Question: I was diagnosed with Hepatitis C thirty years ago. It has never given me any problems until now at age 60 . At present, I feel great and have almost no symptoms of what I am being diagnosed with, i.e., late stage three Hepatitis. I am not tired, no nausea, my appetite is great, I have no jaundice, edema, or pain anywhere. I had a colonoscopy done, and gastro endoscopy which showed almost no pathology whatsoever. No ascites, no esophageal varices, no polyps or anything suspicious from those two tests.

Here’s what the tests did show: I had blood work, liver biopsy, ultra sound scan of liver and spleen, that I have Hepatitis C type 1A and a 6.7 viral load. It also showed low blood platelets (123), and high iron and ferretin levels, which the doctor believes could be hemochromatosis. The ultra sound and a physical exam indicated a slight enlargement of my spleen. I have lost 20 to 25 pounds in the past 6 months to a year which is the main reason for all the tests.

The first infectious disease specialist locally in Saginaw Michigan said 80% of my liver has cirrhosis and is irreversible, and the other 20% is fibrosis the progression of which can be halted. He wants to put me on medication which has a 92% cure rate i.e., peg interferon, ribavirin, and one of the brand new medications, sofosbuvir. Being confused by the cirrhosis vs fibrosis issue and not wanting to endure the interferon and ribavirin side effects, or potential health risks, I sought a second opinion from the XXXXXXX Clinic in Ohio. When I told the specialist at the XXXXXXX Clinic what the Saginaw physician had said in terms of 80% cirrhosis and 20% fibrosis he said he doesn’t even know what that means. He said once you are diagnosed with cirrhosis, you have cirrhosis. It is never cirrhosis with a small percentage of fibrosis, its just cirrhosis. As far as the prescribed drug regime he said there is no longer a need for Interferon and ribavirin and is going to put me on a combination of Sofosbuvir and Simeprevir which have essentially no side effects and also a 92% cure rate.

What I am wondering is if you could comment on what I have told you in terms of my symptoms and whether or not you think it sounds like stage three liver disease. The Saginaw specialist said I am stage three moving towards stage four. Personally I doubt the disease is all that advanced because I feel fine and I don’t have many symptoms that would confirm this diagnosis. What do you think?

Also, what do you think about the two different med regimes? Do you think what I have described sounds consistent with late stage 3 liver disease? The XXXXXXX specialist says with liver biopsies you don’t always see what you think you see. He eventually wants to do another biopsy which will be originated from my neck. I presume this is to compare with the other horizontal sample which was taken from my side. This would give him a better look at whether there is some bridging or if the bridges are starting to connect, or whatever. What do you think? I realize this is a lot of information but I am wondering if you concur with one physician or the other in terms of diagnosis and prescribed med regime.

Thank you for your answer. Still a bit confused about Cirrhosis/Fibrosis. My understanding is that I have stage three hepatitis with my liver still functioning adequately. If we are talking about Cirrhosis I guess this would be compensated? Is that right?
However, the XXXXXXX Clinic seems to be saying that I am at stage 3 possibly even 2, and that what I have is liver Fibrosis. According to them (if I am understanding correctly) if you have Cirrhosis you are in stage 4. Is my confusion just a matter of terminology? When does Fibrosis start being called Cirrhosis?

Thanks again.