There are a variety of ways to interpret a liver biopsy. The most common scoring methods include Metavir and the histologic activity index
(HAI) also called the Knodell. It is important to remember that the length of the liver specimen and the knowledge of the professional reading the
biopsy can influence the interpretation of the report.
The Metavir scoring system was specially designed to evaluate the liver in people with HCV. The scoring consists of using a grading and a staging
system. The grade gives an indication of the activity or amount of inflammation and the stage represents the amount of fibrosis or scarring.
The grade is assigned a number based on the degree of inflammation, which is usually scored from 0-4 with 0 being no activity and 3
or 4 considered severe activity. The amount of inflammation is important because inflammation somewhat correlates with the development of
The fibrosis score is also assigned a number from
• 0 = no scarring
• 1 = minimal scarring
• 2 = scarring has occurred and extends outside
the areas in the liver that contains blood vessels
• 3=bridging fibrosis is spreading and connecting
to other areas that contain fibrosis
• 4=cirrhosis or advanced scarring of the liver
Since you have stage 3 liver disease you should think about starting treatment. You don't want your disease to progress to stage 4 where it is much harder to cure.
What is an HCV Genotype?
Not everyone with hepatitis C (HCV or Hep C for short) has the same kind. In fact, there are six different kinds of HCV. These different kinds
are called genotypes and are numbered from 1 to 6.
Some genotypes have further divisions called subtypes (for example, 1a and 1b). The test to find out the genotype is a blood test.
is important because it tells you want treatments are best for you and can predict to some degree h o w w e l l treatment will work, and how
long someone will need to be treated. The important thing to
remember is that having a certain genotype does not mean that your liver
will become more or less damaged.
You have the same genotype as me. Genotype 1 is the most common genotype in the US. You can't change it but it is good info to know.
You should get an appointment with a gastroenterologist who has extensive experience treating hepatitis C patients successfully with new treatments. It is time to do something to stop the further destruction or your liver by the hep C virus.
You might want to read....
"First Steps with HCV — for the Newly Diagnosed (Updated 2012) "
Offers suggestions for managing the early phases of living with an HCV diagnosis.
f3 means you have moderate damage to your liver from your Hep C virus, and it is important to treat your virus now, before you progress to f4. F3 means that you have scarring on your liver and the scars are connected by scar tissue. As you progress to F4, those areas of scar tissue increase and the liver does not function as well, and cannot heal itself when you get rid of the virus with treatment. Now is the time to treat your Hep C virus, before you progress to F4 (Cirrhosis). You will have improved chances of curing your virus before you progress to Cirrhosis, and the treatment will not be as hard on your liver at this time.
@Paloma: there are many factors to weigh, such as: do you have symptoms? what is your age, and level of health, how long have you had the virus, and how are your labs looking?
It is important to get copies of all the lab-work that has been done, and then when you get new labs, you can compare them, to look for warning signs, like your liver enzymes rising, or your platelets getting lower than normal.
May Doctors dont know alot about Hepatitis C...I know it is surprising, but I have found it to be true. So a Hepatologist can help you, with reading your labs, and there are also many knowledgable people on here also, who can help you to read your labs, which can be compilicated!
I chose to Treat my Hep C, at Stage 2, because I was 49 yrs old, and our immune systems and health, tend to start dropping, at that age (along with a few other things, lol) I also began to have drops in my labs: my platelet count went lower than normal...not a good sign, and they had always been in the normal range, the whole 20 yrs I had the Hep C....that is..I think, becuz I never really ever read my old labs properly. I had been under the falso assumption, that if there was a problem, my Primary Care Doc (who I see frequently) would spot it (she didn't know anything about Hep C, as it turned out) and even my Gastro didn't find it odd that my platelets were under the normal range, he said "that is common in people with Hep C"....oh yeah, only people who are starting to get cirrhosis!
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