Aa
I need your help interpreting my numbers
I need your help interpreting this for me. I picked up my medical records to day. I am a
A doctor might not insist on a biopsy but I would. IF you have little or no liver damage you might just want to hold on for a while and see what happens with the new drugs that are coming out.
Although "2" is considered often enough the "Lucky" genotype there are plenty of people that have NOT gotten SVR on the first shot. In the olden days it was a given that because the odds were so good (80% chance of success versus the 50% for genotype 1) that all 2s should treat but...in my opinion it is definitely worth checking out whether you need to or not.
These drugs can cause long term damage - while they are a lifesaver to those of us who have extensive liver damage (I am geno 1A and 1B, treated 72 weeks, grade 2 stage 3) there are drugs that look promising and you personally might have a lot of time to wait and see if they pan out.
All else said - it's a personal decision. Even before I found out any of my biopsy info I knew I would treat...I wanted this GONE big time - but for others the last thing they want to do is treatment and so they just don't.
Either way - make sure you keep a check on your liver enzymes...that should tell you how much damage is CURRENTLY going on in your liver but it can't tell you what has ALREADY been done.
Good luck
Although "2" is considered often enough the "Lucky" genotype there are plenty of people that have NOT gotten SVR on the first shot. In the olden days it was a given that because the odds were so good (80% chance of success versus the 50% for genotype 1) that all 2s should treat but...in my opinion it is definitely worth checking out whether you need to or not.
These drugs can cause long term damage - while they are a lifesaver to those of us who have extensive liver damage (I am geno 1A and 1B, treated 72 weeks, grade 2 stage 3) there are drugs that look promising and you personally might have a lot of time to wait and see if they pan out.
All else said - it's a personal decision. Even before I found out any of my biopsy info I knew I would treat...I wanted this GONE big time - but for others the last thing they want to do is treatment and so they just don't.
Either way - make sure you keep a check on your liver enzymes...that should tell you how much damage is CURRENTLY going on in your liver but it can't tell you what has ALREADY been done.
Good luck
I actually said NO such thing!
The need or otherwise for a liver biopsy in ALL cases of HCV infection has been debated among liver specialists for years, and there is GENERAL agreement amongst hepatologists that it is NOT necessary in all cases: See the Practice Guidelines for management of Hepatitis C, published by the American Associaction for the Study of the Liver (AASLD) which states, in part:
https://www.aasld.org/eweb/DynamicPage.aspx?Site=AASLD3&webcode=ViralHepatitis
"Utility of Liver Biopsy
The role of liver biopsy in the management of patients
with chronic hepatitis C is currently being debated. In the
initial treatment trials of hepatitis C, a liver biopsy was
regarded as an important parameter in helping to guide
management and treatment, particularly at a time when
response to treatment was low. More recently, with the
improvement of treatment effectiveness, the value of the
liver biopsy has been questioned because of the potential
risks of the procedure and the concern of sampling error.
39 This has prompted some to challenge the need for
biopsy and to suggest that the procedure may not be necessary
as a prelude to treatment. ...."
My point is just that biopsy is UNECESSARY in ALL patients (but may be helpful in SOME, and it is certainly POTENTIALLY hazardous (as any competent Hepatologist is obliged to inform you BEFORE he / she performs one).
I DID NOT SAY biopsy halfway through treatment was the way to proceed; my statement was that IF biopsy had been obtained then the information could be useful in advising people with adverse effects of treatment as to how important continuation with therapy (and putting up with the side effects) is.
I DID not recommend HBV vaccination into the blood stream, just said it would do no harm if performed inadvertently. When HBV vaccine has been administered to HBV patients in high doses deliberately, it actually suppresses HBV replication. This is fact. See the paper by Pol, S. 1995. Immunotherapy of chronic hepatitis B by anti HBV vaccine. Biomed Pharmacother 49:105-9.for this.
I did NOT say the US healthcare system was ineffective; just that there are many people in the US who have little access to it and a more universal Healthcare system (as veing considered in California by that arch socialist, Arnold Schwarzenegger, by the way, may be helpful for some people,
Finally, I try to answer questions as rapidly as possible, and do so in a way backed by the medical and scientific literature. I would be grateful, Catll, if you DO NOT EVER misrepresent what I have said again.
The need or otherwise for a liver biopsy in ALL cases of HCV infection has been debated among liver specialists for years, and there is GENERAL agreement amongst hepatologists that it is NOT necessary in all cases: See the Practice Guidelines for management of Hepatitis C, published by the American Associaction for the Study of the Liver (AASLD) which states, in part:
https://www.aasld.org/eweb/DynamicPage.aspx?Site=AASLD3&webcode=ViralHepatitis
"Utility of Liver Biopsy
The role of liver biopsy in the management of patients
with chronic hepatitis C is currently being debated. In the
initial treatment trials of hepatitis C, a liver biopsy was
regarded as an important parameter in helping to guide
management and treatment, particularly at a time when
response to treatment was low. More recently, with the
improvement of treatment effectiveness, the value of the
liver biopsy has been questioned because of the potential
risks of the procedure and the concern of sampling error.
39 This has prompted some to challenge the need for
biopsy and to suggest that the procedure may not be necessary
as a prelude to treatment. ...."
My point is just that biopsy is UNECESSARY in ALL patients (but may be helpful in SOME, and it is certainly POTENTIALLY hazardous (as any competent Hepatologist is obliged to inform you BEFORE he / she performs one).
I DID NOT SAY biopsy halfway through treatment was the way to proceed; my statement was that IF biopsy had been obtained then the information could be useful in advising people with adverse effects of treatment as to how important continuation with therapy (and putting up with the side effects) is.
I DID not recommend HBV vaccination into the blood stream, just said it would do no harm if performed inadvertently. When HBV vaccine has been administered to HBV patients in high doses deliberately, it actually suppresses HBV replication. This is fact. See the paper by Pol, S. 1995. Immunotherapy of chronic hepatitis B by anti HBV vaccine. Biomed Pharmacother 49:105-9.for this.
I did NOT say the US healthcare system was ineffective; just that there are many people in the US who have little access to it and a more universal Healthcare system (as veing considered in California by that arch socialist, Arnold Schwarzenegger, by the way, may be helpful for some people,
Finally, I try to answer questions as rapidly as possible, and do so in a way backed by the medical and scientific literature. I would be grateful, Catll, if you DO NOT EVER misrepresent what I have said again.
1. A biopsy is the MOST efficient and EFFECTive way to find out exactly what is going on and how desperately we need to treat (or not). There is no other way to find this information out.
2. As far as I am aware - we are not allowed to have a biopsy mid-treatment. So that wouldn't be useful in the slightest bit because we are ALREADY on treatment and potentially our liver enzymes would have been lowered and half way during treatment is a VASTLY different number between some people and others.
For me treatment was 72 weeks for others it is only 24.
What good would it show at that point at all anyway?
The most ideal feature would be a biopsy BEFORE and then AFTER to see how much (if any) recovery had happened and then a year LATER to see even more.
3. Why on earth would anyone EVER give an HBV test into a vain? If an innoculation is made to go into the muscle.............well thats where they darn well better be putting it. I'd imagine a nurse could find your shoulder or your forearm easily enough.
4. I am DAMN glad I live in the US and have this healthcare system as crappy as sometimes it can truly be. Read some of the posts from NICEGUY and some others who do NOT have access to it and then you will realize how absolutely foolish that statement to the contrary is.
While it does have limitations - universal healthcare SOUNDS marvelous and in the perfect would it would be great BUT...have you ever seen how second rate it is to our system? There are serious limitations to the drugs that are allowed to be used and things like that.
Arnold Schwarenneger doesn't impress me very much in the slightest at all to use to make ANY valid point. I think he's an abusive drunken pain in the ass and can't fathom HOW that man got to be governor of anywhere except Fondleland.
2. As far as I am aware - we are not allowed to have a biopsy mid-treatment. So that wouldn't be useful in the slightest bit because we are ALREADY on treatment and potentially our liver enzymes would have been lowered and half way during treatment is a VASTLY different number between some people and others.
For me treatment was 72 weeks for others it is only 24.
What good would it show at that point at all anyway?
The most ideal feature would be a biopsy BEFORE and then AFTER to see how much (if any) recovery had happened and then a year LATER to see even more.
3. Why on earth would anyone EVER give an HBV test into a vain? If an innoculation is made to go into the muscle.............well thats where they darn well better be putting it. I'd imagine a nurse could find your shoulder or your forearm easily enough.
4. I am DAMN glad I live in the US and have this healthcare system as crappy as sometimes it can truly be. Read some of the posts from NICEGUY and some others who do NOT have access to it and then you will realize how absolutely foolish that statement to the contrary is.
While it does have limitations - universal healthcare SOUNDS marvelous and in the perfect would it would be great BUT...have you ever seen how second rate it is to our system? There are serious limitations to the drugs that are allowed to be used and things like that.
Arnold Schwarenneger doesn't impress me very much in the slightest at all to use to make ANY valid point. I think he's an abusive drunken pain in the ass and can't fathom HOW that man got to be governor of anywhere except Fondleland.
Sonic: I would be grateful...if you DO NOT EVER misrepresent what I have said again.
-------------
Sorry you're running into what happens here every day -- words being mispresented and disprectful discourse instead of a respectful exchange of ideas. I think most of us here appreciate that you're making the time to give us your unique medical perspective on some of these issues. Unfortunatly, if you continue to post here, you will continue to be misrepresented at times -- especially when your ideas are different from others or the common "wisdom". Hopefully that will not stop you from participating in the future.
Catll,
You have indeed grossly misprepresented what Sonic said, per his explanation and my own read of the mentioned posts.
Also keep in mind that in the medical community, like here, people are divided on many issues such as the need for biopsy prior to treatment. I personally may not agree with Sonic's take on the biopsy issue, but many doctors do, and to suggest that he "may not know what he's talking about" shows not only disrrespect, but a lack of knowledge on current HCV protocols. Again, I'm more pro biopsy than "Sonic" but you only have to go to the "Clinical Options" Web site to see other (U.S.) doctors more in line with Sonic's point of view, at least in selected cases.
-- Jim
-------------
Sorry you're running into what happens here every day -- words being mispresented and disprectful discourse instead of a respectful exchange of ideas. I think most of us here appreciate that you're making the time to give us your unique medical perspective on some of these issues. Unfortunatly, if you continue to post here, you will continue to be misrepresented at times -- especially when your ideas are different from others or the common "wisdom". Hopefully that will not stop you from participating in the future.
Catll,
You have indeed grossly misprepresented what Sonic said, per his explanation and my own read of the mentioned posts.
Also keep in mind that in the medical community, like here, people are divided on many issues such as the need for biopsy prior to treatment. I personally may not agree with Sonic's take on the biopsy issue, but many doctors do, and to suggest that he "may not know what he's talking about" shows not only disrrespect, but a lack of knowledge on current HCV protocols. Again, I'm more pro biopsy than "Sonic" but you only have to go to the "Clinical Options" Web site to see other (U.S.) doctors more in line with Sonic's point of view, at least in selected cases.
-- Jim
Elaine, Been vacationing the past few days in the local hospital with a case of atrial fibrillation. (The more you know about what's going on, the scarier being in a hospital is. LOL.) Anyway, I'm back home now and doing now doing fine. Assuming my ticker keeps the correct 'time', I should be back to normal activities in a day or so. Thanks for the nice welcome.
-- Jim/Jack
-- Jim/Jack
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