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
Saw GI, they don't normally request another biopsy unless there is some other related problem.
Good luck and best wishes with your tx.
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
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
I agree with bali..... especially when it comes to the fibroscan
Will
Assessing fibrosis in the inbetween stages is anything but exact.
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.
Let's keep this on topic, please. Personal issues don't belong in a thread.
Emily
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.............
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.
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.
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
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! :)