had liver cancer there is a chance it could come back, Also the liver can rejuvenate it self after the Hep C has been cured,, That"s what we were told,, But in my husbands case he will still need a liver even after he's cured only because he had the tips procedure. Every person is different depends how bad the liver is,, You should speak to your GI on your next appointment and see what they say,, best of luck

[genotype1a]

Once cirrhosis has damaged the liver it's very difficult for the liver to regenerate back to normal. It is rare that someone does eventually completely heal their own original liver back to normal even though on occasion it has happened. And it has only happened on a few, rare occasions.

Now, that's not to say that some parts of your damaged liver will not regenerate because depending on the severity of damage and how widespread it is and how healthy the person decides to change their lives. Is also a very important factor to encouraging the liver to regenerate. So it's not that cut and dry with respect to the liver regenerating its self back to normal. And as long as the liver wasn't classified as decompensated then there's always the possibility of over 50-50 chance that the damaged liver will repair itself to function better than it did before tx. Once the liver has reached the point of decompensation, the only hope for them is a liver transplant.

And this is why your husband is on the list. The Tips is a procedure to prevent the body from bleeding internally due to the ESLD being decompensated unfortunately linda. The upside is that the Harvoni Tx being given to him prior to the surgery almost guarantees that your husband will not have chronic recurring HCV because the harvoni us going all over his body inside and hunting each and everyone of those dirty little bastards and killing them where they though they would be safe to hide. Little do they know until it's too late that is, how their fate is already being sealed by the harvoni.. After the transplant and once your husband has improved health wise , they will probably order some sort of hepatocellular carcinoma treatment to kill of any hiding cancerous cells within the body.

But remember that repairing is not the same as regenerating and it's very important to distinguish the difference between the two. Only until recently the Liver was thought to be the only organ besides your skin that could regenerate. But recently, it has been discovered that the human Brain has a similar capability of regenerating some of it's damaged cells and repairing other cells not so damaged yet affected by the underlying cause of the damage.

Finally, I'm not a doctor but, I did stay @ a holiday inn last night - yeah
Right!!! if you have time, you can read my bio if you wish.
All the best to your husband and to you and your family. If you have any questions please don't hesitate to ask.
Henry

[almostsixty]

I am svr from gt 1b for about 6 months. My doc says due to my age it would be better if I became de compensated sooner rather than later as I am 60 years old. He tells me it's almost impossible to get a new liver when you reach 70. Didn't really know how to take that. I feel good and have no symptoms. With the hep c gone it may take a while to get to that point. He is so positive I will need a liver. I am scanned every 6 months for cancer. So far so good. It sounded like he was telling me to take up drinking to hurry things along which I would never do. Feeling doomed no matter what. Kind of like a ticking time bomb. Has anyone else been told this?

[hepcandme]

you need a new doctor

that is the worst thing he could have said to you and it is not true either

your doc needs a lesson in beside manners and some ongoing research and study about hepatology

[Livelife777]

That's about the most ignorant statement I've heard from a so called Dr.
With the elimination of your Hep C, who knows what the future may bring.
Since eliminating the Hep C, I've been removed from the transplant list due to
encouraging numbers.
You will prove him wrong.  Send him an e-mail after you get rid of him with your continuing improving stats!  
......Kim

[almostsixty]

thanks for your encouraging words. It makes me feel better that others have improving numbers. I do call my doctor Dr. Doom. Most of my interactions are with the PA and she is much more positive.

[heart_in_the_keyes]

I have been on the liver transplant list over a year and a half.  In September I got called in for a transplant after a year and due to family circumstances  I was unable to get to the hospital to get it done (long story) and had to meet with the head of surgery of transplant surgery a week later who is one of the best in the US...he said the same thing to me...after examining me and going over my history he said at 67 with a low MELD with no -  to below minimal  fibrosis or varices even though I was stage 4 ESLD decomp cirrhosis of the liver, no signs of HE, my mobilization and coloring were normal he would counsel me not to have the surgery at this time and the only reason he could feel that my hepatologist was pushing for it was because of my age and due to the fact that I was in such good health that the likelihood of me being able to "tolerate" the surgery at 67 was better than it would be at 70 or later. would be harder.

I just completed a drug regimen that cured my Hep C. Just had upper GI for hep to check and my hep said I was fine and would see me in three months.  So who knows.  This is the craziest disease.  I have a upcoming magnetic MRI coming up to check the liver...we will see.  I am doing fine.  

I do think there is hope.  I do agree with almost everything I have read above.  I am also a believer of positive thought. This disease, due to the medications, can lead to other ailments.  But as we all get older we may have gotten other things anyway.  

I am mainly a vegetarian.  Whey is fine. Everyone needs a balanced diet of protein, carbohydrates, fats. You need all three as they work together. Everything in proportion though.  

Eliminate red meats, processed meats, sugar, salt (use spices), If you like dairy, try almond milk.  I eat cereal with Greek yogurt.   I daily eat a tomato, some artichoke hearts and drink a couple of cups of chamomile  tea (a old time remedy for liver rejuvenation).  Eliminate all caffeine.  Coffee is okay.  Never thought I'd be able to drink it black but have gotten use to it with cinnamon. I drink several cups of green and/or oolong tea a day.  And about 64oz of water a day minimum is a must.  

Everyone is different. I have always encouraged everyone to read as much as they can on the medicines they are taking....read labels on your food...read and research food items...you have to be your own advocate.
I went to a transplant meeting with a bunch of other transplant patients and one of the speakers was a nutritionist.  As she sat there telling us what to eat I took notes.  She asked if there were any questions.  I said yes.  I ask if everyone in the group was a liver transplant patients.  They all said yes.  I said well then here are several things that you do not need to do that she said to do....one: do not eat red meat.  two do no drink energy drinks.  And I went on to cover about 15 other things she said and she was po'd.....I said it you would like to walk down to the GI office with me now maybe my GI is there, if not, you can talk to one of the others.  We went down there.  I went over what she had told me then I excused myself and left and thought the hell with that.  If I hadn't been informed and had listened to her ....good grief. I received a letter of apology from her.

So to end this...the best person to know what to do is you....you should know your body by 60.....food is not a cure.....but eating right is a way to keep your energy up.   Get the information from all sources....disseminate it.....read up on it.....and do what is best for you.   You are not creating a diet....you are embarking on a food lifestyle change.  And this is coming from a person who lived on M&M's, Cokes, and nachos and cheese all day,  The only good meal I'd take time to eat was on the way home from working in of all places the ER and stop and eat a everything breakfast and go home and sleep all day.  Oh yeah of course I'd have that good meal every so often but it was usually a steak....I shudder at how I use to eat. So you just have to figure out what you like and what will fit in with what you want to do and then go for it.  It takes time.  

[mzkity]

Hey girl!!!! Great response. You really inspired me. I'm slipping away with the diet. I really appreciate you posting this. I'll keep trying. I know your story so Im impressed with your sticking to your "food thing"

So are you not getting a transplant? Good luck with your decision.

Kitty

[linda803]

Hi again ,, We wont know if the hep c is clear till 3 months after the Harvoni is finished ,, As for the tips, My husband was on life support and in the hospital for 20 day's, he had a very bad bleed out and was lucky to make it through,, All anyone can do with this disease is hope for the best, Everyone is different,, My husband is 65 and he has said if he doest get a transplant by 70 years old, He will take himself off the list and someone younger can a a liver, After a certain age it would be very hard,, So we live our lifes the best we can , because as we all know live is short enjoy,,, best of luck to everyone

[jata_i_rua]

yes I have known people who got cured from cirrosis at the last stage after they had bee discharged from the hospital as "hopeless case" and sent home to dy! After drinking the tee of a Brasilian herbal health plant for three months
they were cured clinically 100%, only to dy of old-age.
The same plant cures Hepatitis-C within 6weeks to 3 months of drinking a potian of the leaves each day!!!!
This is 25 years ago and one x-patient called me recently telling me never to have had a fallback.

[almostsixty]

Thank you for your advise and encouragement.  With my HCV gone I do need to move forward with a healthier life style. At times I feel so doomed, when really what I need to do is move ahead a be kind to my body!

[PaulaAnn]

I know this is an old post but though I dont have Hep C.  I did have Hep B at one time.  I have cirrhosis..and was told by my Cleveland Clinic hepatologist that since I am 65, that I would prob not need a liver trans till I turned 73 at which time I would be too old to transplant. Nice. I have other health issues that "popped up" after his statement (r/a lung after 33 yrs with r/a) so I prob would not be able to pass the transplant eval anyway.  But it made me feel like you did.  Feeling doomed, there is no hope.  I feel pretty good most of the time. My labs have been pretty good too. We'll see in April.  US every 6 mos to check for HCC..thats nervewracking.  I had Hep B in the past *I had no clue till about a yr ago*.  Hep kind of pooh pooh'd it saying "Oh you had it, but you fought it off and are now immune".   I think so many drs are themselves immune to telling their patients the same things over and over again that they dont realize how much damage it can do to a patient. So much to learn with this disease and drs dont tell their patients all we need to know.  They're swamped, overworked, whatever.  
I love the replies you received....we need to hear hope from others.  I know I have so many other things that can kill me but I've learned to make the most of my life while I'm "living" in it..not "dying" in it.  
Now I would not mind being in Florida..love St Pete..my old neighborhood.   Especially after this NE Ohio winter.  Paula  

[almostsixty]

Thank you for your comment. With cirrhosis you are really not looking at any real cure, just taking care the best one can. I do live life to it's fullest. I have even reeducated myself for a new career. Moving forward isn't always easy but that's what we need to do. Living in Florida is good for me. The warmth and the sun are theraputic.   I lived in Ohio for my first 22 years. Cold is not for me. Keep on living!

[ppmguy]

hi all,
my hepatologist did a fibroscan yesterday 3-4-15.  my last biopsy was 1999. it was stage 3F.  so it is very likely i had some level of cirrhosis, when i cleared the hep c virus, in 2012.  

the results of my scan was 4.5 kpa.  the tech showed me the read out of the 12 scans she took.  it showed the surface of the liver, with a stiffness number for each area of the liver scanned.  a couple areas showed some fibrosis at 7.0 kpa.
barry

[Magicalheart]

Please don't listen to all these negative comments from your docs. I am 70 yrs old, a professional dancer, performer and teacher with cirrhosis and doing well. My MELD score went down to 7 or 8 and liver enzymes are normal after clearing the hep C virus. I passed all the physical tests with flying colors to clear me for a transplant list, which was suggested. But I keep getting better. It is quite possible, especially if you don't by into the standard unenlightened prognoses that many docs give.

[Sawdunn]

Not sure it is helpful to advice others to ignore their doctor’s advice. Without a person’s medical history it is impossible for one on the internet to tell whether another will do well or not.  Congratulations on your progress, but try not to project your outcome onto others without any real information on what their situations are. It could be dangerous for some.

[AeiramB]

No matter how knowledgeable another layperson claims or appears to be, take it only as OPINION. They are NOT a doctor and every person's liver disease is unique. None of us look identical. You need to be assertive (not aggressive) about your healthcare. Go to reputable websites like Mayo Clinic, webMD, National Inst of Health, and more. Learn and make a list of questions for your doctor. Don't ever be afraid of asking too many questions. Remember you have no obligation to them. And it's your right to get a 2nd or even 3rd opinion. It's your life and you need to assert yourself. One thing I will say - family medicine and internal medicine doctors DO NOT SPECIALIZE in these matters, no matter what they tell you! You need a gastroenterologist (GI) or a doctor further educated - a hepatologist.  This is your life you're dealing with so don't sell yourself short