Isiscat2011 wrote:

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Huey, you need to rephrase that!!    They have the same beautiful hair color.  

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 Exactly same color and beautiful both of them. 

Isiscat2011 wrote:

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Thank you, Malcolm.  As usual you are a wealth of good information.  

Cute dog.  My cat teaches both feline and canine yoga classes if your pooch is interested.  To the left is a photo of her warming up. 

-- Edited by Isiscat2011 on Saturday 21st of June 2014 01:33:35 AM

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 The dog looks a lot like Cinnamon Girl don't you think?

Hi Isiscat,

Autoimmune hepatitis is identical to chronic HepC. It is more common in females, and the autoantibodies are raised- particularly the ANA and ASMA (anti-smooth muscle antibody). Obviously HepC should be excluded. It's really a diagnosis by exclusion. In my case, the HepC test was not available, so I had a year of Prednisone and Imuran to suppress the autoimmune system, just in case. Great!

After SVR, research has shown that the HCV antibody titre drops. That's because the virus is virtually gone, and there's nothing to stimulate the B cells to produce antibodies. It will remain detectable. I haven't had my ANA and ASMA rechecked so I can't answer your question. Some patients develop RA and thyroid disease after HCV treatment, but this is all after Interferon, and it's hard to know what to blame. The autoimmune diseases are very complex, as we don't really know why we start producing antibodies to healthy tissues. It's worth knowing that about 20% of chronic HepC patients will have raised autoantibodies. Cheers.

Hi guys,

I did a previous post about the association of moderate elevation of the AFP in chronic HepC. It seems to be OK as long as it doesn't suddenly elevate.

The ANA is also often raised in chronic HepC. It does not affect disease progression or response to treatment. Back in 1988, I was put on a year of prednisone as I had a raised ANA, and also ASMA. These are also present in cryptogenic autoimmune hepatitis. Needless to say, that was a waste of time, and it probably accelerated my HepC progression. The raised ANA is said to be an 'immunological epiphenomenon' - love the term!

Thought I'd resurrect this thread since I have new numbers to input. My AFP has fluctuated over the past several years. Not particularly worrisome, as it's symptomatic of the disease, but my docs have monitored it regularly. There were routinely 10-20 point swings in any given 6-12 month period. What was bothersome to me is that I've been trending upwards (on average) for the past 3-4 years. And of course you don't want to see it trend too high.

Just prior to treatment my AFP was 52 ng/mL. 60 and 43 on the two checks prior to that. 4 weeks into treatment it tested at 30 ng/mL. A marked movement in the right direction, but not too far out of line with prior experience. At eot+4 it was 12.6.

So, a 40 point drop in less than 6 months. I'm presumiing (and hoping) it's directly attributable to treatment, lack of inflammation, etc. and that it will stabilize and perhaps drop even more. Time will tell. We are all a work in progress, it seems.

wayne

Hi Iris!  I've been wondering how you are doing and I'm so glad to see you here.  So, are you planning to treat with the S/L combo when it comes out? 

thank you guys for this thread....

I have often wondered about my elevated afp also. It was always a matter of routine blood work, but for years it has fallen within the normal range. Then all of a sudden it pops up as slightly elevated, and it never has gone back down. The funny thing is... it kind of corresponded with the onset of menopause, wonder if there is any connection?

thanks for listening (Hi Isiscat!)

Iris

Thank you, Beacon.  I'm curious about that myself but I understand that there are many questions and fewer answers where HepC is concerned.  I love to read new studies, but I know I can't extrapolate too much about my own situation from them, so don't worry.  

Btw, I read your posts in the new members section today and I think you are using some very sound judgment and making really good decisions about your tx.   Your knowledge and understanding of this stuff is quite impressive.   With a little luck this time next year we should both be SVR and feeling pretty darn good too.    I wish that for all of us.

Beacon wrote:

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Here is a link to an interesting article in the May issue of  Clinical Gastroenterology and Hepatology regarding alpha-fetoprotein levels and its relationship to HCC

 

http://www.doctorslounge.com/index.php/news/pb/46437

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Dang, I wish I wouldn't have read that.  Here's the part I don't like: " HCC in patients with HCV-associated cirrhosis was most accurately detected with AFP levels  > 59 ng/mL."

My AFP was running around 15 before tx.  During and after tx it jumped (up to 67) and now it is hanging around at about 45-50.   

Oh well, no point in worrying about it.  That will only increase my blood pressure.  lol

thanks Tig

Gracie wrote:

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I haven't had a liver biopsy in years so one never knows... I could have cirrhosis. I'm scared to go get the biopsy to find out....

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 Hi Gracie:

It is scary but what we don't know can hurt us.  I don't know where you are at in terms of treatment, but just for general information purposes, for anyone who is interested please consider the following:

Knowing whether you have cirrhosis or not is critical to making informed decisions about treatment, such as when to treat, how long to treat, optimal treatment drugs, etc.   Additionally, in the near future and in the fairly likely event that insurance providers and governmental agencies initially decide to pay for tx only on a medical needs basis (due to the anticipated costs of the meds) patients will need to prove that they have more severe liver disease.   I don't know what will be accepted as proof but it may be either a biopsy or a fibroscan result.  

The good news is that fibroscans are non-invasive and considered as reliable as biopsies.  They are also substantially less expensive.  I noticed you are from Canada, Gracie, which is excellent because Canada has been using fibroscans for some time.  You may already know all about this but Fibroscan was only FDA approved in the US last year.  

Here is a link that shows where people can get fibroscans in the US: www.fibroscan502touch.com/find-a-facility

That reads kind of like a paid advertisement but I promise I'm not getting paid by the fibroscan folks!  I am just sold on them having had both a liver biopsy and a fibroscan.  The fibroscan takes less than 10 minutes and is easier than you can imagine.  And, for those who like instant gratification (who doesn't ?) the results are available immediately!  Pretty cool.  

Mallani,

Thanks for adding more information to this AFP business. My labs read AFP levels in g/mL units and I'm not sure how that relates to ug/L units. But from what you're saying my elevated levels are pointing in the same direction as my Fibrosure diagnosis of cirrhosis but as I posted previously, my serum albumin levels are within range. The elevated AFP levels caught the attention of my PCP. And I know that we cirrhotics have to have ultrasounds forever since we will always be more at risk for HCC and he wants me to have one every 6 or 12 months. It's good to know that AFP is not a good tumor marker.

Hi all,

This has been an interesting thread for me. I was unaware of the association of elevated AFP with chronic HCV. I have had this test done since the late 1990's, and kept a chart of the progress. My Lab uses an upper limit of 12 ug/L, and mine has ranged from 4 to 8. After cirrhosis was confirmed in 2008, there has been no change in the AFP levels.

I played golf with a Pathologist yesterday, and asked about the supposed association with chronic HCV. He was unaware of any direct association, but said that cirrhotics often had a raised AFP, but usually <100, and always associated with decreased serum albumin.

I've since done a search of Publications, and it appears that up to 20% of HCV cirrhotics may have elevated AFP, and this can decrease during HCV treatment.

For my post- SVR 6 monthly followup, my Hepatologist was not keen to include the AFP, as it is such an unreliable marker for HCC. He's put it in, just to shut me up. Good imaging is the best way to exclude early HCC.

I think anyone with an elevated AFP before Rx, should assume they have cirrhosis and get the appropriate tests to confirm this. Cheers.

Wayne,

That's interesting that darkstar's AFP levels fell so far during treatment. I'll assume those units are ng/mL.

Hi Bruce,

We have a forum member (darkstar) whose AFP has fallen from >230 to 3.5 during treatment. Much of that happened early in tx and I believe he's on a 16 week S/O combo. I'm doing 16 wk S/O/R and AFP went from 60 to 30 during first month. Won't have it checked again until EOT, but of course encouraged by his numbers.

wayne

Tig,

Thanks for the comforting information and for the links, now I feel better. And LOL funny on the pregnancy thing. I sure hope I'm not :>)