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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.
13 Comments Post a Comment
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Avatar_f_tn
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! :)
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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
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Avatar_f_tn
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.
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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.
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Avatar_m_tn
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.............
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707563_tn?1395081210
Let's keep this on topic, please.  Personal issues don't belong in a thread.

Emily
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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.

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979080_tn?1323437239
Assessing fibrosis in the inbetween stages is anything but exact.
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Avatar_m_tn
I agree with bali..... especially when it comes to the fibroscan

Will
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Avatar_f_tn
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
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Avatar_f_tn
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
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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.
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Avatar_m_tn
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
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