Actually...... autopsy is the "gold standard". : ) For people who are living..... a biopsy is the next best thing. It only samples very small portions of the liver. Liver cirrhosis is not always uniform and so biopsies still suffer from inaccuracies due to random area of selection, sampling size, or differences in how various people will interpret them. It may be that some of the presumptions of how fast or slow the virus causes progression from stage to stage is due to the interpretations of the biopsies, not 100% damage progression. Since biopsies are invasive very few doctors recommend them following SVR. It is presumed and proven that LFT's as well as liver staging reverse and improve.
I'd venture that studies have been done but biopsies are not a recommended practice post SVR.
A blood test (such as a Fibrosure or Fibrospect) can give one approximate liver staging. I had on a few years ago. It was about 325 US dollars and after insurance it cost me about 25 dollars. It's very cheap, easy, painless and I had the results in a week. One could do that annually for little if one wanted for a few years post TX.
Fibroscans may soon be available in hospitals and will likely be a bit more pricey. I think that they will prove to be more accurate also since they read the actual liver rather than extrapolate liver damage based on results of blood tests. Yes, an interesting thing about the firoscans is that they can pinpoint areas where ones liver staging varies. I'd presume that with the aid of a fibroscan one could do follow up biopsy from select areas of a liver and then draw different conclusions about ones staging. Some folks may have uniform and homogenous damage and it may be less of an issue..... and others not.
Both newer methods are very non invasive and may provide a means of checking ones post TX liver damage staging without much trouble. It is worth consideration and would provide a bit more data or comfort if one drank post tx whether a little or a lot.
best,
Willy
is repeat biopsy the best way of judging improement in liver? I did not get a repeat biopsy. I feel it samples a small part of liver and there could be different stages in the same liver. If the second biopsy comes higher in stage you know your disease is progressing but in case of downstaging you cannot be sure.
If part of your liver damage was due to alcohol...give it up.
That is, if you had problems with alcohol before, your bright and shiny newly recovered liver will still react the same way the last one did...
Why expose yourself and the brand-new liver to needless risk?
Been there, done that.
Just my 0.02
It's good to recognise that you had rather advanced liver disease. A damaged liver may not regenerate as quickly or completely as a normal one. The question is where do you sit today so far as liver damage goes? I have a friend who was reported to improve about 2 stages in 2 years EOT. Results may vary of course. The methods of judging staging changes may also come under scrutiny. Since most folks won't do biopsies following SVR the answers will be a best guess.
Many people wouldn't recommend a stage 3 grade 3 drink, but might allow that one might not hurt. You might get a much bigger allowance made if they knew your current level of damage. I also think that the morning after having a drink(s) your body will also give you some feedback.
Congrats and best wishes,
Willy
As you are/were stage 3 drinking alcohol often would not be wise.
If your liver damage has regressed then the occasional drink will probably be ok.
Cause without a biopsy how do you know that your stage has regressed is a question i would want answered.
CS
I'm also stage 3 and currently txing but have decided I will not drink anymore whether I SVR or not. Just my choice and many without advanced liver disease do occasionally drink. This may or may not be true but I wonder had I not drank for years sometimes more than I should have would I have stage 3 now? Alcohol excelerates liver damage when infected with hepc but like most, I didn't know I had it. I miss my days of wine and sunshine but it's not the end of the world.
Trinity
My doctor said a few drinks a week - never more than one drink in a given day (or two if you're a large man) - and not every day. I drink red wine for my heart, and for my taste buds. It depends on how much damage you have, but a functioning liver can usually handle one drink. It's no worse for the liver than some of the prescriptions we take.
not a question of SVR or Hep C. Any liver damage can be aggravated by alcohol. Occasional is not harmful if it is once a month or so.