Finally got answers to my liver bx quetions

[Guest guest]

FROM DR KWO:

Rita, sorry for delay in getting back to you.

Please see responses to your questions below

(my e-mail to him w/answers)

Hi Dr Kwo,

Thank you for allowing me to e-mail you regarding my results. I have

showed them to the doctor I work for and he says is it doesn't sound

good but he doesn't understand it all.

Being on Interferon hasn't seemed to help much and the virus did not

clear with the interferon and Riba so I don't think I am going to

clear the virus that is causing damage to my liver. I know you

mentioned another study with protease inhibitor added and I might be

a candidate. Would I still be a candidate being diagnosed with

cirrhosis?

DR ANSWER: Absolutely, in fact you will have highest priority for

this study, though it will depend somewhat on how much your virus

decreased the first time

Ginny, can you pull Rita Payne¢s chart for me, specifically, her HCV

RNA titers. On your first treatment, you almost got rid of the

virus, which suggests to me, that retreatment with a protease

inhibitor will have a good chance of curing you (remember not a

guarantee though)

My worry is being able to work again with the treatment. I almost

didn't make it the last time with working. The exhaustion was

horrible. My patient load is much heavier now and that concerns me.

Quality is sometimes better than quantity. Would it be worth it for

me to consider if I end up not being able to work. Is it worth it if

I am going to be extremely sick for a year and not clear again. I

don't know. Your input would be helpful here. I am scared of

treatment again.

DR ANSWER: Let me check your viral loads again, if they went down

significantly, you have a good chance (not a guarantee) of cure.

I know my blood work isn't too bad at this point but how often

should this be checked since I now have cirrhosis.

DR ANSWER: Every 3 montys)

I am concerned about it progressing faster due to the Hep C. I also

know cirrhosis has different degrees of severity and I am assuming

mine is in the first stages. What are the stages and how fast does

it progress usually. Especially if being attacked by the virus.

DR ANS: Yes, yours is in the first stage of cirrhosis and you can go

10 years like this or longer.

This is what I found in a medical journal " If the underlying cause

of cirrhosis cannot be corrected or removed, scarring will continue.

The liver will fail, and the patient will probably die within five

years " .

DR ANS: That is correct, once the liver fails or decompensates, your

liver has not yet decompensated.

I have also read about ammonia levels and wondered if this is

checked routinely or only if a person shows signs of elevation.

DR ANS: Usually do not check, if you are curious, we can.

I just would like to have it explained to me in layman terms so I

can explain it better to my family.

I would like to know what you feel is the prognosis for me. I know

you can't say I am going to die in 5 - 10 years but surely you have

some idea with the Hep C what the prognosis may be. How fast

progression may be. I went from mild inflammation to cirrhosis in 10

years or less.

DR ANS: You should be stable for 5-10 years, some weight loss will

help some, but progressive fatigue will be the toughest thing to

deal with.

I am hopeful we can get you in a nn-responder trial.

Rita

p.s. very scared of treatment again... and the fatigue... I HAVE TO

WORK but will do what I have to do.