hepatitis c diagnosis

November 9, 2005 5:06 PM

Someone close to me has been diagnosed with hepatitis c...

she has had the virus for at least 30 years without knowing and only found out because her routine labs came back with elevated liver enzymes. Now what? What are the real chances of her dying soon? Is interferon worth while? I Googled and got a lot of info, too much, nothing makes sense. I'm freaking out a little but want to be able to offer her real information. Yes, she's going to see her Dr. but he can't get her in for another two weeks. Anyone know anything about this??

posted by yodelingisfun to Health & Fitness (9 answers total)

My husband found out that he had hepatitis c four years ago under similar circumstances. He too has had it for at least 20 years without realizing it. He decided to undergo the rebetol/peg-intron therapy. Unfortunately, it didn't work for him. The efficacy of interferon treatment depends a lot on the genotype of the virus and viral load (how many viral particles one has per ML of blood). The year during which my husband underwent the interferon therapy was nothing less than hell for both of us. The medications are strong and have both physical and emotional effects. When we found out that the therapy did not destroy the virus, we decided, with the doctor's approval, not to try any further drug treatments.

I assume that the first thing your friend's/partner's doctor will do is have him/her undergo a liver biopsy to discover the extent of the damage to the liver. With that information you can make better informed decisions about treatment, etc.

Hepatitis c is not a death sentence for most. Depending upon the extent of the damage to the liver, one can live a normal life in every way....except perhaps it would be wise to give up alcohol.

If you want to talk about this, feel free to email me.
posted by tzuzie at 6:15 PM on November 9, 2005

if the interferon is anything like the treatment used for for melanoma, it's pretty much adjuvant in that it's really there to hopefully aid another treatment regimen - on its own it's not terribly efficacious. I don't know much about Hep-C and I'm sorry if that's a downer, but the experience with it above is pretty much what I've heard it's like for melanoma (which most "cancer" chemos and such don't work for, and int-α/IL2/similar is the only FDA-approved drug regimen I believe).

Dr. Kirkwood out of UPMC has done a lot of work with those drugs on melanoma, if you care to do some reading at PubMed.
posted by kcm at 6:27 PM on November 9, 2005

Sorry to add to the questions, but I'm just curious from a science perspective:

How can a doctor tell how long someone has been infected without knowing?
posted by twiggy at 6:31 PM on November 9, 2005

How can a doctor tell how long someone has been infected without knowing?

usually through a detailed medical history. hepatitis c is a bloodborne pathogen so you can usually trace infection to transfuisions, hospital stays, needle exposure, etc.

my brother cleared hepatitis c after one year treatment with alpha-interferon. it wasn't pleasant. response to treatment usually does depend upon the genotype of the virus. some strains are easier to treat than others.
posted by brandz at 6:57 PM on November 9, 2005

My ex-girlfriend had it for 10 years, and after a nasty year of interferon treatments, she's totally free of it now. The doctor will run various tests and let her know what her chances of success are. Hopefully your friend will have a very flexible and understanding job during the treatment, as interferon seriously fucks you up.

Your friend definitely should stop drinking if she still is, and start taking milk thistle.
posted by cmonkey at 8:09 PM on November 9, 2005

Response by poster: It's actually a relative and she doesn't drink or smoke, isn't over-weight...very healthy in general. The interferon was that bad? Like unable to work bad?
posted by yodelingisfun at 9:50 PM on November 9, 2005

Interferon is a pro-inflammatory cytokine. It can activate immune cells such as NK (natural killer) cells that are good at killing and getting rid of cells infected with viruses. Since cytokines aren't targeted towards just cells that only attack virus-infected cells, there are significant side-effects which may be problematic (a healthy and well balanced immune system, by definition, would be able to curtail non-specific activation - but that's not always the case.)

Hepatitis C is a virus that predominantly damaged liver cells. Drinking is a definite no-no (since the liver is responsible for producing enzymes to "take care of" ethanol and it's (even more chemically damaging) breakdown products), stressing the liver is the last thing that one wants to do.

As long as your friend is not immunocompromised (HIV, post-bone-marrow-transplant, &c), hepC is generally non-fatal and is a manageable infection.

Depending on her doctor's expertise (maybe ask if the local research medical university has any new studies?) and her health coverage, there are some newer treatments that involve activating her immune machinery through toll-like receptor (TLR) agonists to (more specifically) boost anti-virus-infected-cell function (if she gets into this route, perhaps ask about alpha-gal-ceramide [which used to be hot, but it's run into some controversy now] or TLR3 or TLR7 agonists).
posted by PurplePorpoise at 11:26 PM on November 9, 2005 [1 favorite]

The interferon was that bad? Like unable to work bad?

Everyone reacts differently. Some people just notice their sex drive's gone, others are extremely tired and nauseated most of the week, with one or two days right before the next treatment where they can actually function. Don't really know how it'll go until the treatment starts.
posted by cmonkey at 7:25 AM on November 10, 2005

when my brother was doing the interferon he swore by advil to counter the dismal side-effects.
posted by brandz at 6:40 PM on November 10, 2005