Liver Biopsy Results

[patti1957]

hey folks - i have posted a few times - now in 10th of 24 wk TX (gt 2b) but i am still confused as to the degree of liver damage i have. i just found out a few months ago i had hep c (undiagnosed for close to 30 years!) before i started tx, i had a liver biopsy. (fyi - i was never a heavy drinker, but now i know i will never have a drink for the rest of my life)

the direct quote from biopsy "in my opinion, the changes are that of a chronic active hep and also there are regenerative nodules surrounded by fibrous tissue.  the changes present are compatible with a viral hepatitis. in my opinion, this is grade 3, stage 4 disease"

the "grade 3, stage 4" notation is concerning the hep c OR the actual liver damage????  i saw a site where cirrhosis was graded differently.  my first GI told me not worth doing the tx - made me feel like i was on my death bed (i have no symptons of liver failure) but my 2nd GI (a liver spec) prescribed the TX and comments that the pegasys/copegus may help my liver heal?

any ideas folks???   thanking you all for all your prev info

[HectorSF]

"i am unsure as to what my viral load was before i started tx - the blood results show 1,560,000 HCV RVA (IS THAT THE VIRAL LOAD???) and after my first 4 weeks of TX, the doc told me the virus cleared (i guess that's UND?)"

Yes your viral load was 1.56 million. Now the virus is undetectable! Fantastic!
That means you have about a 90% chance of SVR. You want to clear this now, as your stage 4 liver damage increases, the chances of clearing the virus goes down.

Be compliant with all meds. Don't miss any doses. How are your blood levels looking? Talk to your doctor now about what he will do should your WBC, platelet count, and RBC drop to low levels. You don't want anything to stop your treatment now.

You are in a great position to clear the virus and stop the progression of your liver disease. Good job!!! You decided to treat at the opportune time!

All the best! You can do this!
Hector

[patti1957]

thanks for the info - i am unsure as to what my viral load was before i started tx - the blood results show 1560000 HCV RVA (IS THAT THE VIRAL LOAD???) and after my first 4 weeks of TX, the doc told me the virus cleared (i guess that's UND?) but he seems me to want to continue.  as far as my first doc, he advised me to seek a 2nd opinion - i think he just wasn't all that schooled in hep c and as far as the liver biopsy goes, the technician who wrote the report gave much more detail prior to the quote i supplied.  i do know this is the time to treat and stop the damage to the liver in it's tracks - i will stay on the tx for as long as the doc suggests.  it's been a gnarley ride with the sx, but i think i'll get thru it  >;o) THANKS FOLKS - i know i can rely on you for great info and it's a blessing to know you wonderful folks are out there GOD BLESS !!!

[sldb]

Dont let your docs keep you from treating.  I am stage 4 also  and am now svr for almost 2yrs, my hep didnt give me much hope either. Are you und yet? if not you may want to consider extended tx. as willing stated above.  Pls. keep us updated... I was never a drinker, and still ended up with cirrhosis. GOOD LUCK...Leah  

[willing]

just wanted to add to Flguy's comment that having G2 is a BIG advantage - don't let your 1st Drs outlook get you discouraged. You may want to get another pathologist to look over those slides - the commentary seems a bit short on explication of the stage assignment; the difference between f3 and f4 has to do with the extent of fibrosis as well as changes in the normal architecture of the cells. Wouldn't hurt to confirm that two sets of trained  eyes see the same thing. Lastly, you don't mention VL drop, but as a possible F4 you want this to work. If you showed any VL at 4, you may want to directly continue to 48 rather than risk having to restart.

[FlGuy]

The 'stage' relates to the extent of liver fibrosis.  There is some subjectivity to the various stages even though the pathologist writes "in my opinion" the stages are ;0 = No Fibrosis, 1 = Mild Fibrosis, 2 = Moderate Fibrosis, 3 = Bridging Fibrosis, 4 = Cirrhosis.

At stage 4, it's a good thing that you are treating.  Cirrhosis can cause a patient to be harder to treat.  As a geno 2 you have an advantage.  Keep up with the med schedule.  People with cirrhosis can get to svr.

[patti1957]

from above - sorry - here's some more of my info - the virus is gone after the first 4 weeks of tx and my AST is 46 and ALT is 44

i started out in feb AST of 62 - ALT 69

thanks for any input and all your previous info - thanks guys !!!  >;o)