Biopsy results -vs- Therapy

Posted by Rob on June 28, 1999 at 19:35:19
Firstly, let me explain my situation and how I came to know I have Hep C. Overseas on duty I believe I was exposed to the Tuberculosis virus, because my PPD test was reactive. So I was started on INH to kill the TB bug (don't have TB, just exposed to the virus)...since I'm 36, they tested my LFT's after a month. (All patients above 35 on INH are tested monthly). So after a month, my LFT's are way out. I'm immediately taken off the INH. A month later, still off the INH, my LFT's are STILL way out. Further testing showed the HCV. My only chronic symptom prior to Rebetron therapy was chronic fatigue.
Here's my biopsy results:
-Mild piecemeal necrosis
-Mild parenchymal injury (between one and five cells per 10x)
-Mild to moderate portal inflammation with numerous inflammatory cells and occasional germinal centers
Mild fibrous portal expansion
No evidence of bridging fibrosis
Firstly, can you explain all this in English? :-) Secondly... how bad is my liver, how are my survival chances?  Thirdly.. What information from the biopsy determines the need for therapy?
Thanks so much for your time :-)
Rob

Posted by Tim on July 02, 1999 at 09:53:12

Hello I'm a hepper from England, I'm no doctor but I think the results in plain English mean:
- Mild piecemeal necrosis = very small and different parts of your liver tissue are "dead" i.e. no longer functioning,  
-Mild parenchymal injury (between one and five cells per 10x) = your parenchyma is part of your liver, it's mildly damaged

-Mild to moderate portal inflammation with numerous inflammatory cells and occasional germinal centers = your portal tract is is generally viewed as containing a portal vein, hepatic artery, and bile duct, it's mild to moderately inflamed, I don't know what germinal centers are
Mild fibrous portal expansion = your portal tract is mildy hardened and this has expanded it
No evidence of bridging fibrosis = this is a serious condition of the liver which you ain't got
(Sorry I can't give more info - you doctor should explain all this to you).
In short, your liver is damaged but not badly. I would think your survival chances are very good. But this depends somewhat on the Hep C virus. The higher your viral load the more damage Hep C does. To keep the load low you have to obviously adopt a healthy lifestyle and no do anything to further damage your liver e.g. no booze, lay off fried food and coffee etc. Taking milk thistle (silymarin) a plant extract helps your liver - its available at most health shops. At present, the only treatment for Hep C is Interferon, or Interferon and Ribavirin, I think you are probably a good candidate for this. The treatment can have unpleasant side effects, but people react differently to it; some get hardly any side effects at all other get bad ones, different people also cope differently to the side effects - some are not that bothered, a few have to stop the treatment. The treatment lowers the viral load. For much,much more info on this than my rather inept attempt I suggest you go to: http//hepatitis-central.com which more or less exaplains everything about Hep C.
Best wishes, hope everything goes well
Tim
Posted by HFHSM.D.-D.M. on July 03, 1999 at 17:24:50
Dear Rob:
I appreciate your questions about liver biopsy.  I spend a lot of time looking at biopsy