Liver disease – Dr. Jeremy Tibble – Sussex Gastroenterologist

HCV sufferers and the impacts of antiviral treatments

Hepatitis C virus (HCV) is associated with musculoskeletal problems such as chronic widespread pain, sicca syndrome, polyarthritis, and a reduced health-related quality of life (HRQOL). HCV’s extra hepatic manifestations and a reduced HRQOL often develop before hepatic impairment. This means that people presenting with extra hepatic manifestations may not be aware that they have HCV. HCV is asymptomatic and sufferers may show no indications of having the infectious disease. This understanding of associated HCV illnesses helps to uncover people with underlying HCV. People with HCV suffer with numerous problems lowering their HRQOL. These include psychosocial problems, mood related changes and somatic symptoms. Similarly, arthralgia and myalgia are also among the symptoms associated with HCV. Recently, ground-breaking experiments have been carried out to investigate changes in HCV symptoms and HRQOL before and after antiviral treatment. The investigation was carried out by asking 118patients to fill out a questionnaire before and after pegylated interferon and ribavirin treatment. The aims were: · To find out whether the treatment helped HCV sufferers and improved their conditions. · To investigate whether HRQOL improves following antiviral therapy. · To determine whether an association exists between extrahepatic symptoms and HRQOL before and after treatment. The results found that HCV sufferers who underwent treatment found a significant improvement in 6 out of the 12 domains of the questionnaire. These were: physical functioning, physical disability, social functioning, limitations and health distress due to hepatitis, general health and chronic widespread pain. However, sicca syndrome only fell marginally and there was no improvement in mental health and positive well-being. On the whole, it is clear that HCV antiviral treatments significantly improve poor HRQOL and chronic

Revolutionary discovery for liver disease patients

A groundbreaking new study highlights the differences between the successful and unsuccessful treatment of liver disease with relation to HIV and HCV sufferers. If liver disease is left untreated, it can have life threatening impacts upon this group of patients. Sussex Gastroenterologist, Dr Jeremy Tibble has orchestrated the experiment to help find a treatment to prevent liver disease from worsening in HIV sufferers. Of 40 million people infected with HIV worldwide, approximately 25-30% are also infected with HCV related liver disease. Liver disease has emerged as a major cause of death among co-infected patients. HIV negatively affects every stage of HCV infection. It enhances HCV transmission, whilst decreasing HCV clearance, which in turn leads to higher rates of chronic infection. Until now, it hasn’t been understood why liver disease has such a negative impact upon HIV sufferers. However, after much investigation and experiments, answers have finally been reached. T-regulatory cells (Treg) play an important role in self-toleration and immunity. However, in liver infected HIV sufferers, Tregs are associated with impairment of blood immunity responses. The study uses Pathology and Clinical Biochemistry databases as its primary sources. It has concluded that co-infected patients could benefit from the early introduction of highly active antiretroviral therapy (HAART). If HAART can be started before cell numbers decline, then Treg numbers and immune regulatory activity may be preserved. This potential mechanism may help to benefit patients. To view the study in full click here. Alternatively, if you are a medical professional wishing to find out more, or a GP who would like Dr Tibble to talk at their practice, please fill in the ‘contact us’ form or email info@sussexgastroenterologist.com. If you are a patient seeking advice or an appointment with