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Medical Forum / Diseases and Disorders / Hepatitis / August 2008Hello and please help evaluate my two biopsies
Hello to the group this is my first post. I have had Hep C for about 35 to 45 years. I was diagnosed (non A non B) years ago so as soon as C was named I knew I had it. Went with about 56 weeks of combo treatment two years ago but relapsed. My Doc said 48 to 72 weeks, the longer was better. Any way please look at the following info from two biopsies and tell me what you see. Looks to me my liver is about the same as in Jan. of 2000. I have heard a lot about iron lately. Does the second report look good or bad as far as the iron. Thanks for any info... scallawag Liver needle biopsy specimen: 1/28/2000 Chronic Hepatitis C. Grade 1 portal periportal inflamation. Grade 1 Lobular inflamation. Stage 0 fibrosis. ------------------------------------------ Needle core biopsy , Liver: 8/08/08 Chronic Hepatitis with minimal activity consistent with hepatitis C. Total Knodell score : 2 of 22. Portal Inflammation: Minimal. Score: 1 Interface hepatitis : Not Identified. Score: 0 Intralobular Necrosis: Mild. Score: 1 Fibrosis (Trichrome, Reticulin) : No significant fibrosis identified. Score: 0 Number of Portal tracks identified: 10. Additional findings: Pas Stains for Alpha I Antitrypsin globules are negitive. The Iron Stain is 0- 1+ Positive for focal hepatocellular Iron. > Hello to the group this is my first post. I have had Hep C for about 35 > to 45 years. I was diagnosed (non A non B) years ago so as soon as C was [quoted text clipped - 42 lines] > > The Iron Stain is 0- 1+ Positive for focal hepatocellular Iron. //////////////////////////////////////////////////////// Hi Scallawag, It looks like you have been doing something right. I don't know about the iron, and there are some new indecies on your second bx report that I am not familiar with. Having said that, did your doctor say anything about waiting for another treatment regemen that may be more effective with relapsers like yourself? You have nil fibrosis. That is quite something. Ask your doc about waiting for one of the protease inhibitors. 72 weeks is grim. cactus jammies > > Hello to the group this is my first post. I have had Hep C for about 35 > > to 45 years. I was diagnosed (non A non B) years ago so as soon as C was [quoted text clipped - 51 lines] > yourself? You have nil fibrosis. That is quite something. Ask your doc > about waiting for one of the protease inhibitors. 72 weeks is grim. Thanks cactus jammies My doc advised not to try standard treatment again. He said he would get me on the Phase 3 clinical trial with Telaprevir if I wanted. I guess that just adds the Telaprevir to the standard treatment for a limited time. I think that would start this year. He also said one other company has clinical trial starting that look just as promising as Telaprevir. He said he would not have said that two weeks ago. btw: I am genotype 1, 60 years old Thanks again > cactus jammies I'd be at the crossroads in a heartbeat for a 0 fibrosis result! Congratulations, and please tell us your secret :-) >> > Hello to the group this is my first post. I have had Hep C for about 35 >> > to 45 years. I was diagnosed (non A non B) years ago so as soon as C was [quoted text clipped - 66 lines] >> >> cactus jammies As CJ said, your liver is in remarkable shape considering your history. Iron accumulation is a typical hallmark of HCV inflammation, but again, you're at or near the bottom end of the scale there, too. The alternative to Telaprevir is Boceprevir - but the latter is well behind the former wrt clinical trials. With no negatively surprising P3 trial results, I would expect Telaprevir to be FDA approved within the next 18 months, with Boceprevir at least two years behind. Given your Knodell Score, and minimal level of current inflammation, I'd say unless there is some other clinically evident manifestation of your chronic HCV, waiting for Telaprevir to be fully approved would be the most reasonable approach. I wouldn't sign up for a trial - because you could draw the short straw and be put in the control group - in which case you'd be repeating your previous therapy... Cheers /greyhackles |
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