Results of Hubby's Biopsy

[Grace724]

We don't have the results in our hands but my husband called the office about scheduling an appt. to go over the results with his gastroenterologist and the nurse told him the results over the phone. *can we say dumb@$$?* Truly I cannot believe she'd just give him this over the phone and not wait until we were in the office with the doctor so we could ask questions.I find this highly improper but maybe I'm wrong?

Anyway, she told my husband that he is stage 4, grade 1. I know stage 4 is cirrhosis. Can he really be stage 4 and then grade 1? I guess I figured the two numbers would be similar, not one at one end of the scale and the other at the other end.

She did not say anything about what genotype HepC, viral load or any of that. I'm hoping that is on the test results which I believe I should have by the weekend.

Anyone want to take a crack at explaining to this newbie what the information we do have means?

Thanks very much in advance.

~Grace

[Trinity4]

Correct - the genotype and viral load should be forthcoming.  Many of us were infected through blood transfusions back then and didn't have a clue until years later when our liver had already sustained considerable damage.  In '92,  I'm not sure if they even followed current protocols with diagnosis and treatment of hepc.  It's hard to cope with the reality of having this disease, but there are treatments and hopefully he will have the opportunity to eradicate the virus.  Good Luck and keep us informed on docs prognosis.
Trin

[Grace724]

Thanks Trinity, I appreciate your response.

The only risk behavior my husband has had was an operation in 1979 that required him to be given blood. He was diagnosed in 1992.

I too am hoping that we get a clearer understanding when we see the doctor.

I was looking over some of his old blood work and I came across this and wonder if anyone can shed any light on these results for me:

Hepatitis Panel:

HepA Ab, IgM   Negative result Negative Limits

HBsAg Screen Negative result Negative Limits

Hep B Core Ab IgM Negative result Negative Limits

Hep C Virus Ab Repeatedly Positive  Negative Limits

I'm assuming that these results just confirm his HepC diagnosis and do not indicate his genotype...correct?

Thanks again.

~Grace

[Trinity4]

“Stage” is the amount of fibrosis (scaring) detectable by biopsy…
from stage one (mild) to four (cirrhosis ). Fibrosis is scar tissue that forms as a result of chronic inflammation and/or extensive liver cell death . Your health care provider uses the amount of fibrosis in your liver as one way of evaluating how quickly your disease appears to be progressing. knowing when you were initially infected with HCV is a great help in determining your rate of disease progression.

The Stage is assigned a number from 0-4:
• 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

“Grade” is the amount of inflammation , which is caused by the activity of the virus. Generally speaking, inflammation is the precursor to fibrosis .
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 it is considered a precursor to fibrosis.

The two numbers don't always correspond to each other.  You can have advanced liver disease and still have mild inflammation.  It's shows that at the time of biopsy his liver was not as inflammed but in his case unfortunately that doesn't help matters much.  I'm sorry the news wasn't good - but I hope they will give you more clarification once you meet with the doctors and they explain his options.
Good Luck
Trin

[Grace724]

Hubby just told me that the nurse told him that grade 1 meant that it's "dormant" whatever it means? I've not heard that term used since I've been reading this forum, so to say I'm totally confused is an understatement.

*sigh*