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Post Info TOPIC: Annals of Hepatology: Long term changes following treatment


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RE: Annals of Hepatology: Long term changes following treatment
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Tnx Tig, great article! :) bit confusing for baseline fibrosis score, since they have excluded no fibrosis ones. By the look on the tables it seems that "no TX" group is much better than "no SVR", which is wrong.

Confirms that relapsers have just a short term benefit of (failed) tx, which my hepa mentioned. A small break for liver :) I would gladly do biopsy instead Fibroscan, if i only knew a proper clinic here that has a good safety record in liver biopsies. I am not that trustworthy about ultrasound checks (had 3 different ones and only one asked me about possible hepatitis), Fibrotest is just a simple algo estimation, while Fibroscan i am not sure how much steatosis is diagnosed properly?

best



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GT 3 dg. 08-2012 / FibroScan: 5 kPa F1 / FibroTest: F0-1 A1 / SoC TX: PegInt 120mcg+Riba 1000mg UND from w8 relapse EOT+4w
01-2016 Sof+Dac+Riba UND from w8, SVR24!




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Hi Tig,

Thanks for posting this. With the decline in liver biopsies, this sort of valuable information is going to be hard to find.

It's worth pointing out that these patients were treated between 1991 and 2004, with the old Interferon, Peg Interferon +/- Ribavirin, with the last biopsy being performed in 2008.

Interferon stuffs up the immune system for a considerable period. SVR 's using the new DAA's may paint an even better picture.

I like the point the 'Patients with SVR had a significant increase in the platelet count......'. The linking of liver inflammation decrease (after SVR) to fibrosis regression is well known. What is not mentioned is that cirrhosis is a self-fueling disease in some patients. When the fibrotic bands are severe, there is a constant cycle of nodular regeneration, central necrosis as the nodule outstrips it's blood supply, repair etc. so the liver is active even though it is virus free. Such patients will continue to have elevated enzymes, ongoing fibrosis and a much higher rate of HCC. A previous report stated that ~55% of cirrhotics showed a regression of 1 fibrosis stage after 5 years, 30% showed no change and 15% showed worsening cirrhosis. This new report is much more optimistic.

These days, it seems that very few patients in the USA are getting a biopsy before treatment. So we're never going to get data like this in 5-10 years time which is a shame. Cheers.

 



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Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm

Tig


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Our member Rblood or Roger sent this to me yesterday and I wanted to share it with you. It's an article published in July and August of 2014, so it's relatively new. While technical in nature, the charts and discussion on fibrosis regression is particularly interesting. I hope this helps answer some questions you may have regarding the future health of you and your liver. Many thanks to Roger for sharing this! It's that kind of participation that we've become known for and helps everyone visiting the forum! Nice find Roger...

 

Liver Histology Following Tx

Tig

 



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Tig

66 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 9+ years!

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