Post drugs liver healing

[D.B]

How long after finishing meds does it take liver
To heal? We're told to be careful while on drugs.
When is our liver I guess back to normal, or what it was pre treatment?
                                                                                                D.B

[Lynn K]

It all depends on how badly damaged your liver was damaged by Hepatitis c. Our medicines the DAA’s  to not harm the liver they prevent the hepatitis c virus from making copies of itself. The older generation meds of interferon injections and ribavirin for 6 months were somewhat harder in our livers.

If you are only F1 or F2 prior to treatment the AASLD (American Association for the Study of Liver Diseases) says those patients can return to being followed as though they never had hep. For patients with more serious liver damage F3 or F4 (cirrhosis) they will likely need to be followed for the remainder of their liver due to the risk of developing liver cancer (HCC).

It has been said that even patients with cirrhosis (F4) (about 50%) may with time see improvements in liver function but the more damage sustained the longer that process will take.

For myself I am almost 3 years post treatment. Although initially post treatment my platelet count increased from the 80 to 90 range to now about 110 this is still below minimum normal of 150 and hasn’t had any additional improvements since meaning I still have portal hypertension due to cirrhosis.  So at least for me I will likely neve see resolution of my cirrhosis as I was diagnosed with cirrhosis 7 years before I was cured and my Fibroscan score before treatment was 27. Only time will tell. But others here who were recently diagnosed as F4 before treatment some have seen reductions to F3 or F2 just a year or two after treatment.

Really this is all new territory for doctors we are pioneers in a new frontier never before have so many been cured of hep c who have extensive liver damage. There is not much data available we are providing the data for those who come after us.

If you have liver damage and want your liver to heal you will need to continued to be kind to your liver. In other words if you have less liver damage of F1 or F2 being cured of hep c doesn’t give you license to take up heavy drinking. While an occasional consumption of alcohol in moderation is likely ok (but you should ask your doctor) heavy and frequent drinking would not be a good idea.

If you had previous excessive alcohol use before treatment it is more likely that you could go return to excess alcohol consumption so in that case it would probably be best to continue to abstain. 

[gnatcatcher]

D.B., my liver already started getting healthier during treatment. For example, my liver enzymes ALT and AST, which were each over 200 after having had HCV for nearly 44 years, came all the way back into the normal range when I was tested after only 4 weeks on the meds. They've stayed in the normal range ever since.

More proof that my liver continued to become healthier the longer I was cured came from measuring the degree of liver fibrosis. My fibrosis score before treatment was 19.5 kPa, which indicated cirrhosis (F4 on an F0 - F4 scale). Nine months after treatment finished, it had gone down to 11.4 (F3). Seven months after that, it was down to 9.4. Now, another year later, it is 7.6 kPa (F2). The lowest FibroScan score is 2.5, and the average for people who never had HCV is around 5.3 kPa.

I doubt there's a longitudinal study anywhere that measured fibrosis level, ALT, AST, etc. of perfectly normal people, then figured out who had gotten HCV and who was cured and compared their values before their infections to their values at various points after their cures. For one thing, the noninvasive FibroScan is fairly new. Fibrosis level used to be measured by liver biopsy, which is a surgical procedure, so they wouldn't do a liver biopsy on someone unless they suspected the person's liver was under siege.

All that matters is that after nearly 44 years of my liver getting worse because of HCV, not only did it stop getting worse, the cure enabled it to heal enough that my risk of getting liver cancer is now no higher than it is for people who never had HCV.

As Lynn notes, YMMV depending on how severe the damage was before treatment, what kind of care you take of your liver, and probably other factors.

HTH,

Gnatty

[D.B]

Thanks to both of you. The word of wisdom
Is to take of ourselves. I along with you all
am very grateful for a chance of normal life..
I'll stay in touch and let everyone know my
12 week blood test.D.B

[chino1969]

I am several years SVR after a successful 24 week course of only Harvoni and am involved in two clinical studies. The first is a 5 year study by Gilead to track those who have cleared Hep C with Harvoni and includes blood work every 6 months, a yearly Fibro Scan along with detailed questionaires filled out at every 6 month visit. The second study involves a more accurate test than the current AFP tumor marker test. Both tests are run out of U of PA Perelman Center.

[gnatcatcher]

Glad Gilead is doing a five-year follow-up. Do the questionnaires cover possible post-treatment side effects?

It'll be nice to have something more accurate than the AFP tumor marker test.

[chino1969]

Yes. The 6 month questionnaire is approx. 10+ pages and is quite extensive.

[gnatcatcher]

Great -- thanks!