1722607_tn?1335751458
tests
I had a liver biopsy exactly one year ago. F2 stage 2. I asked my gastro to do another biopsy, he said no. Said I can only get one every 2 years. I heard people talk about fibroscan. What is that? Is there any other way to check my liver status without a biopsy? Maybe a blood test? I really want to know if I have crossed into stage 3.
Cancel
23 Answers
Page 1 of 1
Avatar_universal
Since you are G2/S2 this is an "interesting post" you might want to read!

http://www.medhelp.org/posts/Hepatitis-C/Liver-biopsy/show/1790527#post_8241269

Have a great day! :)
Comment
Cancel
Avatar_universal
Comment
Comment
Submit Comment
3230925_tn?1397619565
Your doctor is right about the biopsy,on average it's one every five years.The fibroscan is accurate for mild fibrosis F0-F1 or cirrhosis F4,in the middle stages which is where your at it is not very accurate.Same with the fibrosure test.

   What I suggest is use some non invasive methods and add them together to give a general idea,you can get a fibroscan,do a AST/ALT ratio,a FiB4 score and a APRI index.

AST/ALT ratio and FIB4 score you can do at this web site.Just click on calculators.

http://gihep.com/?page_id=782

APRI index

http://www.medhelp.org/posts/Hepatitis-C/The-AST-to-Platelet-Ratio-Index-APRI-A-Good-Test-of-Fibrosis-/show/1096773  

Hope this helps,all the best to you.

Dannyboi7
Comment
Cancel
3230925_tn?1397619565
Comment
Comment
Submit Comment
Avatar_universal
http://www.natap.org/2010/HCV/120510_01.htm

Diagnostic accuracy of FibroScan and comparison to liver fibrosis biomarkers in chronic viral hepatitis: A multicenter prospective study (the FIBROSTIC study) - published pdf attached

"The overall accuracy of FibroScan® was as good as or better than that of other non-invasive methods......The diagnostic accuracy of non-invasive tests was high for cirrhosis, but poor for significant fibrosis. A clinically relevant gain in the likelihood of diagnosis was achieved in a low proportion of patients. Although the diagnosis of cirrhosis may rely on non-invasive tests, liver biopsy is warranted to diagnose intermediate stages of fibrosis.......The overall accuracy of FibroScan® was high (AUROC 0.89 and 0.90, respectively) and significantly higher than that of biomarkers in predicting cirrhosis (AUROC 0.77-0.86). All non-invasive methods had a moderate accuracy in predicting significant fibrosis (AUROC 0.72-0.78).........According to current practice guidelines, significant fibrosis (F2) is a frequent selection criterion for antiviral treatment of HCV and HBV chronic hepatitis, but the use of non-invasive tests to stage liver fibrosis remains highly controversial. In summary, our study has established that non-invasive tests, especially FibroScan®, may be useful in the prediction of cirrhosis. However, it supports guideline conclusions that non-invasive tests should not replace liver biopsy in routine clinical practice for the detection of significant fibrosis that may warrant treatment [2], [3]."

Conclusions

The diagnostic accuracy of non-invasive tests was high for cirrhosis, but poor for significant fibrosis. A clinically relevant gain in the likelihood of diagnosis was achieved in a low proportion of patients. Although the diagnosis of cirrhosis may rely on non-invasive tests, liver biopsy is warranted to diagnose intermediate stages of fibrosis.
Comment
Cancel
Avatar_universal
Comment
Comment
Submit Comment
3230925_tn?1397619565
Thanks Jules for providing a link,I tend to forget to do that.

Summer you're a G1 at stage 2 and you had a BX done 1 year ago.I seriously doubt your liver damage as gotten worst in just one year.Since the progression of liver damage is usually very slow for genotype 1 unless your drinking alcohol  heavily everyday then the progression could be very fast.For a genotype 1 it can take up to 30 years to get to stage 4.
Comment
Cancel
3230925_tn?1397619565
Comment
Comment
Submit Comment
Avatar_universal
While I agree its to soon for another Biopsy, you do realize even a biopsy can be off a little... Meaning you could be a stage 2 or already stage 3.

Is there a reason why your wondering if you crossed into stage 3? Hope all is well.............
Comment
Cancel
Avatar_universal
Comment
Comment
Submit Comment
707563_tn?1395081210
Let's keep this on topic, please.  Personal issues don't belong in a thread.

Emily
Comment
Cancel
707563_tn?1395081210
Comment
Comment
Submit Comment
2147300_tn?1369693288
Summer,  I see my GI this Friday and I will ask him about length of time between biopsies.   I wondered the same as you, I am stage 3 prior to tx and am curious as to progress since tx.  Sentinel13 has a good story on his liver regeneration. This is link to his photos showing labs. Quite impressive.

http://www.medhelp.org/user_photos/show/270498?personal_page_id=2582125.  

HPguy, you saw 2 posts, you are not delusional, this is only a temporary twilight zone as we treat.  It all gets clearer post treatment.  I find post tx "very interesting" .  Some things seem to disappear but not when you copy and paste as I did my entire history of tx.

Comment
Cancel
2147300_tn?1369693288
Comment
Comment
Submit Comment
979080_tn?1323437239
Assessing fibrosis in the inbetween stages is anything but exact.
Comment
Cancel
979080_tn?1323437239
Comment
Comment
Submit Comment
Avatar_universal
I agree with bali..... especially when it comes to the fibroscan

Will
Comment
Cancel
Avatar_universal
Comment
Comment
Submit Comment
Avatar_universal
When my husband was first diagnosed and had the first liver biopsy (2007), he was told they would re-do the biopsy in three years, which they did (2010).  By then he had transitioned into early Cirrhosis (f-4), and after that point, they did not feel he needed a third biopsy 3 years later (2013), since they already know he has Cirrhosis now.
Advocate1955
Comment
Cancel
Avatar_universal
Comment
Comment
Submit Comment
Avatar_universal
As you mentioned, most of the time liver damage progresses very slowly, but I did want to let you know that my husband progressed from between f1-f2 according to 2007 biopsy to f4 according to 2010 biopsy, just strictly due to damage from Hep C virus (no other causes), so it can happen.  
Advocate1955
Comment
Cancel
Avatar_universal
Comment
Comment
Submit Comment
2147300_tn?1369693288
Saw GI,  they don't normally request another biopsy unless there is some other related problem.  

Good luck and best wishes with your tx.
Comment
Cancel
2147300_tn?1369693288
Comment
Comment
Submit Comment
Avatar_universal
I agree with you doctor. This procedure is not without risks. Plus most insurance companies will not cover that frequent of a biopsy.

A good Hepatologist can get a very good idea of liver damage from blood labs and physical exam. Old time Hep docs could tell what stage you were without the biopsy.

Best of luck
Comment
Cancel
Avatar_universal
Comment
Comment
Submit Comment
Your Answer
1722607_tn?1335751458
Answer
Know how to answer? Tap here to leave your answer...
Answer
tests
Submit Answer
A
A
Recent Activity
6708370_tn?1450863629
Blank
hepcandme commented on nan535's status
5 hrs ago
406584_tn?1399591666
Blank
10356 commented on 0213
12 hrs ago
406584_tn?1399591666
Blank
10356 commented on 0213
12 hrs ago
Blank
Weight Tracker
Track your weight over time
Start Tracking Now
Top Hepatitis Answerers
Avatar_m_tn
Blank
can-do-man
IN
317787_tn?1428318779
Blank
Dee1956
DC
1815939_tn?1377995399
Blank
pooh55811
163305_tn?1333672171
Blank
orphanedhawk
Rural Mural, CA
683231_tn?1438659664
Blank
flyinlynn
Auburn, WA
446474_tn?1446351282
Blank
HectorSF
San Francisco, CA
Hepatitis C Community Resources
RSS Expert Activity
233488_tn?1310696703
Blank
Marathon Running Done Over Many Yea...
May 21 by John C Hagan III, MD, FACS, FAAOBlank
233488_tn?1310696703
Blank
New Article on Multifocal IOL vs &q...
May 21 by John C Hagan III, MD, FACS, FAAOBlank
748543_tn?1443740527
Blank
TMJ/TMJ The Connection Between Teet...
01/15 by Hamidreza Nassery , DMD, FICOI, FAGD, FICCMOBlank
Top Hepatitis Answerers
Avatar_m_tn
Blank
can-do-man
IN
317787_tn?1428318779
Blank
Dee1956
DC
1815939_tn?1377995399
Blank
pooh55811
163305_tn?1333672171
Blank
orphanedhawk
Rural Mural, CA
683231_tn?1438659664
Blank
flyinlynn
Auburn, WA
446474_tn?1446351282
Blank
HectorSF
San Francisco, CA