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4705307 tn?1447973922

Fibrosis

Yes this late is in the game, 37th week of tx, and yet I have seen it so much I can't help but ask. Why hadn't my Dr.s done a biopsy. When I asked him during our last appointment he referred to my my ultra sound and referenced my enlarged liver and spline. Saying I have fibrosis. I have looked and looked trying to decipher it, I see nothing that refers to fibrosis what stage or anything else. Can anybody come up with a good reason not to do a biopsy? Is there enough information in an ultra sound and blood work to make decisions when or if to treat. There seem to be issues regarding my health that have been moved aside until I complete tx    
22 Responses
Avatar universal
One of the reasons people with HCV undergo liver biopsy is to ascertain the condition of their liver to help in making the decision whether or not to treat. You're already treating so in that context there is no need for or value in a biopsy.
Of course, we all want to know the condition of our liver but in your situation I don't know that a biopsy would be very useful. Although the risks are low for biopsy associated complications there is nevertheless some degree of risk. I don't know your platelet count or clotting time but it's not unusual during interferon treatment to have a decreased platelet count so the risk to you may be slightly increased since you're undergoing interferon treatment.
And, hopefully you will achieve SVR and again, hopefully, your liver histology will improve with some time. I am suggesting that the snap-shot a biopsy at this time would give you of your liver might not be illustrative of your liver condition once you achieved SVR and lived virus free for a while.
I just don't see the importance for a liver biopsy at this time. We could argue about the advisability of one before you decided to treat but that's another discussion.

Good luck,
Mike
Avatar universal
            hey timothy,  i have seen a shift by my HMO in their use of liver bx. my hmo uses needle biopsy only.  and because of the invasive nature of the procedure, they only use it for diagnostic purposes, and to check the rate of progression.        barry
5720485 tn?1373566655
You can get Fibroscan now, non invasive.   If you want to know the condition of your Liver, just so you know.  It's 94% accurate.
Shyrl

Avatar universal
  I dont believe we use FibroScan yet, in the U.S., my Dr said the machine is rly expensive.
  An ultrasound is mostly only useful for seeing masses in the liver, or nodules on the edge, and it can measure the size.
   After you get finished with yr Tx you can go and have a biopsy, but not while on yr Tx, when the platelets are low, etc
   I had a test called a FibroSure, which consisted of alot of labs analyzed, and the resultant score of these labs had me as Cirrhotic. So I went and had a liver biopsy, and it had me as a stage 2. It was a good idea for me to know that, because cirrhotics have to treat for 48 weeks.
   Did you have any of the usual signs of cirrhosis, before yr Tx? These would be platelets lower than 80, and edema (think bloated legs, socks hurting and making a mark, legs look full of fluid, cuz they are) or ascites, think: pregnant looking belly, protruding high up, and out, feeling hard...a fetid odor to your breath, like rotten fruit...also Encephe....a rly bad memory at times, from ammonia on the brain-
  
1654058 tn?1407162666
Good advice from all the resident experts. It would have been nice to have for reference or as a baseline. They must not have thought you had severe cirrhosis, or they would have probably referred you to a transplant center for treatment.
I'm happy to hear that you are almost finished! Congratulations! I'll bet you're ready..
xo Karen:)
Avatar universal
Hepatic Encephalopathy..the brain memory symptom of cirrhosis...hurrrr, I can never spell that one, thus it's initials: HE
  And we cant forget varices, which can present as a rupture of the vein in the esophagus (for example) which causes vomiting a large amount of blood, or varicosities in other regions, one is on the stomach, and looks like Medusa~
   There are also a few other labs that will be off, with cirrhosis, like high bilirubin, which causes itching (I had that one without the cirrhosis though, but again, a mild bili elevation, cuz I wasn't cirrhotic) etc.
   The Gold Standard here in the U.S. is still a biopsy, I I like them, cuz we get to look at our liver tissue :)
   You could wait until a year after your Tx, so you could also see the improvement~
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