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Just diagnosed with hep c.
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Just diagnosed with hep c.

Hi,
I was just diagnosed last week with hepatitis c. I have no health insurance so I am going through the "charity" hospital. My doctor has ordered an ultrasound as oppose to a liver biopsy. That being said my AST was 413 and ALT1181. Doctor was really surprised that my enzymes were that high. I am otherwise in good health. My question is, would an ultrasound be sufficient enough to see what kind of damage my liver has so far?
16 Comments Post a Comment
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5326543_tn?1367590865
just recently joined here myself. i hope mentally you are dealing with it well. my first hep dr did both. but as far as the only thing no my dr said she had to do both. it was scary but it wasnt that bad. i would just ask if it were me.. hope it helps...
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1747881_tn?1358189534
"My question is, would an ultrasound be sufficient enough to see what kind of damage my liver has so far?"

No, an ultrasound will be able to tell you whether you have cirrhosis or not but is not a good tool for grading and staging fibrosis, I had a perfectly fine ct scan and was diagnosed stage 3 grade 2 through biopsy
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Avatar_f_tn
While an ultrasound can show a good amount of information, keep in mind that it won't be a complete picture. Nothing beats actual "eyes on"  My husband was diagnosed with HCV in Dec 12 and in Feb 13 he finally had a liver biopsy.  The ultrasound did not show any inflamation (inflammation) and combined with other liver tests we felt at the time that the damage was minimal to his liver.  When we finally got the liver biopsy results back we were devastated when we were told he was already stage 4.  This may sound rather extreme and maybe it is.  But also remember that a liver biopsy is only going to show that "spot" of the liver it was taken from.  It does not mean that it is uniformly damaged at that stage.
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2135877_tn?1381864726
Shdwsidy is correct.  I've had fibroscans, ultrasounds, MRIs, etc.  They all showed conflicting results.  Unfortunately, a biopsy is really needed to assess damage.

I can't have a biopsy, since I'm a hemophiliac and it's not recommended.
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Avatar_m_tn
Im a hemophiliac and have had 2 biopsys through the jugular vein  
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2135877_tn?1381864726
Really, Johnny?  It's standard procedure at my hospital to not give biopsy's to hemophiliacs.  Perhaps I should push the issue.
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Avatar_m_tn
Hi , you will need to have a biopsy , ultrasound and then probably a fibroscan could be misleading as you have high liver reading , alt etc , your fibroscan may show a higher reading  .
I have had high alt etc readings for a long time , about a year and half ago I had a fibroscan and had a score of 16 ( cirhossis ) which scared me .  I then had a biopsy which showed stage 2 fibrosis .
I have another fibroscan coming up in 6 months to be honest I have lost trust in those machines . I will probably have a biopsy again in a couple of years , but hopefully not if something good comes out ( non interferon ) for genotype 1 null responders .
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Avatar_m_tn
Eki , I had 2 biopsys jugular vein , no dramas was back at work within a few days , just careful no lifting for a few days , but really no big deal .
Waiting for the results is the hard part .
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2135877_tn?1381864726
Thanks, Johnny.  I don't have health insurance right now, but when I have it, I'll put pressure on the doctor for a biopsy.  I should have health insurance in a few months, hopefully.
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1840891_tn?1383280315
Welcome to the forum! I just wanted to add support to what you've already heard: no, an ultrasound is not adequate! Some doctors seem to want to believe they are, maybe its a cost-saving mentality, or maybe they think they are shielding patients from painful procedures (a biopsy is not that bad), I don't know what it is. My own hepatologist, who as former head of liver transplant at Stanford University Hospital, ought to have known better, allowed me to go 14 years between biopsies just because my ultrasounds looked okay. When I had major surgery for a choledochal cyst they were shocked by the horrible condition of my liver, biopsied it, and diagnosed cirrhosis. I woke up to the news that I should get my life in order. Before that surgery I had still been consuming wine with most dinners, in the belief that my liver was still not being damaged by the HCV, when in fact it was nearing the end of the road. After surgery I totally stopped all alcohol and reformed my eating habits and OTC meds as well, and my cirrhotic liver has held up as compensated cirrhosis for 9 years now. Last year I completed the triple tx (my third try at treating the HCV) and as of March 2013 I am SVR.

My point is that it is very foolish to trust in ultrasounds for liver condition. I think they really tend to see what they expect to see. When my medical records only included my first biopsy, with very little damage, the ultrasounds always looked smooth to them, right up to and including the last one done a few months before surgery. After surgery, when my records clearly stated cirrhosis, the ultrasounds have all shown an uneven heterogenous texture. Ultrasounds are great as screening tools for liver cancer, but they really suck at visualizing fibrosis or cirrhosis.
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Avatar_m_tn
Thanks everyone!
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Avatar_f_tn
I have HCV and Genotype 1b.  Not a good genotype for interferon treatment and now that I am stage 3 (from liver biopsy this year), I was just about to begin the triple therapy.  However, this week my doctor recommended me to a phase III non-interferon oral medication clinical trial.  There have been great results for 1b in some trials 80 to 100% cure with many fewer side effects.  Has anybody out there participated in such a clinical trial?  I guess I will join this community and post some updates.
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Avatar_f_tn
Deidrewan,
Here is an article that I have posted in my journals.  It was originally shared with us here on the forum by a forum member named specda.  It gives some information about criteria for evaluating clinical trials and making sure an individual trial is in your best interest:

http://www.medhelp.org/user_journals/show/332520/Clinical-Trials-and-Medical-Research-in-Hep-C

Is your doctor a hepatologist?

Advocate1955
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1840891_tn?1383280315
You've probably figured this out by now, but just is case: we have a lot if forum members who've been in the non-interferon drug trials and results seem to be excellent at this point. I'm not one of them, having just successfully completed the triple tx and having achieved SVR, so I can't give you a lot of details on the new drugs. If you search within medhelp I'm sure you will find some of the threads, but if you have trouble then try posting a new question about it - that's the best way to get attention. Good luck!
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Avatar_n_tn
Where I live here in BC, there were two women and two men that were 1a and 1b's and they took the new drug last year, all 4 of they cleared their Hep C. So, that was very hopeful for sure.
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Avatar_f_tn
Usually, a biopsy and ultrasound are used together, at the same time or alternatively for a doctor to know your status and to determine plan of treatment for patient.
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