Disabled Hep Cat - Although I don't drink and I am concerned about alcohol use and liver disease, I am deeply disturbed by this trend in insurance. It may be left over from the old interferon days when the decision made sense. This current trend is not medically-based and I think it is a way to keep cost down. Denying treatment to people who won't fight back may be a business decision. It fries me.
Although, if I were a doctor I would try to get someone in to treatment for addiction first before starting Harvoni or at least at the same time because I think it can't be helpful if you are drinking heavy amounts while trying to cure Hep C.
Comments:
This meta-analysis did not find a consistent association between alcohol use and hepatitis C virus replication. The conclusions from this study are limited due to its small sample size, differences in how studies defined heavy drinking, the cross-sectional analyses, and lack of control for the quality of the studies, duration of alcohol use, and antiviral treatment. However, while the mechanism of liver damage from co-occurring hepatitis C and heavy alcohol use remains uncertain, the recommendation for patients with hepatitis C to abstain or minimize alcohol use remains unchanged.
Kevin L. Kraemer, MD, MSc
I gave up drinking a few years back, and I've got to admit, its put a big crimp in my social life. Its just hard for me to be around drinking people and the liquor fueled dialogue and behavior which results.. I miss the fun and camaraderie that drinking elicits. But I sure don't miss the hangovers, drunken arguments, and lack of clear thought and judgement which more often than not develops.
One thing that should be clear is that insurers do not deny treatment for occasional alcohol use; rather treatment denials are rendered due to alcohol "abuse" and or dependency - both of which have a specific clinical definition.
Best wishes, Mike
Here is an article that explains sovaldi (pretty much the same) svr rates didn't change for those who drank but didn't abuse alcohol.
http://www.hepmag.com/articles/2512_20526.shtml
Management Strategies: Discussing alcohol use results in reduced use for patients diagnosed with HCV. Moderate alcohol consumption does not appear to significantly influence treatment outcome, yet is discouraged due to the hepatotoxic effects of alcohol. Most experts do not recommend initiating HCV therapy in patients with ongoing heavy alcohol use. Multiple pharmacologic agents are available for alcohol dependence, the most promising of which is a monthly injection of naltrexone. A multidisciplinary approach, involving personalized addiction care and case management, may be beneficial. The AASLD recommends preferably suspending all alcohol intake while on therapy for hepatitis C or limiting the alcohol intake to an occasional drink.
Hi Maddawg46,
My doctor said that sugar is metabolized exactly like alcohol and told me I could only have 20 grams of sugar per day! So that is why the decision should be the doctor's decision and the patientand I really just don't have any faith in these boards that are making decisions instead of doctors I really just don't have any faith in these boards that are making decisions and over ruling a doctors decision....... Karen Life is Good!!
Typically, I find that most people who think about alcohol, or "only have 2 glasses a day" have a problem.
OK so 7.2% of the us population has a drinking problem and should abstain. That is about 22 mil out of a US population of about 319 mil.
Frankly, I think those numbers are flawed.
I can believe that only 7.2% of the population suffers from true alcoholism, however, there isn't a doubt in my mind that there is a much, much larger segment of society that abuses it. It cannot be stressed enough that there is a difference between alcoholism (actual physical dependency) and alcohol abuse (drinking more than you should), and I don't believe someone who abuses it necessarily falls under the AUD category.
Abuse vs "true" alcoholism vs a disease... It's all semantics... and a mind set. Take those drinks away from an alcohol abuser (not a "true" alcoholic) and see what you've got in a few days. My guess is - total chaos.
Hi Maddawg46,
My doctor said that sugar is metabolized exactly like alcohol and told me I could only have 20 grams of sugar per day! So that is why the decision should be the doctor's decision and the patientand I really just don't have any faith in these boards that are making decisions instead of doctors I really just don't have any faith in these boards that are making decisions and over ruling a doctors decision....... Karen Life is Good!!
Karen,
You certainly have a good point about sugar. It could even stand as a topic of it's own. Since I have a sweet tooth, I thought I better find out why. Here is an article about it on this site!
http://www.hepatitiscentral.com/news/the_not-so-swee/ (http://www.hepatitiscentral.com/news/the_not-so-swee/)
And thank you Karen, for bringing it to our attention!
I guess I should have titled my post alcohol after Harvoni
Frankly, my hepatology clinic "requires" their patients to not drink or take any drugs 6 months before Tx, during Tx, and 6 mos after Tx. If they figure out you are partaking - you get thrown off Tx...
Anybody who continues on that self destructive path, especially during Tx, should think twice about taking the Tx... especially considering that their insurance company is paying so much money for the Tx. Not that I tend to defend insurance companies, but the more they spend, the higher they charge for insurance - so we all end up paying for the selfishness of those who continue to get blasted while on Tx...
So now the hcv crowd is a impulsive crowd
You can have any opinion you want that's all up to you but, really shouldn't generalized on how anyone contracted hcv
My opinion is that if a person cannot stay off alcohol during TX, then maybe they should take a good hard look at their drinking. A "normal" drinker would not think twice about not having a drink It is usually the people with a problem that try to justify why and when they should have a drink.
** BINGO!!!
Who said drinking on treatment
Everyone has choices And everyone is entitled to their own opinions
MY numbers were high, but was told no fibrsis by my doc. i want to get a fibrasure test, refused biopsy, all was done thru blood. now lynn says her numbers were ok, @she has cirroris/ i dont care about spelling now. at home with the fevery flu
Hi Paul
If the virus is gone nothing I am aware of can resurect the virus either you have the virus or you do not. So if you have been cured the only way to have a viral load is to get reinfected.
But if you have any liver damage I personally would want to give my liver the chance to heal
I dunno could too much Tylenol cause relapse
They are saving SVR=cured
not hiding virus
So I am going with neither alcohol, Tylenol or anything else can raise the dead
To me it just doesn't make sense that it could
I guess it you don't have a biopsy you wouldn't know at least I did not know I had progress officially to cirrhosis until I had that last biopsy in 2008.
I knew my liver was getting worse with each 5 year biopsy but did not know I was F4.
>>For those of you who don't have liver disease, I would still say take care of your liver because you REALLY don't know the extent of the damage HepC may have caused. <<
Deb, not sure what you are saying here. Are you saying that for those of us who dont have liver disease, the diagnosis has a greater than average chance of being incorrect? I think Id have to dispute this. I dont know that any diagnosis is truly 100% but are able to have a pretty good idea of the condition our liver is in. Biopsies have been pretty reliable in giving a true picture of liver condition; non invasive tests not so much, but fairly good with minimal damage and with cirrhosis.. Why would a diagnosis of no liver disease be any less reliable than any other diagnosis?