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Post Info TOPIC: The Next Phase.
bubble


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RE: The Next Phase.
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Thanks Malcolm. That clears up a lot. I appreciate everyone's help also.



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60 yrs. Geno1b 2001. 9mil. VL. �Failed Post Riba/Peg tx. 2006 46 weeks. Diagnosed 1A 2015(?) F3 fibr. 225k VL. Vikera/Riba 12 weeks 3/20/2015. "Undetected" start to finish. Undetected 1yr post tx.
mallani


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bubble,

Many cirrhotics have elevated AFP. The important thing is to keep a chart so any significant elevation raises a red flag.

HCC's form wherever there is rapid cell division. This is the case in regenerative nodules which are the hallmark of cirrhosis. If the liver can be 'quietened down' so there's not as much regeneration, the risk of HCC decreases.

After SVR, the risk of developing HCC drops by ~75% and continues to drop as the liver heals itself. I haven't decided how long I'll have my 6 monthly imaging. I'll probably have a biopsy in a year and decide then.



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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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Hey Bubble,

My take on the AFP is that it's not a reliable tool for primary diagnosis of HCC. There are several things that can cause the AFP to elevate, and if memory serves me, the elevation is typically very high whenever HCC is the cause, but some HCC doesn't elevate the AFP. As Malcolm mentioned, it's like 50/50. Cirrhosis and hepatitis by themselves can cause elevations. So you can see why the test is a tool to help diagnose, not an absolute determination of anything. As far as other tests, there really isn't a single test that jumps out and says "cancer, here I am". It's a combination of tests, invasive, non invasive and symptoms together, that helps to determine diagnosis.

https://labtestsonline.org/understanding/analytes/afp-tumor/tab/test/



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Tig

67yo 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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bubble


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Thanks All, So Malcolm, AFP level is a sign of a cancerous condition?  Doc said my liver was smooth on the surface from the ultrasound. Are there any other enzymes/chemical indicators on the test to suggest cancer?  Do tumors form on the inside generally?  Just looking for some ammo. for my next chat with Doctor. He is good and respects my knowledge and answers my questions.

 

Ma



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60 yrs. Geno1b 2001. 9mil. VL. �Failed Post Riba/Peg tx. 2006 46 weeks. Diagnosed 1A 2015(?) F3 fibr. 225k VL. Vikera/Riba 12 weeks 3/20/2015. "Undetected" start to finish. Undetected 1yr post tx.
Cinnamon Girl


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Congratulations to you, Bubble, you did it!!!  SVR it is!!! 

Time to relax and enjoy being free from Hep C!

I`m very pleased for you, sending all best wishes for a happy and healthy future, starting now!!  biggrin



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Jill 

(71 yo, lives in UK)

Was Gen 3a, 

24wks Peg Ifn/Riba, Sep 2010 - Mch 2011

UND @ Wk.4, UND @ EOT, 

SVR Nov 2011 --> Still UND @ EOT + 4 yrs.

 

 
Groupergetter


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Congratulations Bubble on your SVR!   :)   You've made it.  It's great when you know the virus is no longer part of your life and that your liver can start to regenerate.  My doc also ordered a  6 month follow-up ultrasound which is scheduled later this month.  Much easier than the MRI, also reluctant to have the contrast in my body unless really necessary.  Thanks Malcolm for sharing the info about the AFP, wasn't aware that HCC doesn't secrete the afp much of the time.  Enjoy your hepC free life Bubble  :)   



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1b  Int/Riba relapse @ 48 weeks.  Stop tx Peg Int/Riba 12 weeks ill. Relapse S/O 6/23/14 :(   Started Harvoni 11/12/14  EOT 4/28/15.  EOT+4 UND :)  SVR! 8/4/15  :)     Thankful for every morning.
Gracie


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I asked my doctor about the AFP test as she didn't do one last time for me (I'm f4). She said what Malcolm said. It's not reliable for diagnosis. Better used after something is found to gage the worsening. She asked if I would feel better to have it added and I told her yes so she has. Mine was slightly elevated at 11 or 12, something like that, and I'd like to keep an eye on it. She said my slightly elevated AFP was not a sign that I had HCC, that cirrhotics can have a slight elevation.

Im up for 6 month ultrasound, 3 month Bloodwork screening. If anything did show up, be good to know sooner when something can be done.



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  1. Gracie

1A. Previously treated non responder Rebetron in 2000 And Incevik in 2014 with a breakthrough at week 12. Fibroscan 15.5. VL 6,000,000. Finished 24 weeks harvoni on Dec. 19, 2015. SVR. Latest Fibroscan 8.8.
Observer


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Congratulations, that is fantastic news

Alison



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61 y/o, Infected via transfusion Oct'83, GT-1a, F-4 cirrhotic,
tx Holkira pak/moderiba 12 weeks

4 years.... successful dragon slayer 
mallani


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Congrats bubble!!

The 'tumour marker' is the AFP. As 50% of HCC's don't secrete AFP, this is not really a worthwhile test.

 6 monthly imaging for HCC is only required for cirrhotics. For F3's and F3-4's, this is really not required except for patient reassurance. However, you need to be sure you're not F4.

Ultrasound is good enough for most patients.  As long as you can see a HCC of 0.5cm or more, this is OK. Some patients are difficult to Ultrasound, and they require CT or MRI.  For many years, I was not happy with Ultrasound, and had MRI's. Since SVR, I am confident the image is good enough with the new US machines, and this is far easier than an MRI with contrast..

Followup ultrasounds after SVR are often reassuring. The liver and spleen decrease in size and the echotexture becomes less coarse and echogenic. All good signs that fibrosis is regressing.

Enjoy life. Cheers.



__________________

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
Matt Chris


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Hey Hey Bubble

Super congrats on your 12 week EOT results, YAAAHHHOOO !!! and YES! 

Go out and enjoy a great dinner and celebrate, you deserve it.

matt 



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"And in the end, the love you take is equal to the love you make"

61 year old Geno type A1, F4 Cirrhotic, started 24 weeks on Harvoni 12-17-14 ,EOT-5 week = UND, 8-31-15 =UND , SVR-24 Baby YES! 
Penelope PePod


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Bubble,

Congratulations on your SVR, my fellow Viekirian Warrior!  How g reat it must feel to finally be CURED!!  I'm so happy for you!

  clap.gif clap.gif  clap.gif

My husband is F4, and he goes for a ultrasound every six months.

Penny



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65;  Dx 1997 1a; VL 1.1m; TX naïve; SOT 7/20/15; 12 wks viek/riba 1200mg

09/14/15 draw: Undetected 8 wks into tx

10/12/15 draw: Undetected at EOT

01/05/16 draw: Undetected at E0T+12
wmlj1960


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Congrats on your SVR Bubble! I would think your doctor would want an MRI or CT scan to get a better picture of your liver but this is a question better answered by Malcolm. My doctor ordered MRI because I am cirrhotic so that may be the difference. Nodules are what they are looking for which, if found, are usually benign and do not take a carcinogenic pathway leading to HCC. Also, even with cirrhotics, the likelihood of developing nodules is greatly reduced after SVR is achieved and the liver begins to regenerate. As Tig said, as F3 you have no reason to be overly concerned. Occasional test are a preventative measure and not as big a concern for non-cirrhotics. If you have not had any test done yet then getting that result should give you some peace of mind and allow you to re-direct that worry energy on living your Hep C free life. I would ask your hepatologist about a test now if you have not been tested yet.



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60 yo, geno 1a, Dx 1994 HCV-HIV co-inf, Dx 2013 decompensated cirrhosis
Tx #1 - 24wks Sov+Riba /SOT 7-24-2014/UND@EOT/DETECTED@EOT+16 wks
Tx #2 - 24wks Harvoni /SOT 7-25-2015/UND@EOT,+12,+24,+52 = SVR

Mike

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Bills


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good news Bubble

Sounds like you've Made it to the check up stage.  Now just comply with check ups. We will always be tested if we have cirrhosis. And its a good thing we are. As Tig said early warnings could prevent real troubles. Thats how they found my blood clots. I go Nov 4th for checkup on all these new events.

BillS  



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Bills

Harvoni started 12-12-14 for 24 wks PrevTX Geno 1 stage 3 cirrhosis - non resp Int/ ribv. Started Trial  in Aug 2011 -July 2012 into Incivek relapsed  Feb 2013 Had 72 weeks on interferon & Riba.

Tig


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Hey Bubble,

BIG WOOT!! You finally made it brother, congratulations! Now it's all about staying healthy and letting the anxiety disappear that we all developed waiting for SVR. It's always a load off your mind. Time to relax and enjoy your success.

I'm also an F3 and after I finished, my doc said goodbye. They keep an eye on my annual blood work and an annual ultrasound, but that's it. I think it's a decision you and your doctor have to make. F4 is another story, confirmed cirrhosis changes the guidelines. However, there's nothing wrong with keeping an eye on things. Nobody wants any surprises if they are easily avoidable.

Time to put this award on your mantle:

image.png

 



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Tig

67yo 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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robertsamx


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Bubble,  Congrats on svr 12+.    You being a f3, your Doctors will keep a close watch on your liver for HCC. They may start out doing mri every 3 months, and if they look good then they will move it to every 6 months.  Is your f3 status confirmed by blood work or needle biopsy?Also do you have previous mri"s to compare?   RC



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 M-64) 3 Treatments)( SOF-RIBA 2014)(SOF-RIBA-PEG 2016)(HCC 2016) (LIVER TRANSPLANT 8-2017)(VOSEVI-RIBA 2017)   SVR-12. 3-13-18   
bubble


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Hi all, ok I have completed Tx -  SVR+12 (yes!) .  My Hepatoligist wants me back in 6 months. I have an ultra sound and blood work to get done prior. He said he now he wants to watch for liver cancer. Is this the route? Shouldnt I be getting an MRI?  What technical words am I looking for on my test?  I remember "Tumor Marker" originally. What does that tell me and what other catagories on the test should I be concerned with for cancer signs?

 I am entering a new phase with Hep C and would appreciate the help.



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60 yrs. Geno1b 2001. 9mil. VL. �Failed Post Riba/Peg tx. 2006 46 weeks. Diagnosed 1A 2015(?) F3 fibr. 225k VL. Vikera/Riba 12 weeks 3/20/2015. "Undetected" start to finish. Undetected 1yr post tx.
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