Hep B and Liver Cirrhosis

[European86]

Hello there

I have a question regarding my mom who has Hep B for the last few years. She did ultrasound 5 months ago after blood test shows some change comparing to the past and I recieved the call from Health Professional from the Hospital telling me first that her Liver is okay but later that she has a lot of scars on her liver and that the doctor wants to do biopsy in order to determine the condition of my mom's liver. We didn't go back but we actually turned to a healthy food and mom started taking one therapy with natural teas which we bought back home from one doc of natural medicine who is very well known in Balkan area for curing liver diseases.

My mom did blood test about 10 days ago and it came back as very  normal and with very good results. Her family doctor said the results are very good and so far the best. However, I took my mom to the same Hospital where she did liver ultrasound and we talked with this lady, NP, who told us that we need another ultrasound in a month ( bc of health insurance covering every 6 mo ) and to see what's going on. But, she shocked me when she said my mom's liver has cirrhossis according to the last ultrasound test that she did 5 months ago. I asked for the copy of ultrasound and I showed it to two doctors who said they can NOT see any signs of scars tissue or cirrhossis whatsoever. Mom is feeling great, normal and all good although she had some kind of depression and stress a few months ago when she was about to do ultrasound test but for the past few months, without stress or anything she has no major or even minor problem with health.  Now, my question is: How can they say a lot of scars on her liver and this NP even said cirrhossis when on the copy of ultrasound said this:

"Liver: The Liver is normal in size and echogenicity. The echotexture is smooth. No focal intraphetic mass is identified. There is no intraphetic biliary ductal dilatation. There is hepatopetal flow in the main portal vein. The surface of the liver is smooth. ARFI measurements were acquired: 1. 21, 2.17, 2.25, 2.8, 2.95, 3.42, 3.7, 4.17. Resultant ARFI median is 2.9 m/s."

I am afraid that they actually think there is cirrhossis or scars tissue according to this ARFI measuremtns as her median is 2.9 m/s. Can someone explain to me, please ?

"ABDOMINAL AORTA AND IVC: The visalized portions in the upper abdomen are unremarkable."
PANCREAS: The visualized portions of the pancreas are unremarkable.
SPLEEN: The spleen is normal in size.
KIDNEY: Survey sagittal images of both kidneys show no hydronephrosis. There is a smple cortical cyst measuring 0.9 x 0.9 x 0.9 cm in the posterior cortex of the right kidney."
OTHER: There is no fluid in the uppear abdomen.

IMPRESSION: Unremarkable ultrsound of the liver. ARFI measuremtns as above. "  - That's it about ultrasound.

This ultrasound was performed in June this year/last summer. Now I am posting blood test that she did 10 days ago:

BLOOD SUGAR 89 / range: 65-110 mg/dl  
UREA NITROGEN BLOOD ( BUN ) 17 / range 6-24
CREATININE, BLOOD 0.73 / range 06-1.4
BUN/CREAT 23.3 / range 5-26,
SODIUM 140 / range 135-148,
POTASSIUM 4.4 / rangr 3.5-5.5,
CHLORIDER 105 / range 98-108,
ALK PHOSPHATASE 44 range 35-115,
CARBON DIOXIDE 28.6 / Range 21-31
CALCIUM 9.5 / range  8.3 - 11.0,
SGOT/AST 19 / range 7-48,
TOTAL PROTEIN 7.1  / range 6.0-8.5,
ALBUMIN 4.5 / range 3.3-5.2,
TOTAL BILIRUBIN 0.65 / range  0.2 - 1.2

CBC WITH DIFF

WBC 5.8 / range 4.0 - 10. 0,
RBC 4.43 /  range 4.1 - 5.4,
HEMOGLOBIN 14.5  / range 12.1 - 15.4,
HEMATOCRIT  43.5  / range 37.0 - 47.0,
MCV 98.1  range 82.0-99.0,
MCH 32.7  range 27.0-33,
MCHC 33.3  range 32.0-36.0,
RDW 12.3  range 11.5-14.5,
MPV  10.6  range 7.4 - 10.4,
PLATELET COUNT  161  range 130 - 400,
POLYS 41.8  range 40 - 75,
EOSINOPHIL 1.3 range 0.0 - 6.0,
BASOPHIL 0.2  range 0.0 - 5.0,
LYMPHOCYTE  51.1  range 18.0 - 47.0,
MONOCYTE 5.6  range 0.0 - 12.0,
ABSOLUTE NEUTROPHIL COUNT 2.4  range 1.8 - 7.7

Hepatitis B DNA IU/ML 912  

HEPATITIS B DNA COPIES/ML  5308

Comment: Reference range: Target Not Detected or <20 IU/ml ( Dynamic range: 20 - 170.000.000 IU/ML ) ( 116 - 989. 400.000 copies/ML )
This assay was performed using Rosche Taqman Polymerase Chain Reaction ( PCR ) Assay.

HEPATITIS B DNA LOG IU/ML  3.0  

HEPATITIS B DNA LOG COPIES/ML 3.7

That would be all I have for right now.

Can anyone help me on this, please ?

Thank you

Al

[stef2011]

look for a fibroscan although like for hbsag quant it is very difficult to find in US.we have it in every hospital in europe since 2000 but Us didn t want to approve it for more than a decade...you know biopsy is another source of big money although you cannot monitor fibrosis or cirrhosis severity by that

[terrywillbeok]

probably u are right, endoscopy cost me 2k bucks to do it. my insurance cover most of it but i still need to pay 400 bucks . anyway Kaiser Permanente
is the best hospital in my city.

[stef2011]

keep in mind that US is among the most outdated countries in the world on hbv.europe, india, asia and even soem third world countires have better tools, doctors and hospitals

[stef2011]

US is not so briliant at doctors and hospitals, they are witches definitively and probably are so outdated that they dont even have a fibroscan

or they are just robing your money

endoscopy "IS NOT A TOOL TO DETECT ANY CIRRHOSIS", GO HAVE A FIBROSCAN TO KNOW IF YOUR LIVER HAS ANY DAMAGE"

[terrywillbeok]

after i have done a endoscopy , they give me a litter " we suggest no cirrohsis of liver "

[seza81]

I think you didn't understand from him/her, endoscopy is a simply endoscop through your mouth it can't diagnose cirrhosis , but maybe  your Dr was talking about varices, only Fibroscan, and liver biopsy can confirm your mom's cirrhosis

[terrywillbeok]

I dont know , he is a specialist ( works in a big famous hospital )  , probably he is not a stupid? i prefer to trust him. endoscopy can be see cirrhosis.

[StephenCastlecrag]

An endocopy of the GI tract CANNOT see your liver, at most it can be used to see if you have any varices, a frequent results of liver cirrhosis. Please get your facts right.

[stef2011]

US can see a cirrhosis only when the liver is complitely gone because you can see nodules but still needs fibroscan to confirm because it is not nodules to make a liver failure but fibrosis plus other things and you dont see fibrosis by US

a liver can have nodules but work perfectly

[stef2011]

my god are they doctors or witches?you dont see cirrhosis from US or  endoscopy, you only see it from fibroscan

[terrywillbeok]

my ultrasound report says I have cirrhosis on the liver then they sent me to a specialist liver and gao doctor , when the doctor saw my blood test result , he said that to me , u dont have cirrhosis , and he wasnot recommanded me to do a boipsy . anyway i wanna do to other test about my cirrhosis on my liver . then he have done a endoscopy for me, at the beggining he said if we see something on ur liver during the endoscopy then i need to do a boipsy . thank god! my doctor dont see anything on my liver .
so i think u can ask ur doctor if he can do a endoscopy for ur mom, it is much safe. hope this helpful and sorry my poor English. good luck

[European86]

Yeah, this lady that provide and done fibroscan on my mom said 2.6 is a great number.

All Praise to Almighty God.

[mike9111]

2.6? This sound as more than a perfect liver but members can correct me if im wrong

[European86]

Just some update.

I took my mom for fibroscan test today as recomended by some of you here.

Here is her results:

"The patient's score is 2.6,  F0-F1 no or mild fibrosis."

So, for interpetation of this result see below:

F0 - F1 = 2.5 - 7.4 no or mild fibrosis
F2      =  7.5 - 9.4 moderate fibrosis
F3     =   9.5 - 12.4 severe fibrosis
F4    =   12.5 + cirrhosis

__________

So, mom's number is at 2.6 of F0 or 1.

[European86]

Thank you for that answer.

[European86]

Thank you for that answer.

[studyforhope]

The diagnosis of cirrhosis in your mom was apparently arrived at as a result of acoustic radiation force elastography, a new method to determine liver stiffness in several spots. It is a similar principle than the one in the Fibroscan test, but it uses acoustic frequencies instead of very low frequency shear wave propagation analysis. While there is less clinical experience and research available with this nrw technique compared to Fibroscan, a direct comparison has shown a good correlation of results between these two techniques.
The noninvasive determination of liver stiffness is obviously of extreme importance in practical hepatology and also represents a huge market for machine producing companies. A third method using shear wave propagation measurements is based on magnetic resonance imaging.

Spleen size, albumin and platelet values do not point to anything like advanced cirrhosis in your mom, but are not incompatible with mild cirrhosis. The morphological findings on the US also do not rule out that diagnosis.
Finding a place that performs Fibroscan is indeed your best choice to further clarify this issue.

[Dan_Brown30]

Good to know! Thank you!

[Emily_MHManager]

Hi everyone -

While being rude is never acceptable on our site, we do want to caution people about using unproven herbal treatments to treat a serious condition. Please know that even herbs have side effects, and most have not been studied for safety for those with liver conditions.

Herbal treatments may help, but use with caution. We have an Alternative Treatments Community for those who many want to discuss this further - http://www.medhelp.org/forums/Alternative-Therapies-/show/685

Emily

[stef2011]

i am rude because we have these spammers coming to our community from time to time with the herbs from africa or the balcans, they are always the same and since we have all the drugs we need to fully reverse cirrhosis it is best to keep them away from here

[stef2011]

this community is not about alternative medicine, there is a channel for this, this is only about drugs for hbv and cirrhosis with clinical trials

we dont need anything else because approved drugs work fully to reverse liver damage

[Dan_Brown30]

Thank you so much and I am sorry if this sounds as a spam in your topic.
All the best to you and your mom!
Get better soon!
D.

[Dan_Brown30]

Hi Stef,
I think you are a bit rude asking European86 to stop posting "things".
In the matter of fact this is his topic and I was the one who had interest in these "stupid" herbs. Some people here are not on treatment because you have to qualify for it ( at least in UK). I am 31 having normal LFT, 6.8 FScan,
I have spoken with many doctors and all of them think I should not start treatment at this stage. In general I have no access to antivirals ( I dont have money to buy them every month for unknown time and I dont qualify for free treatment) So yes with herbs as milk thistle , dandelion , artichoke and healthy lifestyle  I am trying to help liver to work normally ( not to cure HBV - we all know herbs cant do it.Right?)

[European86]

Ps. That's why it is irresponsible to ignore one or another medicine ( standard / conv. or alternative natural medicine ) but to try to put it together and, of course, have to be very careful. Healthy life style and healthy foods is nothing but natural alternative medicine of which we are both talking about.