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Author Topic: What next  (Read 406 times)

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Offline Docroccin

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  • Posts: 3
What next
« on: May 14, 2019, 07:14:41 pm »
I am happy to read of those who have lived well for many years following diagnosis of  cirrhosis and mild-moderate varices.  Could I ask, were your liver function, platelets, albumin and bilirubin (and other related tests) normal during this time?
HCV 1970s
IFN 1990s, 9 out of 12 months
gt 1a 2019
6 months daclat/sofos
F4
svr and scope pending

Offline Lynn K

  • Global Moderator
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  • Posts: 4,241
  • Get tested, get treated, get cured, fight Hep c!
Re: What next
« Reply #1 on: May 15, 2019, 12:33:30 am »
Hi and welcome

I was diagnosed with cirrhosis in Jan 2008 with liver biopsy. While I was infected with hep c my liver enzymes were always slightly elevated. Now, since my hep c was cured since I finished treatment with Harvoni in May 2015 my liver enzymes have been in normal range since I don’t have hep c irritating my liver anymore.

Before I treated my platelets were around 85. After my hep c was cured my platelets rise to about 110 and now at 4 years post my platelets are about 125. Still slightly below normal of 150 but improved. Maybe someday they will make it back to low normal.

My albumin and bilirubin have always been in normal range.

My MELD score is 7 because my INR is 1.1 if it was 1.0 my MELD would be 6 the lowest possible score.

How are you doing? Have you looked into treating your hep c? I understand treating hep c is more complicated if you have hep b
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline Docroccin

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  • Posts: 3
Re: What next
« Reply #2 on: May 15, 2019, 03:29:02 am »
Thank you Lyn.  Pleased to meet you.  I have had HCV treatment. Six months sofosbuvir and daclatasvir. Just waiting for RNA result. LFTs, bili remains up largely unchanged since starting. Plt 69, alb 24 also unchanged. Don’t drink at all. Interestingly,  HBVsAb is pos and cAb is neg - yet I don’t ever remember being vaccinated. I’ve had an episode of what might have been liver failure last year - itch and acute leg edema. I guess I’m trying to figure where I’m at. Having scope soon. Things will become clearer.
HCV 1970s
IFN 1990s, 9 out of 12 months
gt 1a 2019
6 months daclat/sofos
F4
svr and scope pending

Offline Lynn K

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  • Posts: 4,241
  • Get tested, get treated, get cured, fight Hep c!
Re: What next
« Reply #3 on: May 15, 2019, 02:04:39 pm »
Hi nice to meet you too,

I’m not really up to speed on how hep b testing results work. Could you have been vaccinated as a child? I don’t know about recommended childhood vaccination schedules either.

Has your doctor said you have hep B?

Having elevated liver enzymes means something is injuring your liver now. That is why my liver enzymes returned to normal when my hep c was cured. No virus, no ongoing liver injury. But I still have liver cirrhosis for over 22 years now.

Thee are multiple causes of liver inflammation (hepatitis) not all are viral caused. There is fatty liver disease and you don’t need to be super overweight for this condition to develop although the risk is higher for those whose BMI say they overweight or more so if they are obese.

There is also autoimmune hepatitis a disease in which your immune system attacks liver cells. Vascular diseases, like Budd-Chiari syndrome, can cause blockages in the veins of the liver and lead to acute liver failure.

Are you seeing a hepatologist associated with a liver transplant center? This type of doctor is best equipped to follow a patient with advanced liver disease. Do you know your MELD score? The MELD is a composite score of a few blood tests. It is used to stage patients on the liver transplant list and also to estimate I think it is three month life expectancy. My MELD has been stable at 7 for many years. It is not the lowest possible score of 6 only because my INR is 1.1 if my INR was 1.0 I would have a score of 6.

You have to have a MELD of 15 at most transplant centers to be eligible to be on the transplant list as well as other factors like having a support network someone to care for you post transplant at home while you recover. Most transplants occur at a MELD of around 30 depending on the wait times in the region you are associated with. The MELD goes up to a max of 40.

Has your doctor said anything about the cause of your continued elevated liver enzymes?

Did they test you for HCV RNA at 12 weeks post? Most are calling not detected at 12 weeks means cured. Six months is insurance. Although we recently have two people here who were late relapsed this is rare.

Keep in touch let us know what you learn :)
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline Docroccin

  • Member
  • Posts: 3
Re: What next
« Reply #4 on: May 19, 2019, 09:08:41 am »
Thank you.

Turns out the jury is out on the hep b question. Serology result has gone missing so will have it again. Core ab result was definitely negative (can find that one).  I would say the serology will be negative, as I haven’t been vaccinated. I’m too old to have had childhood hep b vax. 

Yes, my hepatologist is wondering why the LFTs are still up.  Mentioned liver biopsy.  Not keen. There is still time for them to improve. I don’t drink. CAP score (fat score on Fibroscan) is normal, though I could, and will, lose weight.

I am still waiting for the EOT result. I had 24 weeks treatment due to cirrhosis.  Hepatologist went through the choices for retreatment, if required. “Salvage treatment”- now there’s another term that could be updated.

He said my MELD is 10, but I can’t get it below 15. (bili 61, INR 1.4, Na 141, creat 76)  Plt 69, alb 23. Not ideal.

He gave me preventive rifaximin.

Ah well, I’ll be waiting a bit longer then. And expect improvement.

HCV 1970s
IFN 1990s, 9 out of 12 months
gt 1a 2019
6 months daclat/sofos
F4
svr and scope pending

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,241
  • Get tested, get treated, get cured, fight Hep c!
Re: What next
« Reply #5 on: May 20, 2019, 12:22:47 am »
I failed 3 interferon based treatments and also relapsed after treating with Sovaldi and Olysio 12 weeks treatment.

I was finally cured with 24 weeks of Harvoni and ribavirin.  I was diagnosed with cirrhosis in January 2008 on my 4th liver biopsy. I was having them every five years after I was diagnosed with hep c in 1990. So even though I had failed 4 previous treatments and was diagnosed 7 years prior with liver cirrhosis I was still able to be cured of hep c.

Did they test you for your viral load at 12 weeks post treatment? While later testing isn’t a bad idea if you were not detected at 12 weeks post most doctors are calling that cured. The odds of being cured at that point is about 99.8% and odds of relapse after that time are about 0.2%

While we did have two people recently here let us know they had a late relapse it is very uncommon. I was tested this year after the folks who had a late relapse posted and fortunstely I remain hep c free at 4 years post treatment.
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

 


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