Varices associated with hepatitis c are seen in cirrhotic patients. I suppose that it's possible for someone with advanced fibrosis to have varices but I suspect it is not at all typical in non-cirrhotic patients.
I have read that platelet count and spleen size can be predictors of varices but I don't know the parameters. Also portal pressure might give you a clue if you want to try and get that measured.
If I was stage 3 I wouldn't worry about varices unless my doctor was concerned.
If you have stage 3 fibrosis there is no reason to worry about serious life threatening complications from hep-c including Liver cancer (HCC).
Even if you develop cirrhosis you may not experience any symptoms. Over time and it can be many years, if your liver disease continues to progress you will develop signs of cirrhosis which can be detected by your doctor using physical and laboratory tests.
Liver cancer, portal hypertension, enlarged spleen, varices, ascites, edema, etc. are all symptoms of stage 4 cirrhosis. This occurs when your liver is so scarred it can't perform it functions properly and so starts effecting other body systems.
It is best to treat your HCV before developing stage 4 cirrhosis as cirrhosis makes it more difficult for HCV treatment to be effective and clear the virus.
Varices are primarily a result of decreased blood flow through your liver as a result of the damage it has sustained. Being closest to the liver, your esophageal veins tend to be the first to be affected. Varices are the result of the back pressure resulting from the decreased blood flow.
The best means for detecting a monitoring them to have a endoscopy performed. If it reveals varices are present it may result in routine annual endoscopy to monitor them.
If it reveals that there have been rupture, or at risk of possible rupture in the future, then they may also band those veins at greatest risk to avoid or mitigate risk of massive internal bleeding.
Varices can occur at any level of liver damage where portal hypertension is occurring, but most often are related to extent of damage. Thus they are most often seen in those, like myself, with cirrhosis. They are not restricted to advance cirrhosis, but can also be present during the early stages too.
The key is to have an endoscopy done if there is a suspected risk of having varices and determining from there frequency at which subsequent procedures should be done to monitor any varices present.
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