holy$h!T:
Hated to say it, but thats how I feel. All usernames centered around hepC used up. So, I’m late to the party :-) But, I finally arrived.
HepC Genotype 1a
HepC Quantitation 1,630,000
PROMETHEUS FIBROSpect HCV index 48 Clinical Interpretation Fibrosis Score F2-F4
FIBROSCAN (VCTE) Liver Stiffness -F2 Fibrosis: mildly fibrotic liver CAP Score -S0 Steatosis: less than 10% of hepatocytes affected
AST/ALT scores over last 3 years ast 41 70 54 69 alt 35 67 57 71
My AST/ALT numbers have been slightly elevated for years, not just the last 3. Full abdominal ultrasound all normal. Primary Care Physician always said “your fine, we’ll just keep watching.” Finally PCP ordered hepC test.
JUST A LITTLE HISTORY 60 years old I have probably had hepC for 38-43 years. Assuming hepC was acquired during careless teenage and early adulthood years. I look back today, and see a really lost person who almost give up. Chemical dependency units, halfway house, AA and NA meetings. One of the very first NA members. Still have the very first paper book NA books we proof read. Clean and sober for 38 years. Went back for GED, 4 years of engineering school and have had a great run. I am grateful for all the progress. Spirituality has played a big part.
LOOKING AHEAD The liver specialist says all bloodwork is normal, except AST/ALT. HepA and HepB vaccinations started.
Now choosing Harvoni or Epclusa or just waiting for a while.
Can someone please advise or help me to make an informed decision.
I am at a loss for any other words. Physically, I’m super fit and train/run regularly. Eat pretty good. But I am having a pretty difficult time wrapping my head around this one.
Mugwump:
I would treat as soon as possible. The simple reason is that other viral infections that knock your immune system down can cause HCV to run amok quickly. It seems that your immune system has kept HCV in check about the same as it did with my infection. However when I was about 62 I had a bad case of the flu and after that my HCV infection did accelerate.
I also was F2-F3 at about your age and did not progress to F4 until about the end of 2012 or early 2013 when the key liver enzyme tests consistently went up over 100. I can tell you the result was weakness, loss of mental acuity and a general feeling that I had a case of the flu constantly. So avoiding the possibility of HCV suddenly taking off and suddenly killing a greater percentage of your liver is the best advice I can give you.
So when DAA's became reliable for GT1a at the end of 2014 it was a no brainer to treat immediately. As far as it goes the newer epclusa seems to be a slightly better drug than Harvoni it seems to have a little less stress on the heart and renal system.
It also seems that those who manage to exercise and keep as active as possible do better handling the strain that these DAAs put on the system. The drug works very quickly and your liver enzymes will normalize almost immediately. I experience what some of us called the Harvoni high, all of a sudden I felt 20 years younger full of energy and mentally acute for the first time in quite a while. It was an eyeopener realizing how sick HCV was really making me feel.
All the best getting treated and cured as quickly as possible. Eric
holy$h!T:
Thank you for the prompt response Mugwump. Looks like you are about 4-5 years hepC free, thats something special. Have you had any heart or renal issues since treatment?
I have recently had a stress test on my heart. Everything looked good, and I probably need to get my yearly prostate check behind me.
I have to finalize my decision by August 20th. What also alarms me if starting HEPA/B vaccines were the right thing to do at this stage.
Mugwump:
No issues regarding cardio or renal during treatment or post treatment. However I did experience more muscle deep pain (myalgia) post treatment for about 6-8 months post treatment. I was in no condition to work for that period of time but then again for over 2 years prior to treatment things were allot worse and there were times when my mental acuity was not up to driving a vehicle. My bilirubin was getting dangerously elevated and my platelet count was down around and under 100 for quite a while before being treated. I was starting to get really sick and it was just a matter of time until the more dangerous aspects of having cirrhosis developed.
What you will find during treatment, is that the more you keep well hydrated, nourished and exercise the less issues will occur with both renal and cardio strain. The reason for this is that your renal system related blood flow needs to be as good as possible to aid in the treatment. This is because the dead virus particles and by products of cell replacement in the liver need to be flushed from the system more during treatment than during normal day to day liver function.
One thing I will say about the early stages of cirrhosis is that at times it feels like you have a constant hangover or the flu. Obviously if your liver is not functioning up to par then toxic chemicals build up in the blood stream and bingo you start to feel like hell all the time. Take it from me even mild early onset cirrhosis is not something pleasant to deal with.
There are metabolic changes that occur during treatment and these changes are positive if your system is in good shape. I see you have only minor liver damage which is relative to how much structure of your liver has been damaged. During treatment the liver will rebuild the cells and some of the structure that need to be replaced or strengthened.
My liver underwent major changes during and post treatment and my fibroscan went from 25kpg down to 7.8 and I am no longer considered to be F4 and all indications are that some of the key vascular structure in the liver that builds hepatocytes also rebuilt itself. So it seems cirrhosis was caught in time in my case.
So if HCV is treated in time it is now understood that the cirrhosis can effectively be reversed or in your situation, avoided altogether.
Getting the A/B vaccine is a good idea because catching either of those if you have HCV can be deadly. Again if your immune system is attacked by either A or B when you have either a damaged liver or an active HCV can be almost impossible to control with current meds. It is hard to say which infection it is that flares up the most but my doctor has dealt with a few who have died of new HBV infection after they were diagnosed with HCV. His experience is that both A and B become much more dangerous in the presence of HCV.
Cheers Eric
holy$h!T:
Mugwump your input and feedback is very helpful and comforting. I am sincerely thanking you for sharing your experience. Finding this forum and being a part of the hepC family will help me get through this. I will post my journey through this also, in hopes of giving back what was so freely shared with me.