Biopsy results

[Linda__0__0]

  Hello,
  I've posted many questions to you regarding my sons hep c.  Thank you so much for your responses.  I received a copy of my sons Liver biopsy.
  It read:
  Grade 2, mildly active chronic hepatitis consistent with HCV.  There is 0 to 1+ hemosiderosis, 1+ microglobular steatosis and stage II periportal fibrosis with rare septa.  The inflamation (inflammation) is mild and there is little necrosis.  There is no evidence of cirrhosis.  
  COuld you please exsplain this to me in your own words?  I know having no cirrhosis is a good sign, but what about the other information in the biopsy.  He is still not curently on any treament, I'm still confused on what is best.  I'm afraid he will not be handle taking interferon.  He already suffers from a low white count (3.4) ..We see the doc in a few weeks reagarding treatment..I know when to start treatment is a tough decision, I will have to do more homework to see what is best for him...I've been hoping some new treatments will come available...Ive heard about a pegly interferon which doesent seem to have the side effects..Thanks again for all the info you have given me..I love this site and it is very helpful.
  Have a nice day
  Linda  :)

[HFHSM.D.-D.M.]

_
Dear Linda:
Thanks for getting back to me with the actual biopsy information.  I’ll try to make a few comments about the biopsy and about treatment.
Steatosis and hemosiderosis refer to fat deposition and iron deposition in the liver.  In your son’s biopsy, the pathologist felt these were mild and I won’t comment on them.  probably the most important thing to me in looking at the biopsy is the amount of fibrosis or scarring.  Fibrosis is scar tissue that forms as a result of persistent inflammation.  If you cut your skin, you form scar tissue which is good.  However, if you inflame the liver, you can develop scar tissue or fibrosis which can be bad.  If the fibrosis advances, it can start to destroy the liver. Typically fibrosis starts around the portal tract and the mildest form of fibrosis is “periportal”.  As the fibrosis extends, it typically extends kind of like spokes from the center of a wheel.  The spokes are called fibrous septae.  Cirrhosis is the most advanced form or fibrosis and indicates there is substantial damage to the liver.  However, a liver can still potentially function well with cirrhosis.  However, if the underlying cause of the liver disease is not identified and treated, a cirrhotic liver will usually ultimately fail.  
If a biopsy shows peri-portal fibrosis this is very encouraging though we occasionally see biopsy’s with no inflammation at all.  A person with peri-portal fibrosis has time to think about treatment options because it should be many years before the liver damage advances.  However, decisions on therapy can be complicated because, with current therapy, people tend to respond best when they are early in their course.  In other words, a relatively early biopsy means you have time to wait but it also means you have a better chance of responding to treatment.  In addition, if someone is very young, even if their disease is moving slowly, there is a significant chance the virus will cause marked damage to the liver in their lifetime.  
Decisions on treatment are a very individual thing.  I sit down with each patient as an individual and decide what is best for them.  A good decision for one individual maybe a less ideal decision for another.  I do want to comment, however, that while pegylated interferon looks very promising, it has many of the same side-effects as standard interferon.  
I hope this information is helpful to you. Good luck to you and your son.  I would invite you to contact us again with additional concerns or questions. You can contact us directly at [phone].
This response is being provided for general informational purposes only and should not be considered medical advice or consultation.  Always check with your personal physician when you have a question pertaining to your health.