Am I a good candidate?

[keith_kar]

Hello Forum,

I'm in my mid 60's and probably well into my 4th decade of hep C. All this time I've never had elevated liver enzymes. The results of extensive blood work ordered by my hep c doctor returned everything normal, right in the middle of the range.

My ultrasound revealed a normal liver, nothing out of the ordinary, and a recent fibroscan measured 5.3.

My viral load varies anywhere from 800,000 to 1.5 mil.

The treatment has been offered to me, but I'm reluctant to go on it. The statistics say up to 20% of people with chronic hep c go on to develop cirrhosis, so I'm trying to determine the risk/reward of starting treatment, due to the worry of lingering/adverse side effects. I feel perfectly normal now, no obvious symptoms.

If my blood work was way off, or my scans revealed something obvious, I would most certainly be all over the treatment, but I'm not seeing enough evidence of that right now.

Thanks everyone for any input

[Mugwump]

I was in the complete opposite situation. My liver enzymes were starting to spike when I hit 60 and I was becoming cirrhotic. So I did not have a difficult choice to make.

However the fears of somehow accidentally infecting other people played very heavy on my mind until I got the SVR 12 and I was not absolutely certain until I tested again at 1 year and was SVR! Until then whenever I had to have a needle I always made certain that the perfusionist was aware of the fact that I had HCV. If I had needed emergency treatment for a severe cut or if I was cognizant while being treated by emergency personnel then I would have certainly made it know to the individuals doing the emergency work that they were at risk and to mask and glove up!
The most worrying treatment I ever underwent was Riba and Interferon. It weakened me to the extent that I needed steroid injections to the superior lumbar 4 area in 2006-07 to even get out of bed and go to work! Interferon and riba put me out of work for a full 2 years in 2003-05.

By the time I progressed to cirrhosis in about 2012, HCV and cirrhosis with elevated bilirubin levels put me out of work again, until I chose to treat in 2014. By the end of 2015 I was ready to go back working on my feet 10 hour shifts cooking in a seniors facility. So treating the disease made me productive again.
 In 2013-14 I was taking myself off the road at times because of non clinical hepatic encephalopathy with elevated levels of bilirubin. It caused what was very debilitating for me, I was beginning to lose my reason and ability to mentally focus. I had stopped studying classical music and playing because I could no longer focus enough to memorize even a simple piece of Bach. Like the wonderful little Gavotte en Rondeau from the e major partita #3 for solo violin, which I am now learning and memorizing effectively again. When I record it again I will post it here. I have not played it since I was in my 30's but it is one of those desert island pieces that I just cannot get out of my system until I play it. Just 3 years ago I had given up all hope of ever playing the piece again!

These reasons were just as much a deciding factor in ridding myself of HCV once and for all.

You will read that others have had a hard time with treatment especially with myalgia and arthritic like symptoms post treatment. I cannot deny that perhaps there are those who will pay a price for choosing to treat. I did to a small extent in as much as there was a noticeable increase in muscle aches and pains post treatment.
Regardless for me I can say without hesitation that ridding myself of HCV once and for all was worth the slight changes removing the disease have brought about. Above all I did not want to live the rest of my life with a sword of Damocles hanging over my head causing me to worry all the time about accidentally infecting others.

Your situation is a completely different one, the only benefit you would certainly receive from being SVR is the fact that you could no longer possibly infect others.
All my best with what ever you decide
Eric

[Lynn K]

Yes the odds of cirrhosis are at about 20% of patients but that is at the20 year mark of infection. The longer you have hep c the odds of liver damage do increase with time and age.

My liver enzymes were only slightly above normal the majority of time I was infected but my liver was getting worse and worse with every liver biopsy done every 5 years. After I had been infected for 30 years I was diagnosed with cirrhosis.

But yes for you you have apparently not had any progression which is great. I guess my concerns would be the possibility  of developing extrahepatic manifestations of the virus. Also I always was worried if I would get cut at work or at home the risk of infection others. I always felt like Typhoid Mary.

Personally for me especially after having treated three separate times in the past with the old standard of care interferon injections and ribavirin pills for 6 months duration my treatment with Harvoni for 24 weeks was a walk in the park. I really had little in the way of problems on treatment which is the more common experience of most patients. While sadly that is not the case for some people and the did have a harder time that is not the experience of the majority.

Thise are the things I would consider in making your decision.

Best of luck

[keith_kar]

Thanks for the input everyone.

Tomorrow I'm going for a followup fibroscan. Fortunately the GI doctors want to keep a close eye on me while while I think about whether to start treatment or not. It's only been a year since my initial scan, so not expecting any drastic changes this time. Anything in the 5.0 range would indicate no changes

I can see the benefit of not being able to infect others post treatment, it seems to be one of the selling points of being cleared of the virus. For now, just being careful, I know of the precautions to take. Already told my dental care provider as well.

For now, I'm just leading a healthy life, trying to keep everything stable. I'm really thankful for this forum, seems to be very active.

Keith