HI again KPB, that`s an interesting article, although aspirin has it`s down sides and isn`t usually recommended while on treatment. It can cause irritation to the stomach lining and also have an effect on platelet levels.
By they way, Medscape articles can only be viewed once people have registered with them.
The general advice for people is to be guided by your doctor (hepatologist or GI, rather than Primary Care doctor) ) if pain relievers become necessary, and always stay within the recommended dosage.
KPB said
Jun 2, 2015
I had a visit with my Primary Care Physician yesterday, I asked tips & tricks on how to obtain information on how over the counter drugs effect our liver.
She directed me to Google, showed me that if I just type in the name of a drug ( example: " aspirin , liver disease " ) I could find that information. She then went on to explain that most drugs either process through our liver or our kidney, so with Fibrosis, I should pick drugs to process through my kidney.
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!
KPB said
Jun 1, 2015
This chat room is a wealth of information, since today is my first day on that Harvoni train.
I am sure I will have many more questions as I attempt to learn more about my infection.
Life is wonderful, and I will not give it up without at least understanding why.
Thank you everyone for your time and attention.
KPB
mallani said
Jun 1, 2015
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:
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.
Rubye said
May 31, 2015
That makes sense CG. Thanks.
Cinnamon Girl said
May 31, 2015
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`...
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!
Rubye said
May 31, 2015
MM, Why do you think Interferon makes fibrosis reversal faster than the rate that might be created by no longer having the Hep C virus harming the liver? It seems to me that it would make no difference which drug is used to get rid of the Hep C. In other words, it is the lack of Hep C attacking the liver that allows for healing of the liver. It sounds like you may think there is something about the Interferon in particular that helps. Sorry if I have misunderstood.
I did find this article yesterday that "sums" up some studies on cirrhosis reversal after reaching SVR. http://www.medscape.com/viewarticle/839337
My assumption is that the drug used to reach SVR in these studies was Interferon simply because the new drugs have not been around long enough. Maybe. Not sure. I should go read it closer.
Millercollaborative said
May 31, 2015
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
malekula man said
May 31, 2015
Hi CG,
I'm not saying that SVR doesn't help but interferon has better healing effect for fibrosis in case of it, faster reverse - like a F3 to F2 for 1 year. With inhibitors it begins slowly, certainly. I was asking these questions my hepatologist because of my F4 . However, side effects of the interferon therapy make it outdated. It's a balance between SVR or faster regeneration. Definitely, now we choose for all new inhibitors and sometime Riba with almost guaranteed SVR vs side effects and faster regeneration in case of SVR with Peg. That's what I was saying.
Sorry, I don't want you or anybody understand me wrong.
BR,
MM
Gracie said
May 31, 2015
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.
Cinnamon Girl said
May 31, 2015
Hi MM,
Sorry, but that`s not actually true. It doesn`t matter which treatment drugs you use as long as you reach SVR and then the liver damage will cease and the healing process can slowly begin. Otherwise everyone would still be taking Peg/riba!
malekula man said
May 31, 2015
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
Gracie said
May 30, 2015
If you are successfully treated for your HCV, then further damage is halted and some healing will most certainly take place. My hepologist said at least one number down with SVR and time. As long as you don't do other things to damage your liver that is, like drinking and eating things that are hard on your liver.
KPB said
May 30, 2015
I stopped drinking alcohol 25 years ago, that's probably the reason I am still here to write this today. Now at the age of 60, I would like to stick around another 20 or 30 years or more. Are there any ideas out there on how to reverse and regenerate my liver ?
HI again KPB, that`s an interesting article, although aspirin has it`s down sides and isn`t usually recommended while on treatment. It can cause irritation to the stomach lining and also have an effect on platelet levels.
By they way, Medscape articles can only be viewed once people have registered with them.
The general advice for people is to be guided by your doctor (hepatologist or GI, rather than Primary Care doctor) ) if pain relievers become necessary, and always stay within the recommended dosage.
I had a visit with my Primary Care Physician yesterday, I asked tips & tricks on how to obtain information on how over the counter drugs effect our liver.
She directed me to Google, showed me that if I just type in the name of a drug ( example: " aspirin , liver disease " ) I could find that information. She then went on to explain that most drugs either process through our liver or our kidney, so with Fibrosis, I should pick drugs to process through my kidney.
I thought this was good information
http://www.medscape.com/viewarticle/834662
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!
This chat room is a wealth of information, since today is my first day on that Harvoni train.
I am sure I will have many more questions as I attempt to learn more about my infection.
Life is wonderful, and I will not give it up without at least understanding why.
Thank you everyone for your time and attention.
KPB
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.
That makes sense CG. Thanks.
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 don't think so
www.natap.org/2002/may/050902_2.htm
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!
MM, Why do you think Interferon makes fibrosis reversal faster than the rate that might be created by no longer having the Hep C virus harming the liver? It seems to me that it would make no difference which drug is used to get rid of the Hep C. In other words, it is the lack of Hep C attacking the liver that allows for healing of the liver. It sounds like you may think there is something about the Interferon in particular that helps. Sorry if I have misunderstood.
I did find this article yesterday that "sums" up some studies on cirrhosis reversal after reaching SVR. http://www.medscape.com/viewarticle/839337
My assumption is that the drug used to reach SVR in these studies was Interferon simply because the new drugs have not been around long enough. Maybe. Not sure. I should go read it closer.
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
I'm not saying that SVR doesn't help but interferon has better healing effect for fibrosis in case of it, faster reverse - like a F3 to F2 for 1 year. With inhibitors it begins slowly, certainly. I was asking these questions my hepatologist because of my F4
Sorry, I don't want you or anybody understand me wrong.
BR,
MM
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 MM,
Sorry, but that`s not actually true. It doesn`t matter which treatment drugs you use as long as you reach SVR and then the liver damage will cease and the healing process can slowly begin. Otherwise everyone would still be taking Peg/riba!
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
If you are successfully treated for your HCV, then further damage is halted and some healing will most certainly take place. My hepologist said at least one number down with SVR and time. As long as you don't do other things to damage your liver that is, like drinking and eating things that are hard on your liver.
I stopped drinking alcohol 25 years ago, that's probably the reason I am still here to write this today. Now at the age of 60, I would like to stick around another 20 or 30 years or more. Are there any ideas out there on how to reverse and regenerate my liver ?
thanks ,