Ultra Sound for Hepatitis c

[palmbeachinfo]

1) How accurate is a hepatitis test?
2) Is an Ultrasound a best way to see if there is damage in the liver? besides an liver bioposy
3) I heard the a liver enzme isnt always accurate, how accurate is it?

[palmbeachinfo]

You guys copyman, Andromedae, Magnum and Zellyf


I appreciate the  knowledge you have on this subject,

I have a few  questions:

Can certian drugs supress the immune system blocking your body to make antibodies for Hep b and c? Read case study 1:

if Zoey had unprotected sex on Jan 1st 2008 *the male unknown status)
and she tested negative for Hep b and c on July 1st *but she had 2 sets of steriod blocks in her neck within those 6 months because of slipped discs in her neck.

Can those steriod blocks (block the body or delay the body from making anti-bodies that might cause her to have a false-negative results at 6 months?

[Andromedae]

You we pretty much agree.  I opted not to get the biopsy after having an ultrasound because the ultrasound did show a fatty liver but showed no signs of cirrhosis but more importantly I did have 3 very small and one small to medium sized hemangioma - which is a bleeding risk during a biopsy.  

And although, the guy at the V.A. who does these is supposed to be extremely experienced he guides the hands of an RESIDENT as a training exercise.  I didn't think it worth the risk.

[copyman]

My comment was actually in response to his question "best way" to see if damage in liver. my answer is still no it is not the best way,  but will agree with you that in the case of cirrhosis or severe fatty liver it may show damage. I still would not trust it for a DX of liver damage.

[Andromedae]

"2) No, the ultrasound can show masses,  bile duct measurements, etc but not liver damage such as  (fibrosis). The biopsy is the gold standard or at least get a FibroSCAN. And another choice would be a blood test called a fibroSURE. "

I'm going to have to disagree there copyman.  The ultrasound can show if there is fibrosis  in the following ways that I know about - there are probably more):

1. The ultrasound can show if the edges of the liver are regular or not thus indicating if there is cirrhosis .

2. the ultrasound can show if there is portal vein and other vein distension and irregularities which indicates possible cirrhosis .

3. The ultrasound can show if there are abnormalities in the density of the liver tissue this indicating either fibrosis or fatty liver (Steatosis)

The ultrasound can not rule out cirrhosis and the biopsy is absolutely the best way to determine the precise degree of liver damage.

[zellyf]

When you test positive for Hep B you test positive for the surface antigen.  When you clear it then you will be surface antigen negative with antibodies.  

I have heard of people have relapses as a result of radiation/chemo for cancer treatment.    I have heard of occult Hep B where the person tests negative but has enough antigen to spread the disease.  But in the vast majority of cases once you are surface antigen negative with antibodies its time to go about your business.

[palmbeachinfo]

Lets say
as an example Mr. walker was diagnosed with Hep B at 3 months

then at 6 months he was re-tested and the test was negative. Is it that he cleared the virus or did the virus "hide" into another organ where the body no longer needs to make any anti-bodies? Is it possible that the virus is still in his system but "is laying dormant"?

[copyman]

1) very accurate, less then 5% false positive

2) No, the ultrasound can show masses,  bile duct measurements, etc but not liver damage such as  (fibrosis). The biopsy is the gold standard or at least get a FibroSCAN. And another choice would be a blood test called a fibroSURE.

3) liver enzymes are accurate to tell how much inflamation is going on with your liver but does not correlate with how much damage is present.

[Magnum]

Ultrasound is a basic exploration of your liver, gall bladder, spleen, etc... It will give SOME information, which IF there is something "suspect", then further testing will be done. That further testing will certainly be a liver biopsy, as I will have tomorrow. In other words, no one counts on an Ultrasound as a final analisys...

Good luck...

Magnum