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Are liver biopsy needed for all hepatitis C?
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Are liver biopsy needed for all hepatitis C?

Are liver biopsy needed for all hepatitis C? I just found out a sort time ago that I have Hep C. I found out at the Bolld Bank. I couldn't belive it!  All but one of my blood test are normal and the one that is not is only a little high. I feel normal. However, Kaiser dose what to do a Liver biopsy. Any info would be great.
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254544_tn?1310779332
This is always a topic for interesting debate.  I'm one of those that is a strong supporter of the biopsy in all heppers.  I'm a genotype 1, I had only slightly elevated liver enzymes, the CT of my liver was fine, I had zero hep C symptoms and a pathetically low viral load.  I thought for sure I was fine and fought like heck with my doc not to do the biopsy.  He convinced me to do it and I'm so glad he did.  It turns out that I have Stage 3, Grade 3-4 damage which is pretty severe.  Had I not found out the extent of my damage I would not have treated.  When I saw how bad I was I got on treatment within a week.

The other reason why I'm such a strong support of the biopsy is because people who have advanced stage 4 damage cannot usually treat.  In my  line of thinking (which is not always sane ...  ) I think I'd want to to know also to make sure it's safe to treat.  At the very least there are some blood tests out there (i.e., fibroscan) that can give an idea of liver damage and if you choose not to do a biopsy I think you should at least do one of those.

In a nut shell, the biopsy helps a person look at the whole picture and make an informed decision on whether or not to treat.

Mouse (Missy)
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Avatar_m_tn
A Liver biopsy is the "gold standard" to determine condition of the liver.  There is however, a new blood test available called Fibrosure that can also measure the condition of the liver but it's not quite perfected and results vary. It's more accurate for those who have not yet started Hep C treatment. I had a liver biopy and then I followed up with the Fibrosure and both matched but the general feeling among doctors is the blood test is not as effective as the biopsy....

http://www.labcorp.com/services/hcp/hepatitis/index.html
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Avatar_f_tn
I recommend it too.  You can never be to sure just guessing.   Biopsy really does not hurt much and is quite boring actually.   You might as well find out as much as you can about whats happening with your body as that is your best defense.  
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Avatar_n_tn
Has anyone heard of a test called, Fibroscan?
A machine that uses the latest technology for diagnosing liver damage. FibroScan® uses ultrasound elastography to measure liver stiffness - it is medically accepted that an unhealthy cirrhotic liver is firmer than a healthy liver. Expert consultants use the innovative computerised system to give patients an immediate, non-invasive and painless measurement of the health of their liver, without the need for an overnight stay in hospital.
FibroScan® can be used to evaluate the extent of liver damage in all patients suffering from chronic liver disease, irrespective of the underlying cause, such as viral hepatitis, alcoholic liver disease and autoimmune hepatitis. It is painless and has none of the morbidity or mortality associated with needle biopsy of the liver.
With FibroScan®, it can generate an instant liver stiffness reading to accurately assess damage caused by liver disease - it is completely painless and the whole procedure can be done in just 15 minutes.
With FibroScan®, a consultant holds a probe against the patient's abdomen, on the right lobe of the liver. Vibrations from the probe create elastic waves through the liver and their spread is then tracked by ultrasound. The speed of propagation of the waves is directly correlated to the stiffness of the liver tissue. An algorithm calculates the velocity of the wave, and the elasticity can be measured - the faster the wave spreads, the stiffer the tissue. A reading based on the median value of ten valid measurements is generated by the FibroScan®'s sophisticated computer system. This examination can be repeated as often as is necessary to monitor the progression of the disease with or without treatment.

Ultrasound elastography offers several advantages over other techniques employed in the diagnosis of liver disease. Unlike with a needle biopsy of the liver, no anaesthetic is needed with FibroScan and the patient can be discharged immediately. Also, ultrasound elastography is more similar to seismology than to ultrasound imaging ��" the acquisition speed is very high and the acquisitions are therefore not biased by cardiac or respiratory movements as they are with ultrasound imaging.

Anita



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I have been wrestling with this question for a while.  I had always said NO to Bioposy.  Think some of your responses are making me change my mind.
Thanks
Deb
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