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Suggest Remedy For Recurrent Hepatitis C Infection After Liver Transplant Surgery

Posted on Fri, 24 Apr 2015

Question: 60 yr old male had a liver transplant July 2010 for hepatocellular cancer & cirrhosis from Hep C. Post transplant the Hepatitis C has returned. In the months immediately after the transplant Interferon based treatment was not working and also had to be stopped due to serious side effects. Recent treatment with 2 oral medications seemed to work (viral load went to zero) but then 3 months after finishing the 12 week course of medications he again has a small viral load. Liver biopsy shows moderate fibrosis in the new liver. The hepatologist is looking into other new medications.
My understanding if that the liver disease progresses much more quickly in these circumstances.
How likely is it that the cancer will return? My question is what is the life expectancy if there are no other treatment options for the Hepatitis C?

Answered by Dr. Dr. Klerida Shehu (3 hours later)

Brief Answer:
If virus is still present,there are still chances for cirrhosis&cancer...

Detailed Answer:
Hi,

I have gone through your medical history carefully and understood your concerns.

1. There is a new medication for chronic hepatitis C called Sofosbuvir, a nucleotide analog introduced since 2013. You can discuss its use with your doctor and see if it can suits to your case. It can be used in combination therapy with other medications for hepatitis C you are already taking.

2. As long as the virus and its infection is present, there are still chances for liver cancer and cirrhosis.

3. With regards to life expectancy, no one can predict it exactly. It all depends on :
- severity of infection
- the speed of damages and alterations set
- your body immune response and overall health status

All the best and God bless!
Dr.Klerida

Above answer was peer-reviewed by : Dr. Pradeep Vitta

Follow up: Dr. Dr. Klerida Shehu (20 hours later)

His overall health is fairly good for a 60 year old man. The Hepatitis C is type 1A and seems to be very difficult to treat. Sofosbuvir is one of the medications they already gave him for 12 weeks that seemed to work but 3 months after it was stopped the virus returned.
So in the four years and nine months since his liver transplant his new liver already has "moderate fibrosis".
I wondered about life expectancy because I want to plan for the future. Things like should we move closer to our grown son, should I start to plan early retirement from my full time employment? I know it is not possible to give any exact prediction of life expectancy. I guess I just wondered is 10 years, 5 years, 2 years most likely?

Answered by Dr. Dr. Klerida Shehu (1 hour later)

Brief Answer:
Only the average years for cirrhosis/cancer onset....

Detailed Answer:
Hi back,

It will need 10 to 15 years for the cirrhosis or cancer onset.
The progress of hep C is slower than hep B; so, it is impossible to predict an exact life expectancy.

I can only say regarding the time it will be needed to develop cirrhosis or cancer: 10 to 15 years (average).

Plus, we cannot predict if the therapy you are currently taking will have success and virus will not get active (still cannot predict for how long)?

All the best and God bless!
Dr.Klerida

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Above answer was peer-reviewed by : Dr. Pradeep Vitta