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Forum Name: Liver Diseases

Question: HEP C Cirrhosis level 2


 alterd - Tue Sep 23, 2008 5:02 pm

I was diagnosed with hepc 1999 I have had several biopsies and been treated with the 12 month treatment twice first time caused my RA to flare so bad I could not walk but at the same time I was under a lot of stress because my house had been destroyed in a flood. Now the doctor told me I have level 2 cirrhosis. Can you please explain to me what that is and what can I expect. My Dr. told me that there are 4 levels so if I am level 2 then what happens level 3 and 4. Is this cancer. I would really like to know the whole truth as I need to prepare for what is to come. The second round of treatment for the hepc clear at 3 months then it came back. And now it is cirrhosis. Please tell me what I need to be ready for.

alterd
 John Kenyon, CNA - Tue Oct 14, 2008 9:48 pm

User avatar Hello -

There are at least two grading systems for cirrhosis, the older one using A, B and C, and the newer, Pugh-Child system using 1,2,3 and sometimes stage 4 (end stage). These stages (or levels) don't always correlate well with the actual symptoms (if there are any), and are generally based on laboratory and other clinical findings. Generally the lowest stage (1 or A) has no appreciable symptoms associated. By stage 3 symptoms are commonly seen, and are often fairly serious. Stage 4 or end stage cirrhosis is indicative of greatest sustainable liver damage, but even then some patients do fairly well and have relatively good outcomes, while others succumb to some complication. Much depends upon the underlying cause, which is usually either due to hepatitis or excessive alcohol use. If alcohol use is curbed totally, some patients don't progress beyond whatever stage they are in, and even an end-stage patient may do fairly well, with the caveat that any alcohol ingestion at that stage could potentially be fatal.

If cirrhosis is in remission, is cured, or is resolved, whatever level of cirrhosis was reached during the infection is usually not exceeded so long as no other insult to the liver is sustained (again, drinking is a major factor, even if the patient is not a chronic alcoholic. Also some drugs must be avoided). With hepatitis C, which tends to stay while waxing and waning in some patients, cirrhosis can get worse with severe flareups, but if the underlying disease is well-controlled the patient may well have a good outcome.

With any degree of cirrhosis there is a slightly increased risk of develpment of cancer of the liver, but this is only a statistical risk and does not automatically follow. By the same token, any given stage of cirrhosis does not automatically, at some point, progress to a more severe stage. It can, but it's not a given.

With all other things being equal, excellent nutrition plays a very important role in a good outcome, along with the obvious avoidance of alcohol and certain drugs which are toxic to the liver. Your doctor will have counseled you on these issues, so the next step is to maintain a very healthy lifestyle in general and you may well have no advancement of the disease at all.

Complications of advanced-stage cirrhosis are usually the big problems, and even these are becoming more manageable, so we are seeing more good outcomes in general.

I hope this is helpful to you. Best of luck, treat yourself right and try not to worry too much. Report any remarkable changes in the way you feel to your doctor and be sure to keep your follow-up appointments. Stage 2 cirrhosis is a long way from the worst case.

Stay in touch.

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