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Old 07-04-2006, 11:18 PM   #1
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Hepatitis C girlfriend - is she ok?

Hi

My gf was diagnosed with Hep C years ago (like maybe 10 years ago when she was in her early 30s) and it was from when she was in her late teens/early 20s and was a drug user. No other time would he have been exposed to the virus.

So what I'm wondering is how likely is it that if she's got no symptoms or anything even after all this time (she's 44 now), is it that she will never really develop any?

The last time she was at the docs was several years ago (I have tried nagging but she's sort of very passively stubborn and just "hasn't got around" to going, grr) she was fine, her enzymes werre a bit elevated but ok and she had a slight granuloma or something similar but they said all was ok.

Does anyone know what this means? Is she ok? *scared*

 
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Old 07-05-2006, 10:21 AM   #2
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Re: Hepatitis C girlfriend - is she ok?

Stevie,
If your gf is seeing a GI for regular liver function testing and NOT drinking, then you have no need to worry unnecessarily. HCV is a disease that can lay dormant for many years. Just be sure she DOES NOT DRINK alcohol, ever. That is the death knell. ALso, be sure she gets checked every year, if possible--this is going to sound scary, but they are finding more and more cases of people in their third and fourth decade of HCV who now developing Primary Liver Cancer--and you do NOT want that to go unchecked. In many cases they can ablate the tumor and life goes on. But it must be caught early, hence regular screenings. (A blood test will show elevated Alpha-feta proteins, indicating a tumor) I know this b'cuz my hubby has had HCV for over 40 years and found out at Christmas last year he has cancer and it's inoperable, so we are awaiting a liver transplant. Luckily we have been vigilant about his screenings, so we have a pretty good chance for a good outcome. Don't let her bury her head in the sand about her health care. Don't scare her unnecessarily, just get screened as often as your GI doc says and DON'T DRINK. She'll probably never have a problem and will live a long life and will die with the HCV, not because of it.

 
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Old 07-06-2006, 01:24 AM   #3
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Re: Hepatitis C girlfriend - is she ok?

Thanks Liz for the advice.

If you read this thread again, can you tell me something? My gf actually does drink..she likes a red wine or 2 on the weekends. Generally every Friday she'll have 2 glasses of red wine out to dinner and then have a bottle of cider when we get home later on. On Saturday nights she'll have 2 bottles of cider. Apart from that, nothing. She doesn't seem drunk from this, so I sort of HOPE it can't be affecting her THAT much or she wouldn't be able to tolerate the alcohol and it would be obvious, resulting in drunkenness. Is that right at all?

I wish she wouldn't drink because it does worry me a LOT, but...she likes it, it's an indulgence...she doesn't have any others. She quit smoking a year ago (as did I) and she only drinks 3 cups of coffee a day...

She's not been to any doc about anything since around 2001. I do NOT like this as I've said, but am actually really loathe to bring it up again as she feels like I'm nagging her...I always end up getting really frustrated and angry or really emotional and crying...I also am scared by what might be found if she goes...but I'd still prefer to be in control and to be in control, you have to know.

I keep thinking, like, how would she feel if it were me, and we knew I had this problem, but I refused to go and find out whether I was ok...and then I eventually go and find out, but it's too late to help me and we knew I would die soon...how would she feel then? That she'd done nothing and it COULD have been helped but no...? *sigh*

Thank again for your words and advice...I hope you and your partner are ok and good luck...*hugs*

 
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Old 07-07-2006, 12:04 PM   #4
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Re: Hepatitis C girlfriend - is she ok?

Stevie..
Thanks for the kind words--we are hanging in there, nothing else to do.
I hate to be a downer, but when my husband was diagnosed his GI sat him down and said "You cannot drink alcohol, ever. Never. Nothing. Not even Nyquil. Nothing. I cannot stress this enough." We are Mormons, and a big part of our health code is that we don't drink alcohol---ever. So that has never been a concern. I'm not a dr, but I think that ANY alcohol is detrimental to someone with HCV. This is something that others on this board will attest to.
As for getting your gf in to see a dr--well, personally I can handle the truth, I can't handle not knowing what's going on....it's probably more than likely that she is ok, as her alcohol intake seems pretty minimal. But w/o blood testsand maybe a liver biposy, you really don't know. If she is having problems, she can start treatment with interferon, which in many cases can eradicate HCV altogether. Sit her down and talk to her--likely she's just scared and in denial. Actually, she probably thinks about it a lot and deep down does worry. Those tests will diagnose her state at this time and put her mind at rest, even if it means she does have to have some kind of treatment. She DOES NOT want to go through what we are currently going through-trust me.
Best of luck to you.

 
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Old 07-09-2006, 11:15 PM   #5
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Re: Hepatitis C girlfriend - is she ok?

Thanks again for your words.

Yeah, she doesn't drink anything else besides what I mentioned...she MAY if I wasn't around. I don't like alcohol much anyway, apart from this issue, as my dad was an alcoholic and as a result I feel weird if she drinks too much now.

Did you say Interferon can actually get rid of Hep C all together!? How is this? I thought there was no cure for this? I wish I'd known that and known HER back when she first contracted it. Maybe then she'd be ok now. *sigh*

 
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Old 07-10-2006, 12:12 AM   #6
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Re: Hepatitis C girlfriend - is she ok?

Different forms of Hepatitis work differently in the body. Hepatitis B (HBV) floods the system with virus in the beginning, but almost always reduces levels from that initial period onwards. So, the most dangerous time for HBV is in the beginning, right after being infected. From that point on a person might still be a carrier, but the dangerous period has passed. In general the body is able to clear itself of this virus rather quickly.

It is first of all important to understand what it means when viral levels are low or high. A virus cannot be "killed" because it is not alive in the sense that a bacteria or a living organism is alive. Viruses are said to be active and "alive" when they are duplicating, and dormant or "asleep" when they cease duplicating. So, when a virus stops duplicating it ceases to wreak havoc in the system and stops trying to inject its RNA into healthy cells to destroy them, or more accurately, ceases to make the cells "self destruct" due to the introduction of the nasty viral RNA.

Low or undetectable viral levels mean that the virus is not actively duplicating and has retreated to someplace deep in the body and is dormant or asleep. This is a good phase for viral infections, because during this period the virus causes little or no damage.

High or rising viral levels usually mean the virus is active, duplicating, and doing its thing, destroying cells.

Now liver enzyme levels such as ALT and AST and a few others record activity in the liver. When these are normal, it usually means that the liver is functioning properly and not being damaged. When these are elevated, it usually indicates that liver damage is ongoing, such as from viral replication and virus' efforts to destroy cells.

It is important to understand that with people infected with hepatitis, the gold standard for figuring out whether there is liver damage is a biopsy. There is hope for some new tests that will determine liver damage from a breath test, but for now biopsy is the only way to know for sure if there is liver damage.

The second best way to check for danger due to hepatitis is to do a viral load blood test, using methods such as PCR (polymerase chain reaction) or the more accurate TMA (Transcription Mediated Amplification) tests. These test for levels of virus in the blood. When there is not enough virus in the blood for a positive, the results come back "undetectable." This does not necessarily mean that there is no virus in the blood, but that the test is not accurate enough to detect any. TMA is more sensitive than PCR and has a lower threshold.

An undetectable viral load test usually means that the virus is dormant, and not causing any damage.

The third best tests are the liver enzyme tests, but these are the least accurate in that a person could have no elevated enzymes and very bad liver damage, or elevated enzymes that have nothing to do with liver damage from hepatitis.

Now back to the forms of hepatitis. Hepatitis C (HCV), like HBV, also has a very high level of viral load in the beginning, but this tapers off usually within a few weeks, and then drops drastically and usually stays at these very low levels for many years. For some people, the virus stays at these very low levels or is even somehow suppressed. A person whose viral load remains undetectable for HCV after the initial infection is said to have "cleared" the virus. ALT/AST will usually stay normal as well. This is a good thing. In most cases, this is all there is to it and the person will not have to worry about HCV again.


However, the thing about HCV is that it tends to lie dormant for many years - the usual period is about twenty years - and then for reasons unknown just suddenly wake up and start replicating like crazy. This is part of why HCV is known as the "silent killer." It lies dormant for years and then suddenly without warning wakes up and wreaks havoc like there is no tomorrow.

Because of this ever present danger, it is recommended that people with HCV not drink or take drugs at all and maintain healthy lifestyles - lots of fluids, exercise, good not fatty diets, etc. - so that their immune systems in general and their livers especially stay strong, just in case the HCV comes back to life. They should also be immunized for Hepatitis A and B, because if they contract these, in conjunction with the HCV they already have, they may have some serious problems.

The statistics for people who are not treated are that about 25% of people who contract HCV will eventually have "problems." These problems range from death due to cirrhosis to mild scarring of the liver. In general damage to the liver results in a range of symptoms starting at the low end with fatigue, and ranging all the way to complete liver failure and corresponding incapacitation.

One study that has not been conducted is what percentage of those who develop problems continue with an abusive lifestyle of drinking or drugs. I personally think that the statistics of those who develop problems among those with HCV is very high among those who abuse their bodies and very low among those who really take care of themselves. While HCV may be for many a time bomb that eventually can cause a lot of issues, if the body is kept strong the hepatitis often is unable to cause enough problems before the individual dies of natural causes.

This is somewhat like prostate cancer in men - 100% of men who live long enough will develop prostate cancer, but not all men will die of prostate cancer - usually the lucky and strong body stays one step ahead of a death due to prostate cancer.

The good news for HCV sufferers is that there are now treatments out there, such as pegelated interferon combined with ribavirin, that have success rates of up to 85%. The length of treatment required and the success rate depends partly on the genotype of the virus. HCV is classified into different genotypes - the first forms are known as type 1 (1a or 1b) and the more recent strains type 3 or 4. Typically, treatment of genotype 1 is the most difficult and requires the longest treatment (at least one full year), and genotypes 3 and 4 are easier to treat.

So, a person with HCV should also find out what genotype he or she has. There are blood tests for this too.

The final question is - when to start treatment. Most doctors will not start someone on the treatments, which have some nasty side effects such as feeling flu like sickness constantly, until a biopsy detects at least some liver damage, but some doctors will start a person up when the liver enzymes are elevated and the viral load high, even without the presence of much if any liver damage.

Another thing to note is that while HBV is readily transmitted through close contact or sex during the initial period of infection especially, HCV requires blood to blood contact and is not even thought to be transmitted sexually (at least, there are no certain cases of it having been transmitted through heterosexual vaginal sex). Also, once a person is treated or has cleared the virus and the viral levels are undetectable, the danger of transmission through any means is almost none - no virus in the blood, no virus to infect someone else with.

The bottom line is: take this silent killer very seriously. Cease all potentially abusive or body weakening behaviors including drinking. Get checked regularly with blood tests and if necessary a biopsy. And, stay vigilant and be aware that no problems today do not mean no problems ever.

Last edited by Podee; 02-19-2007 at 10:07 AM.

 
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Old 07-10-2006, 09:48 AM   #7
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Re: Hepatitis C girlfriend - is she ok?

Hey, Stevie,
I was thrown off a little about your mention of 'cider'..here in the states it isn't alcoholic, but after realizing you're from down under and consulting my hubby he informs me that 'cider' is a type of hard liquor--I guess step up from wine or beer.
Sadly, alcohol, cause it is filtered straight through the liver, will do the most damage to the liver. If your gf could SEE what the alcohol has done to her liver, she'd be appalled and grossed out, perhaps enough to quit.

And, yes, the HCV genotype most common in Austraila is very sensitive to interferon treatment and so your chances of recovery from HCV with it are very good, better than someone with the genotype that's common in the states. It's probably not too late--but your gf HAS to stop drinking, altogether and she HAS to see a dr, pronto. She might have to sober for 6 months prior to interferon treatment, but again, I am not sure.This is not an option for my husband at this point as he has cancer---feel free to go ahead and use his cancer as a scare tactic for her if she isn't responding to you just talking to her. She would not want to live ONE SINGLE DAY with the kind of stress we have to deal with waiting for a compatible liver and not knowing if he's going to get it or not before that cancer gets him. I turned 50 yesterday....all day all I could think about was "I might be a widow this time next year" Not a happy thought or day. Ask her what she'd be doing if your roles were reversed! Probably just what you are doing--worrying. I wish you the best of luck.

 
Old 07-10-2006, 11:58 PM   #8
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Re: Hepatitis C girlfriend - is she ok?

Wow...well, I really don't want to be in your situation. No offence meant, as I'm sure you understand.

I just wish I knew more...I mean, I knew a little less than what...*forgotten name of very educated person who posted just before you, Liz* said...but I just wish...I wish she didn't have it at all, is what I wish. *sigh* I think even though I'm babbling on about it, that we're both living in denial which really doesn't help anything, as you know.

All I know is that when she last went to the doc (which was in 2001) her enzymes were up but not a lot, and she had a bit of granuloma, which as far as I understand is scarring/hardening of the liver. Apparently the doc said it was healthy though, the liver...

See, there's another thing that really scares me, which is that in 2001 she also had a cancer scare. Well, not really but a little. She went to the doc (unrelated to anything with the hepatitis) and they found she had abnormal cells in her cervix. So they did their stuff, and said it was a CIN 2 or something...which I think means they were pre-cancerous, but if she hadn't found them, they'd have become cancerous at some stage.

SO...now I'm thinking, if she'd not gone then, we'd never had known this...and she may not even BE here now. So...and then another thing which makes me very scared and also angry is that after this, she was SUPPOSED to go back 6 months later and then each year thereafter, and how many times has she been back? NONE! So I mean, the cells could have returned!!

*sigh* But whenever I bring it up, it ends in tears or fighting or defensive behaviour from her. Every time.

 
Old 07-11-2006, 11:32 AM   #9
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Re: Hepatitis C girlfriend - is she ok?

Stevie--
Wow, I totally understand you gf--she is just scared to death. You can't force her to take care of herself, but she needs to. You obviously care a great deal for her and one would think that would be enough to spur her into action, but sadly, being in denial as she is, it probably just makes her angry.
You need to distance yourself from the situation. Don't engage in the argument, Talk to her calmly, intelligently (all the things podee wrote are correct but kinda over the average person's head) and then tell her she needs to be proactive in her health care. It could be very likely that she is just fine! We often work ourselves up into a state of thinking the worst, and in reality the problem is not so bad.
Do not look back and wish things had been "different"--that is negative, pointless thinking. Of course I wish my hubby hadn't messed around with IV drugs when he was 18, but nothing I can do now can change that, so I never think about it--it's POINTLESS. Can you get her to talk to me on these boards? I would be happy to. Maybe if she saw it from my point of view--(a total outsider & a woman) she might feel differently. Also I think I'm old enough to be her mother.
In my experience, nothing was ever gained by yelling, screaming or confrontation. Only by love and patience. I'm sure she knows that you are scared and frustrated, but she has to want to care for herself. Ask her if she'll talk to me....who knows? Maybe she'll open up. You take care of you, ok? Try no to worry too much.
Oh, and as for that cancer scare--I had a similar experience back in '87 and I was fine after 1 treatment--tho I did follow up. But nothing recurred. Don't go looking for trouble!

 
Old 07-11-2006, 10:00 PM   #10
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Re: Hepatitis C girlfriend - is she ok?

Quote:
Originally Posted by stevie_23
All I know is that when she last went to the doc (which was in 2001) her enzymes were up but not a lot, and she had a bit of granuloma, which as far as I understand is scarring/hardening of the liver. Apparently the doc said it was healthy though, the liver...
That level of damage would be more or less a 3 or 4 on the scale of 1 to 10, with 10 being death from cirrhosis. Many doctors would recommend treatment at that point. All of them, I think, would recommend that she stop drinking....

 
Old 07-15-2006, 10:22 PM   #11
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Re: Hepatitis C girlfriend - is she ok?

I was diagnosed with non-A non-B Hepatitis in 1988. It was not called Hepatitis C until a few years later. By 1990 I heard of a Research Study going on with an experimental drug (not yet passed by FDA at that time) called INTERFERON. Was interviewed, qualified as a candidate and became a participant in the Study. The Gastro-enterologist running the Study was great! I stayed on the Interferon injections, 3 times per wk for 9 years. Learned to give the injections to myself; office visits were required once monthy for bloodwork to check liver enzymes. Side effects were mimimal; like queazy stomach and bad headaches after each injection, but would only last for 6 or 7 hrs. Queazy stomachs stopped completely after 6 months, but headaches continued for the few hours after shots. By 1999 (11 yrs later) the dr. had started combining Interferon with Ribaviron and my liver enzymes were finally back to normal and have remained so ever since. I get tested 3 times yearly and they are always normal. I am not cured, I know, but the Hep C virus has been in remission for several years now, and I've not taken any Interferon since '99. My prayer is that the virus will remain INACTIVE. I eat lots of fruits and veggies, very little meat.

My health background: never smoked, never drank alcohol, never did drugs. BUT, I was in the hospital and received multiple blood transfusions in the early 70's before blood was ever tested for Hep C. The Dr. believes that's where I picked up the virus, and it remained INACTIVE for 15 years in my blood, later becoming ACTIVE. The liver bi-opsy which was done at the start of the Research Study, actually showed that cirrhosis had already begun in my liver. Keep in mind, -- I do not smoke, drink alcohol or do drugs. I am so thankful that now Interferon is available to all

I highly recommend a person to see a Gastro-enterologist as early in the disease diagnosis as possible.

Last edited by riveter; 07-15-2006 at 10:53 PM.

 
Old 07-16-2006, 08:08 PM   #12
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Re: Hepatitis C girlfriend - is she ok?

Riveter-
You are very fortunate that you were able to be part of the interferon study and I am so glad for you that it has been effective for you. You do not state where you are from but you mention the FDA so I am going to assume you're from the USA. They have found (and my hubby would be way more informed about this than I) that interferon treatment is effective in many, but not all cases of HCV in the US. They can usually tell pretty early on whether or not it's going to help control the virus. The strain of HCV here is a different genotype than is found in Asia or Austraila, which seems to be better controlled by interferon-ribavarin (sp) combo. After my hubby has his liver transplant (God willing) he will still have HCV and may need to undergo inteferon treatment too--I can't even imagine that--but your post gives me hope, it does not sound like the horrible nightmare that some have painted it to be. Stevie--maybe if your GF reads this she won't be so scared of treatment. 9 years is probably longer than she would be on it--in the US the treatment it tailored to each patient but usually runs about 1 year.

 
Old 07-18-2006, 08:43 PM   #13
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Re: Hepatitis C girlfriend - is she ok?

I do not consider myself "cured" but I have been in remission for 7 years nowl Since many medications are metabolized in the liver (a pharmacist can tell you which ones are) I try to avoid them. I do not want my liver working any harder than it has to, so I try to keep it healthy. I avoid even OTC drugs used for headaches. I realize the virus is in an Inactive state right now, and I want to do my part to keeping it that way.

 
Old 07-28-2006, 04:19 PM   #14
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Re: Hepatitis C girlfriend - is she ok?

Wow nine years on interferon sounds unbelievably hellish. The only people I have heard of taking it that long are chronic non-responders who take it for maintenance/damage control purposes.

Five years or longer with undetectable viral levels and normal liver enzymes means that the virus has been cleared. Studies show that it can return within two years but beyond five no documented cases of remission.

 
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