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Biopsy, FibroScan or both?
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Biopsy, FibroScan or both?

Many thanks to Stefano on bringing information on the FibroScan for regular monitoring.  How many of you have had biopsies for a baseline?

I have a somewhat difficult question. Seems like most of the folks in the Hep C group are getting biopsies for a baseline. Surprisingly a lot of them have discovered they have Cirrhosis.

I guess I have 2 questions.

1. Should we be getting biopsies on occasion in addition to Fibroscan, since Fibroscan is not very accurate on Fibrosis and is pretty accurate on Cirrhosis which is a stage that we all would like to avoid?

2. Any idea why so many members in the Hep C group have Cirhossis? I always thought Hep B was a faster moving disease and many of us have had it since we were young. Is it possible we are not aware because we are not getting biopsies like them?
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Avatar_m_tn
I think the main reason people say C is worse is because its progress to cirrhosis is much faster than B. This would also answer why there are more cirrhosis cases on Hep C forums.

Maybe there are a lot of US people on C forums? Fibroscan is not that popular over there yet as its a French patent. I think ultrasound + Fibroscan give you a pretty good idea of whats going on.
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Avatar_m_tn
hi

I had twice in my life biopsy (27yo-male). the first i was a kid 7yo and the last one in 2007 with Fibroscan.

and Ultrasound twice yearly.. biobsy/FS are useless they have to be interpreted in conjunction with a number of test: utlrasound, bloos test etc..
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Avatar_m_tn
2. HCV cirrohsis may occur becuse there are no long term drug (ie.TDF/ETV) blocking liver damage even they need to be take lifelong..
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Avatar_m_tn
hcv is common in US only and most of members there are from US.there are no fibroscan there, there is little knowledge too

in europe biopsy is not used anymore since it is totally useless for monitoring,  you may use if in case of interference factors since fibroscan measures fibrosis+inflammation+fatty liver+nodules in case there are cirrotic nodules

once more thing why to get liver in pieces...i had 2 biopsies in my life, the second was wrong and will never had another one (plus even if wanted they re not done here)
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Avatar_m_tn
biopsy can very easily miss cirrhosis, it takes a tiny pieces of liver ony, fibroscan cant miss cirrhosis but can miss f0-f1 but f0 and f1 are not important at all you need the sick stages to be detected not the healthy ones

it is wrong, at least for hbv, to say it misses midle stages, it only misses the very low stages f0-f1

hcv has metabolic disease too so you need an expert doctor to see the interference from that and from fatty liver.hbv has rarely fatty liver and even if so milder

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Avatar_m_tn
@calebz, thanks for the replies guys. I wan't able to find any studies or literature saying that Hep C folks progress to Cirhosis faster than Hep B.

@GRMR they dont seem to have long term drugs like Hep B, but even Hep B drugs have not been around that long to be proven long term.

My point is that many of them are at the Cirhosis stage prior to treatment, and I am wondering if this is because they often get biopsies as baselines so they might have a more accurate diagnosis of thier liver condition.
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Avatar_m_tn
Thank you Stefano, I follow a lot of your posts, you are very knowledgeable.

I was just reading a lot of the Hep C posts, seems a lot has changed over there in past few years as they seem to have better information on how to cure.

As I was reading two things stood out, a lot of them get biopsies, and yes most seem to be from USA, also alot of them have Cirhosis in the liver.

I am thinking about flying to India to get the Surface Antigen test and Fibroscan.  Here in the USA there are hardly any doctors familiar with Hep B. Because of insurance I am forced to go to Gastroentrologist who dont know anything about Hepatitis.

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Avatar_m_tn

you can get those tests bothin europe, india and many asian countires, india is probably very very cheap for both tests and drugs
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Avatar_m_tn
Thank you Stefano, I was looking into India, but then I found the following information:

FibroScan for people in USA: looks like we can get this done in Canada which is very close to the USA. There is a new place called Liver Scan Direct that opened up this year as well as many hospitals.


Surface Antigen Quantity hbSag: This I haven't been able to locate, I am going to ask my dad about this since he works in a lab doing blood tests all day. Also maybe I can call Abbott who is also hedquartered in my home town and ask them about it.
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Avatar_m_tn
I have found a very informative article/study that explains Fibroscan and its scores, compares it with Biopsy, gives monitoring guidelines for both HBV and HCV and summarizes many important studies findings. I found it very informative and useful. Please share it with others:

http://www.intmedpress.com/serveFile.cfm?sUID=f5a2b13c-be5b-4c78-b4b7-669ee8add616
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