Just diagnosed & surprised!

[Victorino545]

I was just diagnosed with Hpc. I am so confused as to how I could have got it. I had phlebitis 38 yrs ago when I delivered my son. They used blood thinner to reduce clots  and blood clotting agents when I went in for a cesarean to stop bleeding and I got some blood. Could I have had it this long and not known. I have never been tested and doctor said I have probably had for awhile. Never used drugs, alcohol or had multiple sex partners. Been married 42 yrs. I go see a G I doctor next Friday. I was tested cause A l t 47u/l and liver enlarged to 16.7 cm. I have been bloated, big belly & very tired. I also have emphysema and don't know how I am going handle all this. 

[gnatcatcher]

Victorino545, yes, you could have had it this long and not known. After I had HCV for more than 3 decades, I still didn't have any symptoms except for being somewhat more tired than others my age. It was only because my HMO began testing everyone who'd had transfusions before 1982 that I found out, and then I was able to wait for the good treatments to come along.

You'll handle this just fine. Further tests will reveal which genotype (subtype) of HCV you have, how much of it (viral load, or VL) you have, and how much fibrosis (on a scale of F0=none to F4=cirrhosis) your liver has. Then you'll be prescribed probably one pill a day for 8, 12, or 24 weeks (depending on your genotype, viral load, F score, and the medicine chosen). All of the current medicines have very high cure rates; most people experience no or only a few mild side effects. Your emphysema shouldn't be a problem. In fact, "Patients with COPD have increased prevalence of HCV infection, and patients with HCV infection, have increased prevalence of COPD. COPD may be an extrahepatic disease associated with HCV infection." ( http://hepatmon.com/?page=article&article_id=480 )

I waited until 2015 to get treated because earlier medicines had many side effects and low cure rates. By then, I had other chronic medical conditions, my ALT and AST were very high, my energy level was very low, and I was nearing my 44th anniversary of the fateful transfusions. The treatment went very smoothly, the virus was already undetected by the fourth-week labs (it remains undetected, so I am cured), and my liver has already recovered so much that my fibrosis score has gone from 19.5 (F4) down to 9.4 (borderline F2/F3). The liver is very resilient!

Wishing you well,

Gnatty

[Victorino545]

Thanks Gnatty for your support. I am all new to this and looks like there are a lot of numbers & tests involved. I would like to know if there are any important questions I need ask GI during my first appointment?

[gnatcatcher]

Get copies of all lab reports and be sure that the GI explains what the results mean. If he/she speaks in medicalese, we can translate into ordinary English as long as you have copies of the actual reports.

The reports should contain your genotype and your viral load. There may also be a fibrosis score based on a blood test such as a Fibrosure. If not, ask how the GI plans to assess your fibrosis level. In the old days, people had a liver biopsy. These days, it is done either by a blood test such as a Fibrosure or by a special kind of ultrasound called a FibroScan. Some GIs do both (I had both a Fibrosure and a FibroScan).

Ask how your emphysema might affect and/or be affected by the treatment.

Find out what treatment the GI is recommending. Ask what the GI's office does to help you get insurance approval, and what the office does if you have difficulties getting approved. Ask when you will be tested to find out if the treatment is working.

Ask how to contact the GI and/or a staff member if you experience side effects.

That's what I can think of right now. Chances are, your GI will go over most or all of the above matters before you ask.

Best wishes,

Gnatty