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.
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.
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 , ."
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.
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.
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.
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.
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.
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.
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