TOPIC: Fibrosis F4

For an overall picture, I'm adding his last blood results, they slightly changed.Glucose 5,1 4.9 .......4,4
Urea 3,4 3.9 .........4,4
Creatinin 74 80........(same)
Proteins 62 78
AST 27 22 ........25
ALT 45 24 .........28
ALP 90 82.........90
GGT 101 44.......48
Amylase 78 86........77
LDH 186 159........191
calcium 2.34 2,36........2,37
sodium 141 (same)........142
potassium 3.82 3,6........3,90
chloride 104.2 101.........102,8
CRP 0.30 (same).........0,32

He's been wondering if it's ok that AST and ALT have increased a little bit?
But all of the results are normal, except for cholesterol (6,61 - should be <5,2).

Hey Sonja, Those liver function results going up and down within normal ranges is just the way things are. You can start worrying about that only when they go up, and up, and up. On the other hand, that cholesterol - doesn't mean much by itself as 6.6 is total cholesterol. The number you need is the ratio of low density lipoprotein (ldl) to high density lipoprotein (hdl). See if the blood results have one of those details?

Hi, thank you for your answer!
HDL is 0,87 (lower than it should be)
LDL is 4,84 (higher than it should be)
Sorry, I should have added these details.

Hey Sonia, It's good that your BF's liver is getting so healthy that this minor cholesterol issue is now the question. So, how to raise the protective hdl cholesterol while reducing the artery-clogging ldl cholesterol?

Raise the beneficial hdl through (1) excercise, (2) lowering trans fat intake (unhealthy trans fats are found mainly in partially hydrogenated shortenings), (3) moderate alcohol intake may help (usual advice is that if you do not use alcohol already then do not start). And reduce the ldl cholesterol through (1) increasing dietary fibre intake by eating more of the good stuff (legumes, vegetables, grain foods, fruit, nuts, seeds), and reduce saturated fat intake. (2) Loose excess body fat if you're over the recommended body weight recommendations, (3) reduce sugar intake (remove sugary sodas, fruit juice, processed foods).

The detail in this advice sheet covers the basics - www.mayoclinic.org/diseases-conditions/h...esterol/art-20046388

Have fun now that you're BF has reached end of treatment, that's the most important part

Hi! Thank you!
Now that you've mentioned exercise, I'd like to ask if it's ok -considering that he has cirrhosis- to exercise? Because he's been avoiding exercise thinking he could worsen his condition.
He eats well overall and he is at normal weight, hasn't been drinking alcohol for over 20 yrs... His only problem is smoking cigarettes. He's been talking about replacing them with an electronic cigarette but he's not sure if the electronic one is harmless (especially for his liver).
Thanks for all your answers and opinions, I aprecciate them very much.

Electronic cigarettes can undoubtedly provide useful harm reduction. Go ahead. They are controversial in certain jurisdictions but not in others. Seems to be many moralistic judgements on this topic, with people saying we shouldn't use any nicotine products, but the fact is people do (for the record, I do not use e-cigarettes or any tobacco products).

Exercise with liver cirrhosis does need to be done under medical advice, but getting up to 5,000 steps a day would likely be a harmless way to begin. Someone else on here will be able to give more advice

Hi Sonja,

Smoking is bad for your BF's liver as tobacco contains many toxic chemicals that his liver will need to process and I would urge him to stop. Having said that, I know how hard it is to give up! If he can't do so immediately then e-cigarettes will at least reduce the chemical cocktail he is ingesting and may help wean him off them eventually.

Cholesterol balance tends to be thrown out of whack by HCV which may help explain the low HDL but after SVR this is likely to improve particularly with good diet and exercise.

I have cirrhosis and 18 months ago I would become exhausted and need to rest after walking 500 metres to the local shop and back. When I commenced my treatment I decided to do something about that so started excercising. Slow, short daily walks at first but gradually building up speed and length until I can now walk for a couple of hours at a brisk pace.... the improvements to my general health and feelings of wellbeing have been fantastic. Assuming there are no other medical reasons for not exercising and that he builds up gradually, I believe exercise would be beneficial for your BF. If he does have any concerns then a checkup with his PCP/GP before starting will provide more guidance.

hepatitiscnewdrugs.blogspot.com.au/2014/...p-patients-with.html

Hi Gaj,
thanks for your answer
Yes, it's unfortunately very hard for him to stop smoking...that's why he's been looking for an alternative that would satisfy him without causing that much harm to his health. We'll see about the e-cigarette.

That's great how much you've improved! I will try to convince my BF to walk as well. Until few years ago he used to do pushups, situps, lifting some light weights etc, but I assume that wouldn't be so great for him? (Just to confirm.)

Thanks again and have a nice day!

As long as he doesn't try to bench press 250kg straight away I don't think that should be a problem. From what I understand and also experienced, exercise and improved fitness is beneficial for cirrhosis assuming it is within done our current capacity. Your boyfriend knows and will be able to feel what he is capable of so can build up slowly just don't go nuts. I try to do similar but I'm lazy so that resolution tends to get broken too often.

edit: though I still walk every day

Ok, thanks a lot!
He would just exercise a bit at home, nothing major. Definitely won't go nuts.

Haha walking every day is a huge thing, you're definitely not lazy!

Hello Sonja,

The ALT and AST are fine - they wander up and down a little in everyone.

Yes, the cholesterol is a little high. Over time this can be a problem and it is high enough for me to discuss treatment with a Statin class drug with my patients.

Hello guys,
I have great news, so I wanted to share them with you.
It's been 12 weeks since my BF finished treatment so he did pcr test and he's NEGATIVE! If I understand this correctly, he's almost 100% sure the virus is not going to return.?
Also, he did blood tests and his results were:
AST 20
ALT 16
ALP 93
GGT 27
cholesterol 4,63 (3 months ago it was 6,61)
-HDL 0,76 (lowered from 0,87)
-LDL 3,22 (compared to previous 4,84)

Oh and one more good news- he's quit smoking! (he's now a vaper)

Have a nice day and keep fighting.

Fantastic news about your boyfriend, SonjaTheGF!

(Nice to see he gave up the cigs too )



- Regarding your question about the virus returning, here is some information Dr Freeman provided a while back. (Keep in mind that some of the 0.4% difference between SVR12 and 24 are likely reinfections.)

fixhepc.com/forum/viral-load-and-svr/151...ot-to-svr.html#24035

Hello SonjaTheGF,

The BF is a lucky man to have a supportive GF!

Best wishes to you both.

Hi SonjaTheGF,

I remember when you first came online and it was great to see what a team you and your BF are.
Congratulations to your BF and well done you.