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[QUOTE=jessy28]I hear thanebey say all the time that hep c does not kill hardly anyone. But the fact is that attacks the liver. and that winds up killing people i think. what happenes? i don't get it? or maybe i am scared to know about it. from what this one workshop said you either usually go of cirosis or liver cancer that is connected to hep c. so what starts happeneing in the end stages of this desease? anyone know??? in what time frame? anyone had this thing for a long time? i am scared. i just got it three years ago. i just had a baby and while preg i found out i had it along with my husband. my husband just started treatments today. i want them too. if you catch it early is it best to treat?[/QUOTE]


What I tell people is that most people do not die of hepatitis C. The vast majority of patients die of causes other than hepatitis C after a long life. Only about 20% of those with hepatitis C progress to cirrhosis. That is still not a death sentence in most cases. The statistic is that about 2% actually die of the disease itself.

People who die of hepatitis C are most often those who have not been diagnosed in time to make changes or those who do not make the requisite lifestyle changes. , those who have genetic presdispositions to liver disease, those who continue to consume alcohol, smoke (anything) and those who are exposed to toxins in the environment.

Women have been followed in studies for nearly thirty years and the findings of those studies demonstrate that there is not a large number who progress to end stage liver disease in the absence of these factors, at least in women. Men have a greater risk of liver cancer (after progressing to cirrhosis) Obesity is another factor that has recently been shown to be a negative factor for those with hepatitisC.

The single greatest predictors of bad outcome are alcohol consumption, smoking, and obesity. These remain factors of a bad outcome whether or not someone treats with interferon therapy.

The treatment has risks and potential benefits for each person (many scientific studies support this) and that assessment is made by a person and their physician on a case by case basis. However, if a patient continues to smoke (or is exposed to other environmental toxins including second hand smoke), consume alcohol and does not attend to their nutrition and exercise requirements, the outcome is a bad one regardless of whether they treat or not. That person can expect to progress to more serious liver disease.

Additionally, while there has been shown (again in studies) to have improvement in the health of the liver after therapy whether someone clears the virus or not, a person who does not have a durable sustained response has a greater chance of not only being back where they started after one year's time, histologically, but having the fibrosis worsen. This has been shown in studies where patients had repeat biopsies over time and this information was presented to the FDA as well.

Genotypes 2 and 3 have shorter treatment duration making the risk of side effects less, but still not zero. And they have a greater response rate IF THEY DO NOT CONSUME ALCOHOL DURING TREATMENT AND EVER AFTER. They otherwise risk not responding to the treatment in the first place, relapsing if they do initially respond and having progressive damage to the liver over time.

There is a lot we still don't know about hepatitis C. The new information on liver disease seems to be pointing to progression, when it occurs, being the result of a number of factors in combination with the virus (for sure any alcohol consumption, an unhealthy lifestyle and smoking anything at all) Have you seen the movie Supersize Me? It's worth renting if you haven't.

We just do not have all the answers yet. What we DO know is that we repeatedly see that the viral load is not an indication of how severe the disease is, yet the treatment is solely approved to eliminate the viral load., We know that no virus is better than some virus, but we also know that how much virus doesn't seem to matter that much. So, we have distance to go in our understanding.

I hope this answers some of your question.

thanbey
[QUOTE=jessy28]But what actually happens as in physically? And the thing I wonder is how fast does that process happen? What if you are healthy and you don't drink or smoke....then do a lot of people not ever feel the effects of hep c? Also what is fibrosis? I know what cirosis is. But I just don't get it. Once people have cirosis how fast does it progress? I did watch the movie super size it. I then stopped eating fast food which was a very bad habit of mine. i now probably eat fast food maybe one time every two to three weeks. I used to eat it three times a day. I also did not know i had hep yet. Also as far as eating good....we eat maybe red meat like twice a week and mostly pork (baked) or chicken (either grilled or baked) the rest of the week. We do veggies or salad with our meat for dinner. I usually eat a bowl of cereal like cherrios with splenda or tuna fish or egg salad for my lunch. Is that bad? What are some ways we can get better at that? I am using smart balance for our sub butter. Is trans fat an issue? I hear so many things that I get confused as to what is good or bad for us. Pork and chicken are not bad are they? I would think they would be the way to go. We have made tremendous progress with our bad habits and still more to go. I am proud of us. we do not drink pop anymore and drink plenty of water. and the part that scares me about the fda findings is where you said that someone who does not have sustained response will be worse after a year. What do you know about what they have found as far as people with sustained responses? The one doctor I did talk to said that he recommends testing on a yearly basis for the rest of someone's life even if they clear the virus. sounds right to me.[/QUOTE]

Fibrosis and cirrhosis are the same process. It is a scale leading to cirrhosis and then there are stages of cirrhosis. So fibrosis (a a small amount of damage) CAN lead to cirrhosis (more damage), but this doesn't happen frequently in people who take care of their health and do not expose themselves to the bad things. Essentially, it is scarring, like when you get a cut on your skin and it heals over. Cirrhosis is severe scarring that makes the liver less pliable and hinders its function. Even so, cirrhosis is not end stage liver disease (that's another scale) and the liver may very well be functioning adequately.

For nutritional information, transfat and saturated fat are to be avoided and the good fats are to be encouraged (olive, canola, soy, etc) Meats are neutral. Everyone needs protein and meats (low fat cuts) are a good source. Unless you have progressed liver disease, there are no restrictions on eating meat. Even then, doctors vary in what they advise. But, a liver that is functioning well will have no difficulty digesting meats. Check out "heart healthy" because that is exactly what is liver friendly,too, in terms of diet. Exercise and activity matter, too.

Fibrosis may progress or it may not. Research suggests that it progresses when people consume alcohol, are overweight (too much fat in the liver) and smoke but it may not progress at all in anyone else. Again, viral load has no bearing on this at all in any study. Only those who realize a durable (five years) sustained response realize the benefit of treatment long term. But not everyone who has an SVR gets benefits, just some people.

A person still has to be mindful of medical follow-up and lifestyle issues. Some people have symptoms early in the disease and some on the transplant list do not. Seems to be very individual. Aging ages the liver and just by breathing, the liver gets some degree of fibrosis. Add obesity, poor eating habits, alcohol consumption and smoking and even someone without hep will have damage to the liver and is at risk for cirrhosis. Nevertheless, the chances of arresting progression through better choices is at least equal to the outcome of the treatment in most people. Some people are going to progress no matter what they do, including treatment. We just do not have the secret to that yet but genetic research may produce some of those answers. Hepatitis C progresses very slowly when it progresses at all. That's why people can have it for 30 years or more before they have any symptoms or signs. And, they may never have any signs, which makes testing so important. 2% of those with hepatitis C will die from it. Two people out of 100 people will progress to that point.

With newer treatments coming down the pike, people with no fibrosis and who take lifestyle under control as you have, have time to wait for better treatments if they wish to do so. There is no rush to treat. For someone with more advanced damage to the liver and who may be suffering symptoms, they may wish to take a chance on the treatment, especially if they have a favorable genotype.

I agree with your doctor on the testing. Current testing has limitations and future tests may detect virus where we didn't before. That has already been happening with the new generation of testing.

Check out the website and past posts for more information.

Keep up the good work!


thanbey





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