Eating Prior to FibroSure (with venting)

[jab1979]

My liver doc never wanted to order a FibroSure test on me, because he felt my labs were to good to really worry about anything drastic. 27 years old now, probably had HepC since age 2 from contaminated hemophilia blood products in the early 80's. So, a nurse practitioner who is under hematology, decided to play doctor and order a test without my Gastro. Docs consent. Turns out the test showed some scary and startling stuff in relation to liver activity and damage. By scary, I mean shockingly bad. But, the nurse never told me to fast prior to the test, and I read elsewhere that fasting is a requirement for FibroSure, it even says it on their LabCorp PDF from their web site not eating at least 8 hours prior. Well, me not knowing this bit of vital information went out and had myself a nice sausage biscuit, orange juice, then a Kashi bar and oatmeal cake as close as 1hour 45 minutes from having the labs drawn.

In theory, could eating so close to lab work be the culprit for a false positive? I know that eating prior to a CT Scan or Ultrasound is forbidden at least 8 hours prior, as it will read falsely. I am doing remarkably well considering my hemophilia problems from time to time. My labs are all normal range with exception of ALT and AST, and we believe those are elevated due to the high powered HIV cocktail I am on to combat that infection, which is working amazingly well.

I have also seen other factors for the test and protocols that could alter or show wrong readings including things like while on therapy, don't do test until 6 months post therapy etc.. I had mine done just at the 3 month mark from being off therapy, not sure if that made a difference, but I can tell you I was still metabolically adjusting even after 3 months post tx.

Sorry to be using this space and time for a venting session. Just wanted to share what I've been dealing with the past month.

[iceman778]

I had the test without fasting as told I did not need to by dr.s office

[MarkFly1]

Thanks Copyman.  I did have a biopsy which indicated a score of F0-1 in between two Fibrosure tests.  My other blood numbers suggest a more healthy liver (I don't have a spleen).  I'm wondering if the high alpha 2 macroglobulin is high because of kidney issues.  I've had some frothy urine in the last couple of months.  ???

[Forseegood]

Just wanted to tell you, that I can't comment on your case of course, but I spoke to Hepatitis Researcher, and he feels that you would do well to get a fibroscan...if this appeals to you, I'll let you know how to contact me...

[jab1979]

I can't have a biopsy due to severe bleeding from hemophilia. I also suffered from toxicity back in January 06 due to a very potent regimen of HIV meds that I was on to combat that infection. The Meds kinda started this whole liver ordeal with the enzymes being elevated, but my doc is reluctant to change anything at this point. I have no other known problems with my body including bowels, kidneys, spleen, heart, lungs etc... Platelets last visit was 174K, and albumin levels were normal range.

I did have an ultrasound back in Jan. 06 after the toxic thing flared up from an much too powered cocktail. The ultrasound showed diffuse liver disease, with mild diffusion. When I asked my doc about that, he said more than likely it's fatty deposits on my liver surface from the many years of taking HIV meds. But he wasn't really all that concerned with the ultrasound, so I'm sticking by his judgment.

I am scheduled to have a CT Scan, Ultrasound and some sort of dye that shows liver function to rule out the FibroSure result. This happens the morning of April 27th. I'll be sure to let you all know what they see and find.

Thanks

[copyman]

i agree that someone with bad damage should have some other signs, like spider veins on trunk/face, red palms, and/or some other indicators on their bloodwork like out of normal ranges on one or more of the following tests, bilirubin, alkaline phos,albumin, platelets etc. did you have ultrasound or ct recently? not that the US or CT always shows cirrhosis but an enlarged spleen (over 13cm) with low platelets "could" be and indicator of cirrhosis.
with an F4 on the fibrosure i would consider getting a biopsy to see exactly where i was at. or if you are near one of the sites where there is a fibroSCAN machine you could get one of these non-invasive tests instead. and perhaps at least re-test with the fibrosure or similar with fasting this time. hope you are in the % that the test was false.

[nygirl7]

If you are really and truly concerned - now your doc (GI) should order you a biopsy to rule out these "shockingly bad" results.

I think the NP was trying to do the right thing in ordering the Fibro - most people would be glad it was ordered so they could see what was going on.  Are you more mad that it had the bad results?

Either way - I'd definitely want to know if they were correct.

Liver damage is not really something you can judge for sure without the biopsy (if you are that sure the Fibrosure is wrong).

But as for eating....................eating anything won't "show" as fibrosis.  The sausage biscuit couldn't change that. It's either there or its not.

[jab1979]

I got a copy of the test, not just some lab tech telling me.
1. Fibrosis Grade - 0.8 or F4 is the score
2. Necroinflammatory Activity Score is 0.66 - high

[ladybug52]

Sorry that she was trying to help and added more stress to your already stressful life.
If you didn't follow the testing protocol then I would not consider it a valid test. That's like testing blood sugar without fasting, and then when the numbers are elevated telling a person they are diabetic. Doesn't work that way.
Bug

[jab1979]

amen darlin'. That's what I'm assuming as well. I didn't follow protocol, thus the test is somewhat off. No doubt I have some damage, but I rebuke the results from that test.

[copyman]

i had the fibrosure test done and did extensive research on it as well. what were your results? if you do not have a copy of the test ask them to send it to you. i would not trust a tech tellling me the results, i would like to see them myself. like the other poster said the fibrosure is around 80-90% accurate but only for the low end F0 & high end F4 not the middle F2&F3. not sure if not fasting would skew the results that much but to be sure why not have the test done again? perhaps try a different labs type of fibrosure test making sure to fast this time. best of luck

[jboyhk]

Fibrosure test  does not have 100% positive predictive value. Depending on what study you read (the most optomistic is 88% from original founder study, to 75%).

You could easily be in the 12-25% group of a false positive, which may be likely since you have other health issues that might skew results.

[jab1979]

I don't know about this test result to be frank. The more and more I dig, the more I realize this nurse practitioner may have bit off more than expected by ordering a test that isn't even affiliated with her line of work. She's a close friend, and been with me almost 20 years, but digestive health is not her specialty, hemophilia is. Also the more I realize about certain protocols not being met, like fasting, the more I am doubting the validity of this test. Surely if I were this bad off as the test indicated, I would have "some" bodily indication of my declining health, which there is none. I have read several articles stating that people never find out they have severe liver damage until they accidentally find it on a health exam or routine checkup, and show no signs or symptoms. I know my body like none-other, having hemophilia has taught me pain, endurance and suffering, as well as living with HIV for over 25 years. I know when something isn't right, or something is wrong. I am somewhat trained to see a warning sign for all facets of my body from severe hemophilia.