Biopsy results

[Gracie_Lue]

I had got my biopsy results recently which was stage 3 fibrosis. I had got the results by phone and was kind of in shock so didn't really ask many questions. I had called back today to kind of get a little better understanding of where I'm at. I had read and heard that you can be stage 3 but close to stage 4 or just at the begining of stage 3 so anyway the results said Ludwig and batts 2 of 4 stage 3 of 4 and I also asked for my viral load which is 20,700,000. The guy I was talking to couldn't really tell me where I was at in stage 3 or what ludwig and batts is? I think it was some kind of scale or something. Does anyone know what that meens? Also he said not to worry about a high viral load which I'm sure he's right but does that seem a little on the high side? Thanks in advance.

[Gracie_Lue]

I'm starting treatment In August. I decided to wait a little longer due to both of my baby's birthday's. I don't want to feal worse than I already do Because I do a big party and stuff for them. Willb yeah I guess it doesn't really matter too much as to where at in stage 3 I am. I'm probly just obsessing over being scared that I'm close to stage 4. I was reading that a high viral load could lower you'r chance for clearing in treatment? I don't know how true that is but that's what I've been seeing on the net. Maybe it would just meen longer treatment? I'm genotype 1 so I have a longer treatment anyway. Thanks for the comments guys : )

[HectorSF]

AS other have said. You need to start planning on treating your hepatitis soon. Perhaps when the new meds are available to you. (If you are genotype 1). As the amount of fibrosis progresses the odds of clearing the virus go done so you want to treat relatively soon. Before cirrhosis for sure.

Here is more info on the Batts and Ludwig system used to evaluate the the condition of your liver.

http://www.medpedia.com/questions/2252-there-are-4-stages-of-cirrhosis----are-there-also-grades

One grading system used for assessing inflammation and fibrosis is that of "Batts and Ludwig".

Grading and Staging Liver Disease on Biopsy :
Grading describes the degree of inflammation and necrosis.

Necrosis One of the two mechanisms by which cell death occurs (the other being the physiological process of apoptosis). Necrosis is caused by the progressive degradative action of enzymes and is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, and uncontrolled cell lysis. Decay or death of one or more cells, resulting from irreversible damage. Death of living tissue; death of a portion of tissue differentially affected by local injury (as loss of blood supply,burning, corrosion, or the local lesion of a disease

Grade 0 no inflammation
Grade 1 peri-portal inflammation no hepatocellular necrosis
Grade 2 inflammation with mild interface hepatitis
Grade 3 severe portal inflammation with moderate interface hepatitis
Grade 4 marked inflammation with severe interface hepatitis

Lobular:
Grade 0 no inflammation
Grade 1 minimal, no necrosis (inflammatory cells within the lobule)
Grade 2 moderate inflammatory cells with occasional liver cell necrosis
Grade 3 marked inflammation with severe focal liver cell necrosis
Grade 4 extensive inflammation with bridging necrosis

Staging describes the degree of fibrosis (scarring).

Fibrosis:
Stage 1 none or mild peri-portal fibrosis
Stage 2 peri-portal fibrosis with/without extension and portal-portal bridging
Stage 3 portal-central bridges but no nodular formation
Stage 4 probable or definite cirrhosis

There's 3 stages of Cirrhosis:
Stage A ("compensated"; not too sick)
Stage B (beginning to decompensate; complications beginning to appear)
Stage C ("decompensated"; end stage)

Good luck.
Hectorsf

[NorthIdaho54]

Make an appt with your doctor and have him go over the biopsy report with you (make sure to take your list of questions to ask.) I would include any questions about tx also.

I asked for a copy of the pathology report. Mine had a lot more detail in it than what my doctors clinical report stated.

Every time I checked in for an appt. I would ask the receptionist to print out any current lab work so I could go over it myself before seeing the dr. or tx nurse.

Take care - Rhonda  

[willbb]

Hi gracie...Ludwig and batts  is one of the scoring systems used by labs and clinicians.
Where you are at exactly in stage 3 is really of not much significance at this point as you have already decided to treat this fall,as I recall you saying from a previous post.

The viral load is considered clinicaly high ,however that also is nothing to concern yourself with as 1) it fluctuates all the time and 2) your viral load will be taken at the very start of treatment ,and how the load responds to such is the  important number going forward.

Best to you

Will

[Diane12855]

I don't know about the Ludwig and Batts thing, but I do know that stage 3 means you need to be talking with a specialist face to face, not the nurse over the phone. You said, "Also he said not to worry about a high viral load which I'm sure he's right but"... First thing you need to know is you can NEVER be sure that he is right. Unless the doctor's office that this call came from specializes in Hep C patients, there is little chance that the office people there know much of anything about the disease.

I went to college to be a Lab tech in 2003, and shared many classes with RN students. All of the info that we got on Hep c was one paragraph in one course. There was lots about Hep A and Hep B but only one paragraph about hep C.

My viral load was 6 million. You don't really need to worry about that until you are doing treatment though. That is how they know if the drugs are working... if your viral load drops quickly.

I can tell you one thing though. With fibrosis at stage 3, you need to get started taking care of it soon. You aren't very far away from cirrhosis. Stay away from alcohol for sure.

This is a great place to come for info. I made it through my 48 weeks of treatment largely because of the help and support I got here. Welcome to the group.

Diane