Hep C Discussion Forum

Hi KPB, congratulations on your first day on Harvoni!

You have a lot of living to do yet at 60, giving up isn`t an option!  I did my treatment when I was the same age, with the older Peg/riba regimen, and since SVR my general health and quality of life has improved a lot.  There`s no reason at all why you won`t achieve SRV too, you`re taking a very powerful drug combo, so keep thinking positively!

You did the right thing giving up alcohol when you did, that was very sensible.

Keep asking questions and best of luck! 

 

 

 

 

 

Hi all,

Great topic. We know liver fibrosis is produced by activated liver stellate cells, and to some extent by activated portal fibroblasts. I did a post on the stellate cells:

http://hepcfriends.activeboard.com/t59746520/the-livers-stellate-cells-good-guys-bad-guys/

You would expect that after SVR, the stellate cells would be deactivated and fibrosis could be resorbed. For post-SVR patients who are <F3, this probably happens in most cases.

Cirrhotics have a problem. The fibrous bands and scars may be too thick and the liver disruption may be too great. New layers of collagen are no longer produced, but how do we stimulate fibrolysis.

Various cytokines are being studied, especially those from the CCN protein family. We need to activate scavanger cells, like macrophages, to start breaking down the collagen. There is evidence the stellate cells can revert to macrophage-type cells. A number on anti-fibrotics are being trialled.

As I said in another thread, for cirrhotics the chances are : 2 years post SVR, 55% show improvement of at least one stage (Metavir), 35% shown no change, and 10% show worsening. We need 5 and 10 year figures, and perhaps SVR with the new DAA's will produce better results. Also, be careful about what test you use to assess fibrosis reversal.

Finally, MM's reference was from 2002, and there is no evidence that Interferon plays any part in fibrolysis. Cheers.

Thanks for the link, MM, and there are lots of older studies that show improvement in fibrosis and cirrhosis following successful treatment with Peg+Riba because they were the standard treatment drugs for so long.  The new DAA drugs haven`t been available for long enough for long term studies to have been done yet. 

I believe the main factor in this is SVR, whatever treatment drug protocol is used to achieve it.  Once the virus has been cleared and there is no longer an active infection going on then the liver is able to start the process of healing and regeneration, depending on the degree of damage and over a period of time, often many years.

Here`s another link, originally posted by Matt Chris, ` the Impact of SVR on Liver Fibrosis and Cirrhosis`...

http://hepatitiscnewdrugs.blogspot.co.uk/2014/04/impact-of-svr-on-liver-fibrosis-and.html

I love this thread as it's inspired by all the SVRs which seem to be the norm now, instead of the lucky. We are all thinking about the future! I'm hoping to join the list by years end.

We need somebody with medical advice to give us some answers to what can happen medically, however I've read a few posts about Fibroscan results going down after successful treatment so it is possible for sure. Even probable I'd say. At the very least, very few get worse (although a small percentage do).

I have heard talk about cirrhosis reversal as well. 

One thing is for absolute sure, we, as hep c warriors have hope to live long, healthy lives and it's more possible now than ever before!

Hi there, reversing fibrosis - in my case, cirrhosis - is one of the major issues I have been trying to deal with since I finished treatment 2 years ago.  In my case, my liver damage was not only a result of 40 plus years of having Hep C, but also a result of having NASH (fatty liver disease), discovered through my pre-treatment biopsy.  So, when I asked my doctors what I could do to try to reverse cirrhosis, I was told to get my BMI down to 24, which in my case meant losing about 20 lbs.  I did that, along with starting a fairly rigorous workout regimen. 

When I did some research online, I found a few other things that seemed to offer  healing for liver fibrosis, backed up by some small clinical trials.  These seemed mostly geared to NASH sufferers, but I hoped that cirrhosis was cirrhosis.  Because of those studies, I began taking Vitamin E and DHA supplement (one of the kinds of fish oil).  While I certainly don't have any evidence that these are doing any good, I can say that my liver enzymes are starting to normalize now (and they're not doing any harm).  Its definitely worth asking your doctor about.

The other thing that is happening in the NASH world is a very heated competition by many big Pharma companies to come up with a "cure".  Currently no treatment exists and now that Hep C has been conquered it looks like the drug companies see the next big winner.  Gilead and Intercept are both in Ph II trials, I believe and I think there could be something coming in a few years that might really be able to reverse some liver damage.  Keeping my fingers crossed! 

I am always so happy to read about all the SVR's happening these days.  It feels miraculous, compared to only a few years ago.  Best to everyone, Karen

It's the stopping of the daily assault from the virus that allows the liver to regenerate but it takes time, years even. It won't go back to perfect, but will improve. And with F3 and no cirrhosis, you should love a long healthy life. Just stay away from liver damaging triggers like alcohol, fatty foods, and no high risk behaviours as you could reinfect. 

Starting treatment is your priority, especially if your F3.

Hi, KPB

Never to F0 and there's no special treatment to reverse the fibrosis. Certainly, with SVR you will prevent your liver from future damaging and it can start to build new cells. Reversing the fibrosis with interferon-free therapy is harder then with interferon... Yes, it's true: best thing that helps our liver to regenerate is the worst of ours nightmares - interferon. All the inhibitors do not help regenerate the liver in the same context, they only kill the virus and affect the virus replication mechanism. However, killing the virus will give you more then 10 years of life + possible reversing of fibrosis (too many factors are included: your age, other health problems and etc...).

Best thing to settle the matter is to talk with your doctor about your treatment and post-treatment way to achieve your goal.

Good luck!
MM