Watch information videos on Hepatitis C
VIDEOS ON HEPATITIS C
July 28th, 2011Hepatocellular Carcinoma
March 1st, 2012Key points
• Hepatocellular carcinoma is a well recognised complication of chronic liver disease.
• Viral hepatitis remains the most common cause with alcohol also a significant contributor.
• Screening and surveillance is often performed to detect early lesions where possible.
• Surgery can be considered in fit patients with early stage disease.
• Palliative therapies are now available with lower toxicities and improved patient survival .
• Although key, endoscopy is not the only element in managing such patients.
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Hepatocellular carcinoma refers to a liver tumour originating from within the liver tissue. Liver metastases are approximately 30 times more common than primary tumours and making this differentiation is imperative to further investigations and management. It ranks as the 5th most prevalent cancer in the world
Symptoms
Patients may in fact be asymptomatic and have their tumour picked up on routine scanning for other reasons. Others may present with one or a combination of fatigue, abdominal pain, ascites, weight loss, jaundice or abnormal liver blood tests. Any of these should lead to further investigations.
Cirrhosis is known to be the greatest risk factor for the development of HCC. Significant geographical differences are apparent in relation to this risk factor.
In cirrhotic alcoholics there is a four-fold increase in HCC compared to the general non-cirrhotic population.
The mechanism of HCC is thought to reflect disorganised DNA during cellular repair or nodule regeneration in the presence of cirrhosis or chronic inflammation. Addressing some of the other chronic liver conditions, iron overload, as seen in genetic haemochromatosis, is also high risk for HCC when cirrhosis is present.
Cirrhotic hepatitis B or C patients co-infected with HIV are possibly at the greatest risk.
Diagnosis
Small lesions can be hard to see in a nodular cirrhotic liver and may simply represent a regenerative nodule. Once a liver lesion has been identified, often by ultrasound, several factors, including it’s likely aetiology, need to be considered. Multi-phase CT scanning, or MRI, may be required to define a lesion further and follow-up interval scanning performed as appropriate, if deemed low risk.
The current evidence suggests that the standard initial imaging interval should be 6-monthly. Higher risk patients do not warrant more intensive screening. In addition to appropriate imaging the serum α-fetoprotein level is often monitored as it can be elevated in HCC. However, it may not increase in 20-40% or so.
Liver biopsy is avoided if at all possible due to the high incidence of tumour seeding, particularly if a potentially curative outcome is predicted.
Treatments
This depends on the location, size and number of the tumours and also on the fitness of the patient. Small tumours (<2-3cm) will have a 1-year survival close to 85% but only a 50% 2-year survival. Surgical resection or liver transplantation both offer the only real chance of cure. Tumours that are invading the portal vein or breaching the liver capsule would be considered un resectable and perhaps only amenable to palliative therapies. A size of 5cm is the usual cut off for suitability of a single lesion resection.
Resection offers a greater than 50% 5-year survival with a 70% likelihood of recurrence. Patients with advanced cirrhosis are poor candidates for resection with an increased mortality and risk of liver failure post-operatively. Therefore, a liver transplant offers the best alternative. A shortage of donor organs has lead to live-donor right lobe transplants, with improving results.
Radiofrequency ablation (RFA) is a palliative therapy which can induce tumour necrosis. An electrode is passed via the peripheral vasculature into the liver. Heat can be delivered directly into the lesion and therapy repeated. It can be offered in patients with lesions >2cm, with a procedure-related mortality of 0.3%. Studies have shown upto a 70% 5-year survival with this treatment.
Image-Guided Liver Ablation
December 20th, 2011Hepatitis C Virus
December 20th, 2011Always attend your follow up scans ect
December 18th, 2011I recently discovered the importance of why my Hepatitis C health professionals ask me to go for regular follow up scans. It was discovered that I had developed liver lesions and needed urgent treatment.
I have to hold my hands up and admit that after 11 years of regular visits to my local hospital for Hep C Virus I had become complacent about my liver scans and other regular checks carried out by my medical professionals. Sometimes it was not convenient and I would put off going for a gastroscopy and a scan and re arrange them. Recently though after attending a scan appointment it was found that I had lesion on my liver and a follow up scan was arranged to confirm this, as you can imagine I did not miss that appointment. The existence of the lesion was confirmed and a MRI scan was arranged within a couple of days, not pleasant experience but necessary.
Once my Hepatitis C medical team had all the information I had to see a surgeon who arranged for me to have a Radio frequency Ablation of the lesion, a treatment which raises the temperature of the lesion and destroys it with the heat. This is done under a local anaesthetic and I found it very similar to having a liver biopsy. I was in hospital less than a day and recovered quite quickly.
Liver lesions can be very scary but they are usually non cancerous. However, there can still be a serious problem with the liver that has to be looked at. These are small masses that can develop for a variety of reasons. It is often associated with individuals that consume alcohol excessively. The use of narcotics either illegally or through the use of prescription medications can also contribute to them forming.
There are a variety of symptoms that can be present when someone suffers from liver lesions. It can be very painful due to the fact that the liver can become inflamed. As it swells up it can cause pressure because it is pushing up against other aspects of the body internally. The pain can be caused by cysts that develop as well.
Some individuals don’t feel pain but they do seem to feel full all the time. As a result they may not eat as much as they did before. The feeling can be overwhelming at times though, making it hard to sleep and to concentrate on other tasks. Some individuals feel like they are bloated or they have gas but the problem can’t be helped with over the counter products for those problems.
The answer is to always take notice of your Hep C Virus health professional, if they are sending you for certain tests it is because it is needed and gives them information that they need.
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Pitt Chronicle » Center for Global Health: Creating a Healthier World – Hillier (third from left in yellow shirt) meets with local women and (on Hillier’s left) their tribal chief in Blantyre, Malawi, where the Microbicide Trials Network (MTN) operates a site. Hillier is an internationally recognized microbiologist who is the principal investigator for the MTN, an HIV/AIDS clinical trials network established by the National Institute of Allergy and Infectious Diseases. She is also a professor and vice chair for faculty affairs and director of reproductive infectious disease research in the Department of Obstetrics, Gynecology, and Reproductive Sciences in Pitt’s School of Medicine.
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forum.UNAI.edu • View topic – Hepatitis C – UNAI Forum – Hepatitis C. Informasi yang berkaitan dengan kesehatan. 81 posts • Page 4 of 6 •
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Pitt Chronicle » Hepatitis C Virus May Need Enzyme to Cause Liver … – A key enzyme may explain how hepatitis C infection causes fatty liver a buildup of excess fat in the liver that can lead to life-threatening diseases such as cirrhosis and liver cancer, report University of Pittsburgh Graduate School of Public Health and School of Medicine researchers. The study, published in Hepatology, shows that an enzyme known to play a major role in lipid production, fatty acid synthase (FAS), was highly elevated in human liver cells exposed to the hepatitis C virus. While preliminary, the research suggests that testing for elevated levels of FAS could help determine which patients with hepatitis C virus may go on to develop more serious, long-lasting health consequences brought on by fatty liver.
Hepatitis Central
December 18th, 2011Medical Videos Radiofrequency Ablation of HCC Animation Interventional Radiology
December 12th, 2011What Is Hep C Virus ?
November 28th, 2011The hep C virus is a small, enveloped, single-stranded, RNA virus in the Flaviviridae family. The virus is able to enter liver cells from the blood and then use those cells to make more copies of the hep C virus. As more and more of the hep C virus is made in the liver cells, they can become damaged and may even die. Just as there are different types of hepatitis viruses, there are also a few different types of the hep C virus itself. Though they all cause hep C, each type of the virus has a slightly different arrangement of its genetic material, in this case called RNA. The specific arrangement of the RNA is called the genotype. The main hepatitis C genotypes are known simply as genotypes 1, 2, 3, 4, 5, and 6. Of these different genotypes, genotype 1 is the type most commonly found in the United States. Between 70 to 90 percent of Americans with hepatitis C have this genotype. Hepatitis C virus genotypes 2 and 3 are less common. Only 10 to 20 percent of infected people in the US have either of these genotypes.How Is Hep C Spread?The hep C virus is spread mostly through infected blood and blood products, whether it is from working in a laboratory or a dialysis unit, by infected needles used for tattoos or body piercing, or through sharing drug needles. In a very few cases, people have been infected with hepatitis C by sharing objects that may have a very tiny amount of blood on them, such as a toothbrush, razor, or tools used for manicures.
- Tattoo You? » AZ Dept. of Health Services Director’s Blog – Regardless of what you think about tattooing and body piercing- it’s clearly popular. Tattooing and body piercing are obviously invasive- which brings up the question: do these (now common) practices pose a health threat? Are they safe? The answer is simple. Like just about everything else in life- it can be safe as long as it’s done right.
- Pitt Chronicle » Hepatitis C Virus May Need Enzyme to Cause Liver … – A key enzyme may explain how hepatitis C infection causes fatty liver a buildup of excess fat in the liver that can lead to life-threatening diseases such as cirrhosis and liver cancer, report University of Pittsburgh Graduate School of Public Health and School of Medicine researchers. The study, published in Hepatology, shows that an enzyme known to play a major role in lipid production, fatty acid synthase (FAS), was highly elevated in human liver cells exposed to the hepatitis C virus. While preliminary, the research suggests that testing for elevated levels of FAS could help determine which patients with hepatitis C virus may go on to develop more serious, long-lasting health consequences brought on by fatty liver.
- How To Avoid Common Liver Problems | Healthy Lifestyle – Your liver is located just under your rib cage on the right side of your abdomen, it’s about the size of a football, weighs 3 to 4 pounds and performs hundreds.
Telaprevir
November 17th, 201160% of patients with hep C virus genotype 1 do not have a sustained virologic response to therapy with peginterferon alfa plus ribavirin.
In a randomized, phase 3 trial, the addition of telaprevir to peginterferon alfa-2a plus ribavirin in patients with HCV genotype 1 infection who had no response or a partial response to previous therapy or who had a relapse after an initial response.
Telaprevir combined with peginterferon plus ribavirin significantly improved rates of sustained virologic response in patients with previously treated HCV infection, regardless of whether there was a lead-in phase..)
More great resources for Hepatitis C
- How to Cure Hepatitis C Naturally – hepcvirus profile image · hepcvirus 2 months ago. Milk Thistle is proven to help
- The UK Hepatitis C Forum :: View topic – Side effects – Jul 31, 2011 … Its all about trying to manage your side effects, talking to your medical team
Bristol-Myers Squibb Reports83 Percent Hepatitis C Cure Rate In Phase 2 Study (ICAAC 2011
September 29th, 2011Results
from a Phase 2 clinical trial indicate that Bristol-Myers Squibb’s
investigational hepatitis C drug BMS-790052 yielded an 83 percent cure rate
after 48 weeks in previously untreated adults with genotype 1 hepatitis C when
combined with peginterferon alfa-2a (Pegasys) plus ribavirin (Copegus,
Rebetol). Eight percent of participants reported serious side effects (anemia,
or low red blood cell counts). Based on the results, Bristol-Myers Squibb has
initiated a Phase 3 clinical trial with the drug. The results were presented
last Saturday at ICAAC. For more information, please see the study (abstract) at the ICAAC website or the Bristol-Myers
Squibb press release. For more information on the Phase 3 clinical trial,
please see the U.S. Clinical Trials Registry.
To read more resources on Hepatitis C, visit these great sites
- How To Live Well With Chronic Illness | Boomer Back-Beat – I had Hepatitis C for 33 years. Unlike most people who fall victim to this virus, I became very sick at the onset of its attack. That was in 1977 and, at that time, there was no test to diagnose any serum hepatitis and I …
- “my swollen up prostate… and then one has to pee several times a … – “my swollen up prostate… and then one has to pee several times a nite LOL… well I just keep a bottle by my bed but I still have to wake up to do it LOL” Flick keeps a bottle under his bed so he can relieve himself at …
- The mood before the dummy disappeared: paranoia, misogyny, hatred … – Well, I am not gonna go surfin tonite after all. my liver is achy and swollen and I am beat for now. lying down on a hard surf board paddling around will not help too much LOL. I am learning patience. one cannot just …
Bristol-Myers Squibb Reports 83 Percent Hepatitis C Cure Rate In Phase 2 Study (ICAAC 2011
September 29th, 2011Results
from a Phase 2 clinical trial indicate that Bristol-Myers Squibb’s
investigational hepatitis C drug BMS-790052 yielded an 83 percent cure rate
after 48 weeks in previously untreated adults with genotype 1 hepatitis C when
combined with peginterferon alfa-2a (Pegasys) plus ribavirin (Copegus,
Rebetol). Eight percent of participants reported serious side effects (anemia,
or low red blood cell counts). Based on the results, Bristol-Myers Squibb has
initiated a Phase 3 clinical trial with the drug. The results were presented
last Saturday at ICAAC. For more information, please see the study (abstract) at the ICAAC website or the Bristol-Myers
Squibb press release. For more information on the Phase 3 clinical trial,
please see the U.S. Clinical Trials Registry.