Thanks a lot guys,
much appreciated!
biopsy remain "golden standards", but has to be considered only in secial cases, in other cases fibroscan monitoring can be done and form time to time fibormax can be used to double check fbroscan results.
this is a 2011 post so do not consider it, quite a few things have changed since then
best method to determine the liver's state?
regular monitoring by fibroscan, no other method allows monitoring of liver state, biopsy is not precise and can have big errors and can be done once in 5 years
fibromax almost useless alone, can improve fibroscan results according to some studies
What would be the best method to determine the liver's state?...Liver biopsy, fibromax, fibroscan, a combination of fibromax/fibroscan (as specified above by 4est), or something else?
Thank you!
4est
no AFP in your regular tests?
I dont know regarding resistance test, I think that is not available here in the Philippines
Before starting a treatment a HBV drug resistance test have to be performed in order to avoid resistance.
Treatment scheme (after the doctor establish that a treatment is needed) have to consider the flowing results:
- HBV drug resistance
- HBV genotype
- qAgHBs
Monitoring program:
every 3 month:
- test ALT and AST
- Vitamin D (if you take supplements / this can go on every 6 months if in case of no supliments or in case that you found a maintenance dose )
every 6 month:
- doctor appointment
- test HBV DNA
- test AgHBe, AbHBe (if AgHBe negative and AbHbe positive - this test can be spiked because is unlikely to change
- test AgHBs quantitative
- test other liver related parameters (SPEP , GGT, ALKP , TBIL .... )
- US (ultrasound ecography)
- Cholesterol / HDL / LDL / VHDL
every 12 month:
- test fibroscan
- test a normal scan blood (CBC, Serum Glucose, serum Urea, Serum iron, TAG, VSH ...)
- test fibromax (this cam be skipped because is a blood related test and not very precised but combination fibroscan / fibromax can be a good indicator)
If any one of this test is out of regular parameters, your doctor have to be notified and some supplementary test have to be done!
Anyone wanting to add something? :)