Fibroscan: Is it any good?

[mike716]

Hello again, fellow Medhelpers! Greetings from Buenos Aires, where we avidly await the beginning of spring. The winter down here in the Southern Hemisphere has been too long, and some people here think there won't be any summer at all this year. Global warming, melting ice caps, and all that sorta stuff. Argentines are hysterical. But it sure is unseasonably cold.

I hope I am still remembered by y'all with affection in spite of my past weird and occasionally wicked postings. I certainly haven't forgotten any of you dear people. You have been my port in the storm.

To give a quickie update, I am still without Tx, waiting for my hep MD to make up his mind what to do with me. I think these Argentine medics are kinda scared to do anything, afraid of scandal (can you see the headline: "American Tango Dancer Succumbs to Third-World Hepatitis Treatment"?).

The latest, and the real reason for this post (aside from my penchant for aggravating everyone with my dubious attempts at humor), is that they just got a Fibroscan machine at my hospital, trained a young female medic to run it, and I have been one of its first victims...er, I mean subjects.

The results are crazy and scary. It gave F2/F3. Now, just a year ago a biopsy and a FibroTC (tomography analyzed, see my images page), as well as many blood analyses and ecodopplers and whatnot, gave me as being F0/F1. How the heck can someone with almost normal hepatic enzymes (transaminases), otherwise totally normal blood tests, and scores of F0/F1 a year ago, suddenly be F2/F3? Is this possible? Is it credible? Or is their new Fibroscan machine a piece of junk, despite the cute operator?

Anybody out there with an opinion on this, my latest predicament?

All replies will be appreciated, and the one that is most helpful wins a free trip to Buenos Aires (by kayak and Moped) and three free tango lessons from yours truly (if I'm still above-ground).

Hugs.

Mike

[mike716]

I tend to agree with you, Trish. The time has about come. And I think the idea of doing a trial back in the States may very well be my best option at this point. But after five years here in Buenos Aires, it's a really hard decision to make.

How do you see a VL test that only goes down to 50U/ml working during a trial? How can you tell if and when you're SVR with such a test? Wouldn't it just be shooting in the dark?

M.

[Trish77]

And what about doing a trial in the US?  Is that possible?  You're still an American.  You might not need medicaid or insurance of any kind to do a trial in the US.  In most cases, you're getting top notch care - alot of trials are done out of major medical centres.  And as for the Medicaid, it's the doc you have and the treatment you're getting that is important.  You may qualify for the drugs to be free if you go through the drug company's assistance programs.  You put up lots of roadblocks, Mikey.  Start taking them down.

I think I'd like to see you do treatment and get it done.  I'm still not buying the F3/F4 diagnosis - even if you're there and the scenario has gotten more complicated, you can't change that, can you.  You still have to go for it and get it done and it ceases to be a matter of if but when and how.  

I'd check out both options - treatment in the US with a good medical team - pick your centre - isn't Mount Sinai where Dr. Dieterich treats out of in your 'hood? - and check out the protocol they're using in B.A.  A test of <50 is workable as long as the protocols you're being treated with are sufficient - the dosages, the testing, all that.  You can get tested sooner than 4 weeks, if they'll agree to it, to give you a good idea how you're doing up until that 4 weeks.

Anyway --- seems the time has come, don't you think?

[Rockerforlife]

The NS3-4A serine protease enzyme and the NS5B RNA-dependent RNA polymerase enzyme are primary targets for oral antiviral agents, since both enzymes are essential for HCV replication. Unfortunately, HCV's high replication rate -- billions of copies per day -- leads to drug resistance. In fact, mutations in HCV's protease and polymerase domains have already been characterized, both in vitro and in vivo (Le Pogam 2006; Zhou 2008).

The consequences of acquiring HCV drug resistance are currently unknown; it may be a transient phenomenon since HCV does not integrate into the host cell's genome. But it is possible that mutations may confer resistance to an agent -- or an entire class of agents. Drug-resistant HCV may be less fit, but a lower replication capacity will be a scant consolation for people who have acquired a treatment-resistant virus (Mo 2005; Zhou 2007). Studies of people who have developed resistance to HCV antivirals should be performed in order to fully understand the clinical implications of HCV drug resistance.


http://www.thebody.com/content/art46370.html

"If an atheist has to go to court, do they make him swear on the Bible?"

[Rockerforlife]

P I just means protese inhibitor......polymerase inhibitor is  a different drug ,im not sure of the short lingo for it,i think its just Poly.

Yes,ive read if you dont respond to the PI`s,you can still do the Poly.,im not 100% on this ,but ive read it

[mike716]

You wrote: "When you do PI`s,and you dont respond,its known the virus mutates and becomes resistant to that PI.But ive heard you can still do the Polymease Inhibitor.and you can still do SOC."

Do you mean that you can still do another polymerase inhibitor?

M.

[mike716]

I read that,too. In the enclosed brochure. But I took it to mean that if you've got hepatic insufficiency then your liver can't clear it and that it therefore stays in your system longer, not that it causes fibrosis or liver disease. It's not the same thing, I don't think.

But it is a worry. All meds are a worry when your liver's not right. I've stopped my dental work from fear of amoxyciline, a baaad antibiotic that's what they prescribe for dental surgery. It also loused up my intestines so that now I've got Irritable Bowel Syndrome. Antibiotics are nasty. So, probably, are all sorts of other drugs.

And these pill-pushers just keep pushing them. Seems like that's about all they know how to do.

Mike