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:
http://www.medscape.com/viewprogram/2053
Look for articles 4 and 5. Free Medscape registration may be required but well worth it.
All the best.
-- Jim
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..
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.
Ron
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.