Harvoni treatment outcome with cirrhosis

[BubbaT]

Hi folks,

What is the best outcome to expect for one with cirrhosis like my condition after 12 weeks Harvoni and say I clear the virus?

Do you have some evidentiary cases similar as mine to  compare outcomes?

Can the liver heal with cirrhosis ?  Can I expect a normal life?

Thanks, for your replies, I understand you may not know and aren't sure, but I know you guys are readers, I already figured that out!  Lol

[Sam1224]

Google liver regeneration cirrhosis. There are a bunch of articles.

No matter what, treat your liver well going forward.
I am F4. Basically same profile as you.

[lporterrn]

Bubba,
There is every reason to be hopeful. If you want to wade through some data, start here: http://hcvguidelines.org/full-report-view

[Lynn K]

Hi Bubba

"Can the liver heal with cirrhosis ?  Can I expect a normal life?"

Yes and maybe to both.

You will still need to be followed for cirrhosis but in the report Lucinda listed there is evidence that after getting rid of hep c even a liver with cirrhosis can heal. Part is how bad is your liver already. If you are treating and currently high on the transplant list odds are you will still need a transplant but at least the new liver wont get infected big plus.

But for me, you and others still compensated or only slightly decompensated our livers could improve. We will reduced our risk of HCC but will still need to be monitored as we will still have higher than average risk.

The odds are in our favor we can live a normal lifespan if cured. That is as long as we still take care of out livers to give it that chance to heal.

So no alcohol, liver friendly diet, and getting at least some exercise.

Live long and prosper

[Johnny_Wayne]

Hi Bubba,
I asked my hepatologist if someone like me (who had a meld score of 15) could hope for an improved prognosis after SVR. The resounding answer was YES! She said this is new territory, so we may be talking about a transplant (for me) again in 20 -25 years, but no one really knows. Personally, my meld dropped to 10 during treatment. Now, 6 weeks post treatment my eyes are as white as ivory and I have more good feeling days than bad days. I even sometimes get an occasional GREAT DAY now. If I am still dying from liver failure, I surely cannot tell it.

But looking forward through reality, our livers are very badly beat up. For me the most hope lies in this question: "Do I have enough healthy liver left to sustain life?" For someone like us, the most important thing is to stop ongoing liver damage, and to protect whatever precious function our livers have left remaining.     

[DisabledHepcat]

In simple form the livers rejuvenate process is creepy, cirrhosis starts at one end and works itself inward from the sternum, however even though cirrhosis has begun does not mean it cannot be removed and grown back. As far as I know cirrhosis damage is permanent, they say it is like shoe leather. The liver has soooo much oxygenated blood running through it that the healing process is ten fold towards other parts of the body. A wound needs 2 things to heal, one is fresh blood and the other is non infection. This is the main reason the liver can rebuild from fibrosis since fresh oxygen rich blood is a constant occupant. I think maybe if you have cirrhosis you will need to treat your liver nice even after it's HCV free since cirrhosis is dead tissue period. Depending on how much you have that is reversible  I believe that time with a healthy liver (non toxin) diet can only tell after HCV is gone. Some of our roads are longer than others 

[BubbaT]

Thank you all for your valuable replies:

The information you have shared is very beneficial and appreciated, one of the comforts of being sick is not being sick alone.

 It's a bond we share even though we
Don't know each other on a personal level, we do know what each other is going through and therefore can be supportive and empathic to each other.

Today was a tuff day, I'm not sure why, It could have been something I ate, just feeling bad, needing sleep, blurred vision, tired...pain in my left side..

 I get my results cbc from 2 weeks treatment Friday .

Start week 5 next Tuesday .

[Tpropane]

I have cirrhosis and have been undetected for 8 weeks. I am on Harvoni for 24 weeks because I was non-treatment naive. I will diligently kill every little bugger hiding in my poor, scarred liver. So grateful to have insurance that approved me for the full 24 weeks but I was approved for it because my liver is kind of f$cked. (AND I fought for it,(HARVONI) clawed  tooth and nail, for 3 months!!!) Doing much better energy wise after week 8. I have been so fatigued, practically incapacitated. I put in an 10 hour work day today! So busy and made it through the day. My hot shot GI says my liver could heal, alot or somewhat, his advice varies... once the HCV is gone. I just need to completely abstain from alcohol and advil. I was in so much pain today I thought I would fall on the floor and not be able to get up. I seriously gave thought about life alert, I'm 57. But I have a major knee issue. Had my hip replaced in 2005. Arthritis. Nothing works like one advil, half a vicodin, one glass of wine and a traumeel or icy hot knee massage. mineral salt bath, then Ice, elevation and PT. ALL of those things put together and I can walk up my staircase. I'm too young to use a cane but I'm sure I should. Otherwise I'm like an invalid. I miss hiking, walking and just getting around in general. Weighing the consequences against quality of life... I prefer a little pain relief. That difference is astounding enough to keep it in the medicine cabinet for IN CASE OF EMERGENCY, BREAK GLASS.
I had arthroscopic knee surgery one year ago. Double meniscusctomy, total debride of the knee, and removal of a baker's cyst behind my knee. $6000 deductible and one year later ...I should have just gotten knee replacement. My hip is perfect and pain free. 10 years later.
If just can't function and I refuse to be bed ridden with the arthritis. I'll balance and justify mobility for whatever... My choice, my life, just for me...offering no advice. Just love sharing with those that understand and get it. Not those who judge.
Liver disease sucks when you have pain issues. Because all pain meds go through the liver. I'd rather have less pain and not need even a tylenol. But that is not the case.
Yay us!

[BubbaT]

Hi Lynn, Lucinda, John Wayne , propane, Sam , hepcat, thanks so much for your suggestions and comments, I have learned so much since I started the forum, I am better equipped to deal with this virus, for so long years and years I tried to just mentally overcome the physical and emotional test of this sickness, that I almost hardened myself to the pain and became numb to others pain, but I learned I was only making my case worse. I find that when I'm kind to others that I sense that God is watching over me, so I can endure and now that I'm taking the meds I'm starting to feel hope again, it's really wonderful to feel like your gonna get well!
Today was a good day!

I'm feeling better about my recent blood results,  after 2 weeks. 3-17-15
My ALT  18
My AST  22

The GI said I was compensated cirrhosis,
He said I didn't need to worry about meld score, or transplant now,
He did inform me of the 2 people who died taking that heart med with Harvoni !
And told me to protect myself from vibro bacteria in saltwater.
The fibrosure read .                  .89.           0-0.21.       Taken.   2-5-15
Alpha 2-macro globulins ,qn.    407.           110-276
Haptoglobin.                             14.            34-200
ALT                                          70                                Result.               Range
AST                                          54.   1-20-15
My previous HCV. RNA quantitative real time PCR was 2289864 H.        <15 IU/ml
".                 ".       ".        ".            ".      ".   ".   was. 6.36 H.             <1.18log IU/
Taken on 6-2014


I will get the week 4 Viral Load in 2 weeks,
So I just have completed 4 weeks.

Looking forward to health again!  Yes!

[Johnny_Wayne]

Bubba T,
It is my understanding that most people (if compensated like you) have a very good prognosis if the damage can be stopped. I have also read that some patients, *might* experience a one grade improvement in liver condition over several years. My F3/F4 might improve to F2/F3 over a couple of decades. But I would be happy to simply maintain the status quo for another 20-25 years.
Bubba, you are in a very good place. With all the good treatments coming out, and with your liver being compensated, I would bet my last dollar that you will not ever get sick from liver disease.

[BubbaT]

Thank you john Wayne,

I always liked john Wayne, I like you too!  Thanks for your positive spirit!
I also hope you get super well and live a great life!

I've met some really good folks on this blog!

Keep me posted on your improving condition...

[MEG]

Bubba

He did inform me of the 2 people who died taking that heart med with Harvoni !
And told me to protect myself from vibro bacteria in saltwater.

Hi Bubba, I agree with what everyone here said. From everything I've read over the years and as recently as 2014, the chances of your liver healing are great. And your chances of HCC are dramatically decreased once you clear...it's pretty amazing, eh?

What does the bacteria vibro refer to?

[BubbaT]

Hi Meg ,

The GI was telling me about a  bacterial infection called vibrio, it's common is warm coastal waters like galveston, he said folks with cirrhosis should be careful to limit their exposure to bacterial infection because of the de compensated liver condition and the  suppressed immune response .

Google vibrio...

Thanks for the encouraging words Meg!

[MEG]

Thanks Bubba. I'll google it...I've had such issues with bacterial sinusitis this winter(while also on Harvoni ;-(  that I'm on hyper alert for bugs going around.

[Lynn K]

I have also heard no raw oysters for I think that reason

Yet another thing I can't do anymore no raw oysters and no beer or tequila chaser

Oh well next life I guess

[inaglasshouse]

There are signs that in the future cirrhosis might become treatable (I'm on the same bandwagon).
For example Phenex Pharmaceuticals, recently acquired by Gilead, is developing an FXR agonist (google it).

http://www.gilead.com/news/press-releases/2015/1/gilead-sciences-announces-acquisition-of-phenex-pharmaceuticals-development-program-for-nonalcoholic-steatohepatitis-nash-and-other-liver-diseases

http://www.phenex-pharma.com/en/r-and-d-programs/fxr/

Hope this can help.

[BubbaT]

Thanks glasshouse,  looks like gilead may be a good place to work!
I see they have openings in med communication,

I think I could help them with that!   Lol

[Debula]

Hi Bubba
I'm glad I found this thread.  I am finding myself thinking about this all the time now
(I have pretty much the same profile as you do)
I have also been feeling pain in the "liver area" the last week or two and that is scaring me
I am still waiting for approval from my insurance co for Harvoni
I must have too much time on my hands because I can't stop thinking about what this all means.  I don't understand a lot of the  lingo either so that makes it worse.

Anyway...I am glad you have started on your treatment and I am right behind you!!

Here is to curing the Hep C and hopefully making our liver healthier

[Marynessie]

Well in the same boat with you guys, just got my test back last week, F-4, severe activity. Anyway got approved for Harvoni, starting on Monday, just got it delivered today, see GI Doc in am before starting. Have had Hep C since 80's found out donating blood, I 'm a nurse. Was treated with triple therapy about 12 years ago, it was HELL, increased viral load instead of decreasing, so they pulled me. This all happened so fast, ( getting retested, getting approved Harvoni 6 months) I am also so happy to find this thread, so much info. Have been a lurker the last week.
Anyway hopefully, we will heal some after getting cured, fingers crossed, they said last treatment would only be flu like symptoms,  no so, I hope I am not so sensitive to Harvoni, meds always work freaky on me

[BubbaT]

@Debula and Marynessie, Meg

Glad you are getting treatment, you are gonna be SO glad, don't fret too much over
The side effects, the positive results should far outweigh the temporary discomfort.

I am on week 5 now and I'm feeling lots better, I have more energy and less mental
Fog,  @Meg, I get pharmaceutical grade vitamin C powder, that I take help fight off bacterial infections because for me it's better not to take drugs or antibiotics or steroids if possible,

Also I'm noticing my immune system is fighting Back now that I'm on Harvoni, I have had a chronic  infection for months with the diminished immune response due to the hepc, so that is also making me feel better.... YAY!