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Hi Cudie,

Well, here's what I know, as an interested amateur and hep c patient, NOT a physician:

The most common grading and staging system used, Metavir, divides fibrosis progression into four stages--five, really,considering that zero, or normal, is one possible score.

The stages are not exactly mathematically precise, requiring observation and judgement by the pathologist and hepatologistBut in lay terms, stage 1 would be called "mild" usually, 2 is often referred to as "moderate" fibrosis, 3 is called by some doctors I've read or heard as "significant," or even "progressing," and 4 is cirrhosis. Cirrhosis itself--a word dreaded out of all proportion to reality--is not actually a death sentence, not nearly so, and is divided into its own stages of progression--usually two.

Yes, you can have hep c and not progress much along this scale at all. I have apparently had it for more than 30 years and am at stage one--or was two years ago when we biopsied. To slow or even halt fibrosis we must avoid alcohol, stay slim and fit, avoid other liver toxins (do not go near organic solvents, for example), get vaccinated against heps B and A, and so on. [I personally add to that: eat lots of fresh veggies and fruits, and I take a few simple alternatives such as vit E and silymarin. But these are my own choice, not yet well-supported by research for fibrosis fighting.]

You seem to have a good doc, not one of those who is so panicked by what he doesn't know about hep c that he winds up scaring the patient into treatment before figuring out, really, whether it is the best course.

I've known about my hep c for more than two years now and have not as yet chosen to treat--although what I hear about Pegasys sounds tempting.

So, yes, you can go on for quite a while, not getting "sick" at all--at least not sick in any way that we can tell. As was long ago said to me, you are much more likely to die WITH hep c than OF it (I miss you, T!).

As for me, I don't intend to die at all, so I would be the exception, there. Everyone is different.


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