Do I have enough imformation to make a decision whether to take treatment?

[woody03]

         I have a positive antibody test and a positive quanitive test (no numbers on the quanitive test). I most likely contracted hepatitis c about 35 years ago. My liver enz. has always been about 67 for the last12 years. I have a clear ultrsound completed last week. I feel good, some fatigue but not cronic. I did exsperice a spell or 2 of joint pain lasting a few days,recently.
        Do I need a biospsy to determine if I can wait to tx?




                                                                                        Thank you, Woody

[nygirl7]

I ditto the guys above.  I thought (wrongly) when the ultrasound was done and it was fine that so was my liver. I too was stage three already.  I never had any symptoms or anything that I know about and was pretty shocked.

Knowing the stage that you are in is very crucial. If you are a 0 to 1 you definitely have time if you want to wait and see what meds come about. By stage 2 you start thinking hum how much longer to stage 3 (cause by then it's pretty much a non-decision if you can do it).  Just because it might take 20 years to get to stage 2 doesn't mean you have another 20 years to stage 4 and cirrhosis. It could be a year or five - nobody knows. As they say it's not "linear" progression, it just can't be guessed at or charted.

Also insurance, job security and family/friend support is a big deal. For example you might have good insurance right now but will you DEFINITELY have it later should you need to treat?  I figure that the cost of my 72 weeks came to almost $200,000 altogether. That's a FAR cry from the figure of $20,000 that my GI said when I started.

You want to have the best healthcare and doctor that money can buy so that is definitely a big factor.

Good luck in your decision but yes DEFINITELY get the biopsy!

[Bill1954]

Probably more important than biopsy is genotype testing; it’s necessary to determine duration and sometimes dosage of meds. Biopsy yields additional information, but is not necessary to qualify for treatment. If you are going to postpone treatment, a biopsy along with an evaluation of your physical condition and biochemical markers should be considered.

I understand you have no insurance, and are trying to accomplish his out of pocket; but at minimum, you should consider a consult with a gastroenterologist or hepatologist to help you sort this out. He/she can perform a physical exam as well as provide invaluable insight and help you understand this process thoroughly.

The intent of this forum, in my opinion, is not to provide advice; but to inspire questions.

Best,

Bill

[Trinity4]

Absoutely, unequivocally yes.  An ultrasound can't show the amount of liver damage you may have.  My ultrasound was "normal" according to the tech but I have stage 3 liver disease.  You also need to know what genotype you have to determine length of tx and baseline vl so they can tell if you are responding to the meds.  You don't have nearly enough info woody and if you are serious about wanting to tx you will have to go through the necessary testing so that you can be treated effectively if tx is warranted.  Good Luck
Trin

[FlGuy]

You still may be a few cards short of a full deck. You should have your doc look at several aspects of your health through additional testing like a CBC and may be a metabolic panel.  Treatment duration will be based partly on the geno-type of the hcv virus that you have, so that's an important one.  Understanding the current condition of your liver is done best by biopsy. So, the biopsy is an important decision ingredient.  On the non-medical side of things, understanding your insurance situation is a big deal.