Suggest Treatment For Hepatitis C
Here’s what the tests did show: I had blood work, liver biopsy, ultra sound scan of liver and spleen, and they indicate I have Hepatitis C type 1A and a 6.7 viral load. It also showed low blood platelets (123), and high iron and ferretin levels, which the doctor believes could be hemochromatosis. The ultra sound and a physical exam indicated a slight enlargement of my spleen. I have lost 20 to 25 pounds in the past 6 months to a year which is the main reason for all the tests.
The first infectious disease specialist I saw locally in Saginaw Michigan said 80% of my liver has cirrhosis and is irreversible, and the other 20% is fibrosis the progression of which can be halted. He wants to put me on medication which has a 92% cure rate i.e., peg interferon, ribavirin, and one of the brand new medications, sofosbuvir. Being confused by the cirrhosis vs fibrosis issue and not wanting to endure the interferon and ribavirin side effects, or potential health risks, I sought a second opinion from the XXXXXXX Clinic in Ohio. When I told the specialist at the XXXXXXX Clinic what the Saginaw physician had said in terms of 80% cirrhosis and 20% fibrosis he said he doesn’t even know what that means. He said once you are diagnosed with cirrhosis, you have cirrhosis. It is never cirrhosis with a small percentage of fibrosis, its just cirrhosis. As far as the prescribed drug regime he said there's no need to use Interferon and ribavirin and is going to put me on a combination of Sofosbuvir and Simeprevir which have essentially no side effects and also a 92% cure rate.
What I am wondering is if you could comment on what I have told you in terms of my symptoms and whether or not you think it sounds like stage three liver disease. The Saginaw specialist said I am stage three moving towards stage four. Personally I doubt the disease is all that advanced because I feel fine and I don’t have many symptoms that would confirm this diagnosis. What do you think?
Also, what do you think about the two different med regimes? Do you think what I have described sounds consistent with late stage 3 liver disease? The XXXXXXX specialist says with liver biopsies you don’t always see what you think you see. He eventually wants to do another biopsy which will be originated from my neck. I presume this is to compare with the other horizontal sample which was taken from my side. This would give him a better look at whether there is some bridging or if the bridges are starting to connect, or whatever. What do you think? I realize this is a lot of information but I am wondering if you concur with one physician or the other in terms of diagnosis and prescribed med regime.
Interferon,Ribavarin and Sofusbuvir is the best
Detailed Answer:
Hi Sir,
I have carefully read your query and understand your concern.
let me clarify few facts to you once for all.
Cirrhosis and fibrosis literally mean the same.
Its meaningless to say that both exist together.
A person once cirrhotic,is cirrhotic for lifetime.
A cirrhotic liver is histologically termed as Grade 4.
Grade 4 is termed as an End stage liver disease.
Hepatitis C has maximum propensity to show cirrhosis.
Hep C also has notorious tendency to be asymptomatic even in stage 3 or 4
Cirrhotic liver is diagnosed accurately only on liver biopsy.
Liver biopsy has no conflicting results.
Its an excellent sensitive and specific mode of test for liver histology.
Regarding Treatment aspects,chronic hepatitis C is being treated currently with a combination of Interferon ,Ribavarin and Sofusbuvir.This treatment is US FDA approved and is effective against all four genotypes 1,2,3,4 of Hep C.
The main goal of treatment is to suppress the replication of virus to undetectable levels.
Get back to me once you have your 2 liver biopsy done by your doctor.
i hope this info is helpful to you
thank you