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Treatment w\out a biopsy
I was diagnosed HCV+ in the Navy back in 2003. I am told by the VA that I have Genotype 3. Anyways, I had a fibrosure blood test done to see if there is damage to my liver. The test came back fine. They are saying this test is like a biopsy and want to start me on the treatment. I have been told by my old skool psychiatrist that the VA is crazy if they were to treat me w\ out a biopsy first. What do you guys and gals think. I am considering treatment soon. I had a drug and alcohol problem but have been sober a year now. I just want some help and I rather ask the people that have been there and done that. Thanks - H
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I would definately get a biopsy .  There have been others here that have had a fibrosure test and it wasn't always accurate.  You need to see if you have any liver damage and the biopsy is the best way.  I had one a couple of weeks ago and its no big deal.  Although - you have one of the genotypes that is easier to treat and clear the virus ...thats definately a plus!  Best of luck.

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with the easier to treat genotypes  a biopsy isnt always necessary.   I was geo 2b and never did have a biopsy.   I just treat my liver well.  I did have a fibrosure and it showed low level fibrosis.   I was cured of this virus.   good luck on your treatment
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217229 tn?1192766004
I think that currently 50% of the doctors do not feel that a bx is imperative in 2/3 genotypes any longer.

Some feel that it is too invasive - and it really doesn't matter how much damage you have --- if you're going to treat the disease.

Some do Ultrasounds - and other's MRI - Scans, etc.

I believe if you have any reservations about treating then a biopsy is necessary to either let you know if you have time to put it off --- or if you need to treat immediately.

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with 2 & 3 geno types biopsies are not always done. the fibrosure test is very accurate, about 80-85% for FO or F4. not that accurate for the middle scores F2 & F3. if you had an FO result along with other good test results (ultrasound,bloodwork,etc) then not having a biopsy is the right decision.
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I am a Geno 2b and treated 24 weeks (ended July 07) I did not have a biopsy. My first doctor did not order it, but I had an ultrasound which showed only cyst that he said was "nothing of concern".  He ordered a Fibrospect II test which showed "consistent with  Metavir F2-F4".   I didn't know anything about  this disease in beginning, took his word and started tx last Feb.     After first 3 weeks my original doctor vanished.  Was left trying to find another.    During this time I was able to learn a bit on the disease (this forum helped dramatically) and asked current doctor about  biopsy/ultrasound/FibrospectII - was told that because of being 2b, no biopsy ordered and because I chose to treat.  She concurred with ultrasound, and told me that the FibrospectII test was good at telling no damage or severe damage, but anything in between was not clear, and my result was in between  (whatever that means),but she would not have ordered biopsy either.

Anyway, I treated.   I had over 4 log drop in VL at 3 weeks----at 8 weeks it was UND.   Latest doctor said at end of 4 weeks I probably was UND.    Was UND at 24 weeks as well.

Good Luck  to  you.
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Congrats on your year.. I have 2.5 under my belt.. I was a geno type 1a, I do have a time frame with when I was infected. (prob. 2-4 yearsbefore I started treating. My Dr sais there was no way I could have liver damage in such a short period of time, so he opted not to giv e me the biopsy. Do you know about when you contracted this??

Goodluck to you..
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please do not even consider tx without a bx. if your liver is fine and you have no symptons why tx with the poison they use today when in 1 or 2 years much better, shorter, less dangerous tx is likely to be ready. i had it 37 years and did abuse alcohol and hard drugs and still could wait. this stuff is dangerous and debilitating so do not take it litely.
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148588 tn?1460783517
Get the biopsy. When you start doing viral load tests during treatment you're going to want all the info you can get if you have to decide whether to lengthen, shorten, terminate the treatment or stay the course.
Knowledge=Power and for most, the procedure is no big deal.
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I am without insurance, so I have had to do this as the situation presented itself, and paying out of pocket for a biopsy after a clear scan, and being type 2, I passed. My care has been under the care of a nurse practitioner, and I qualified for the Patient Assistance Program.
So I have injection 24 of 24 on Sunday, UD at week 4 and 12---
Hoping for SVR-
Anyway, I proceeded without the biopsy, as I live outside of the Corporate Feudal Protection of Corporate America, and the Government Serf System.
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131817 tn?1209532911
I wouldn't count those "easy to treat 2's and 3's" as to be not necessary to do a biopsy. You will WANT to know how much damage you have, and you won't without a biopsy or Fibroscan, which I would recommend if you can get one of those. They are accurate and can show many more spots of the liver than a biopsy. Some of the rock star doc's have there own machines now and it is not invasive.

I didn't have one as I started treating (had one 5 yr's before) and I was always worried I was stage 4 or something. Once on tx they won't give you one, usually.  So best to know the amount of liver damage before you start.
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