It might be more than liver function tests if the suspicion is hep-c. The progression, at least for me, abnormal liver fucntion tests, test to confirm presence of hep-c, geno typing, viral load (at this point hep-c diagnosis confirmed) and then a biopsy. Some people here report that, based on the geno-type, some docs may not order a biopsy before treatment. I think that most people would agree that having a biopsy is important to give the doc and the patient a 'full view' of the condition. Biopsy is not as bad as it sounds - scary until you go through it and then looking back, no big deal.
A doctor friend of mine I grew up with. ( a GP works at the free clinic in seattle) said that almost everyone would show some kinda damage on a biopsy. Even if you have been a casual drinker for many years you would show damage.
Yeah, blood labs are just about meaningless as far as damage goes. I had PERFECT blood labs, and ALT's only slightly elevated prior to tx. My CT scan showed nothing, actually came back 100% normal. Yet, biopsy revealed stage 2/3 fibrosis.
If HCV is present, you really want to get a biopsy done to get a feel for what is "really" going on inside. Find out if you have time to wait, or tx and intervention is necessary right now..
As true with many aspects of hep c treatment, there probably isn't any one standard regarding biopsy. Some doctors biopsy practically everyone HCV postive, some own biopsy genotype 1's, others may use liver function tests as part of a determining formula. Biopsy is relatively risk free but not absolutely so. On the other hand, the risks of not having a biopsy may outweigh any risks involved.
You'll find a good dialogue on when/whether to biopsy here:
Look for articles 4 and 5. Free Medscape registration may be required but well worth it.
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