PakMediNet Discussion Forum : Medicine : Hepatitis C Cured Rate
Hello to everyone.
My name is Farrukh and I am 24 year old from Lahore. I diagnosed with Hep C in April 2003, at that time my ALT's in normal range.
Now at the moment my ALT is 60, Serotype 3 which is Genotype, Viral Load 5200iu/ml but I don't do a biopsy or my Doctor don't advise me.
Now My doctor said that i should treat with Anti Viral Tharapy (Interferon+Ribavirn).
So what you guy's think what is my chance of cured.
I hope to hear from you soon.
Best regards,
Farrukh
Posted by: farrukhis (Guest) :: 28-08-2003 :: | Reply to this Message
Although your ALT is high, but since you have a very low viral load, therefore you dont need any treatment. Viral load should be above 2 million copies/ml for effective treatment.
Posted by: yasirPosts: 90 :: 29-08-2003 :: | Reply to this Message
dear farrukh,
One should consider the following points in your case described here.
1. You have HCV genotype 3 .
2. Your viral load is low.
3. Your ALT is elevated.
4. You are young male.
5. Liver biopsy has not been done.
6. You have never been treated.
There are certain other points which need clarification
1.Ultrasound of the abdomen about liver and portal system.
2. Synthetic function of liver i.e albumen,total protein,PT,INR,
3. Complete blood count with platelets.
4. Presence of risk factors about acquiring the infection.
5. Body weight (obesity- BMI)
6. Diabetes
7.Other medical problems
After getting the above information I would suggest to get a liver biobsy if there is no contraindication.
Liver biosy is absolutely necessary in assessing the degree of fibrosis and inflammation. Viral load alone may be misleading and cannot be used to decide the need of treatment. A low viral load however might suggest a more favourable outcome. Genotype 3 is amongst the ones who respond well. A Six month course of pegylated interferon & ribavarin is expected to give a sustained viral response of about 80%.
I hope you complete your assesment. I will glad to offer any further professional help.
Posted by: drkhawajaPosts: 37 :: 13-05-2004 :: | Reply to this Message
I want to know what is the need of all these investigations you have listed in your answer, when the patient clinically is not in cirrhosis or the duration of infection is aound 1 year? I think cost effective and time saving approach would be to monitor ALT levels and go for liver biopsy only (ofcourse PT, and Hb/Platelets, Blood gouping should be done before that). If liver biopsy shows any evidence of fibrosis (chronic active hepatitis) then treatment would be beneficial. However, consensus statements for treatment of Hepatitis C usually recommend to start treatment at a certain viral load.
Posted by: docosamaPosts: 333 :: 13-05-2004 :: | Reply to this Message
Since you have been diagnosed with HCV, I'm sure that have read quite a bit about this. But just in case you missed a piece of info:
Chronic infection develops in 75% to 85% of infected individuals and its course is insidious; most patients don't develop signs or symptoms untill they have been infected for 20 years or more. Some 60% to 70% of the chronically infected patients develop chronic liver disease; they are at risk for cirrhosis (affecting 10% to 20% of patients) and hepatocellular carcinoma (affecting 1% to 5%).
Recently, there has been a shift in thinking towards advocating early treatment of acute HCV to prevent chronic disease, even though therapy for HCV is often suboptiamal (benefiting only about half the patients), many patients with acute HCV infection will have self-limited disease, therefore, doing all the above tests will be an added expense and no benefit.
Recommended therapy is usually monotherapy with IFNa (3 million units SC 3 times a week for 12 months), will result in 50% improvement and sustained response rate is only about 15% to 25%.
Combined therapy IFNa + Ribavarin (Ribavarin 1000mg/day orally) is approved for those who relapse with above monotherapy. It increase response rate to 40% to 50%.
I hope this helps you in making a well informed decision about therapy or no therapy.
Posted by: chameedPosts: 173 :: 15-05-2004 :: | Reply to this Message
Sir, i wanted to know what is the reference of treatment for Acute HCV you have mentioned?
Posted by: docosamaPosts: 333 :: 15-05-2004 :: | Reply to this Message
quote:
docosama wrote:
Sir, i wanted to know what is the reference of treatment for Acute HCV you have mentioned?
Posted by: chameedPosts: 173 :: 16-05-2004 :: | Reply to this Message
I am afraid we are drifting from our case in discussion. The young man has raised certain issues relating to his sickness. There is no argument about chronic hepatitis C in his case. To me some of the problems which need to be answered ( & for which we can share our expertise including issues of cost effectiveness) are as follows,
1. The basic investigations needed in evaluating his liver disease?
2. Is liver biopsy absolutely necessary? (? cost in Pakistan.)
3. Availability of newer tests to assess liver fibrosis without biopsy.
4. Coorelation of viral load with the severity of liver damage.
5. Factors adversely affecting response to therapy eg diabetes, obesity,alcohol,Fe load etc.
6. Type and duration of treatment for our case ie genotype 3.
7. How to follow response during and after completing therapy.
I hope our discussion and exchange of ideas stay healthy , clinical and supported by scientific data.
3.
Posted by: drkhawajaPosts: 37 :: 17-05-2004 :: | Reply to this Message
quote:
drkhawaja wrote:
I am afraid we are drifting from our case in discussion. The young man has raised certain issues relating to his sickness. There is no argument about chronic hepatitis C in his case. To me some of the problems which need to be answered ( & for which we can share our expertise including issues of cost effectiveness) are as follows,
1. The basic investigations needed in evaluating his liver disease?
2. Is liver biopsy absolutely necessary? (? cost in Pakistan.)
3. Availability of newer tests to assess liver fibrosis without biopsy.
4. Coorelation of viral load with the severity of liver damage.
5. Factors adversely affecting response to therapy eg diabetes, obesity,alcohol,Fe load etc.
6. Type and duration of treatment for our case ie genotype 3.
7. How to follow response during and after completing therapy.
I hope our discussion and exchange of ideas stay healthy , clinical and supported by scientific data.
3.
Posted by: chameedPosts: 173 :: 18-05-2004 :: | Reply to this Message
What is the evidence of Acute Hepatitis C in this patient? One should know that Acute Hepatitis due to HCV is very rare.
Posted by: docosamaPosts: 333 :: 20-05-2004 :: | Reply to this Message
quote:
docosama wrote:
What is the evidence of Acute Hepatitis C in this patient? One should know that Acute Hepatitis due to HCV is very rare.
Posted by: chameedPosts: 173 :: 04-06-2004 :: | Reply to this Message
Please refrain from criticizing others in a discouraging language. Moderator will might take action against this.
According to the definition, acute process cannot be insidious or slow. It is only the chronic process which takes years to show its effects. This patient has not mentioned status about other viruses, therefore it would be improper to comment his disease as a result of acute HCV.
Posted by: yasirPosts: 90 :: 04-06-2004 :: | Reply to this Message