treatment/biopsy results

Posted by Terry on June 10, 1999 at 14:17:58
First let me give you the results of my tests and then address my questions that I hope you can help me with.
I have had two LFTs with the ALT and AST within the normal peramiters.
The ELSI tested positive.
I am waiting for the RNA tests.
The liver biopsy report reads like this:
Microscopic Description.  The biopsy shows predominantly portal inflammation with focal limiting plate necrosis.  The inflammation is composed predominantly of lymphocytes. No bridging fibrosis or cirrhosis is present.  There is very mild, focal steatosis.  No evidence of iron overload on special stains for iron is observed.
Final Diagnosis:
Chronic Hepatitas with mild periportal activity (grade 2) and minimal portal fibrosis (stage 1) consistant with chronic hepatitis c. No evidence of cirrosis (cirrhosis).
I must have contracted hep c about 20 years ago.  I have had no other means to contract it since then that I am aware of.
The question of treatment is my Dr has recomended a dual treatment. She tells me that I will have to have my systems monitored fairly closely during this treatment.  I am scheduled to go to Korea for a year in two months and she does not know if I will be able to be monitored or treated there during that year.  From what I have read the best time to treat this is before any fibrosis is seen.  Should I push the issue and start the treatment or am I not putting myself at further risk if I wait a year?
Secondly if you could give me your impression of the biopsy results I would apprecate it. From what she told me they do not seem to be to bad.
Thanks.  I have gotten a lot uf useful information from this web site.  Plain clear english that I am under to understand.
Terry

Posted by HFHSM.D.-D.M. on June 25, 1999 at 17:29:44
Dear Terry:
I really appreciate your questions which are fairly straight-forward.  The other thing I really like about your questions is that they really point to the advantage of having a liver biopsy in some one with hepatitis C.
When I look at a liver biopsy from some one with hepatitis C, the most important thing to me is the amount of fibrosis or scarring.  Fibrosis is scar tissue that forms as a result of persistent inflammation in the liver.  If you cut your skin, you form scar tissue which is good.  However, if you inflame the liver, you can develop scar tissue or fibrosis which can be bad.  If the fibrosis advances, it can start to destroy the liver. Typically fibrosis starts around the portal tract and the mildest form of fibrosis is