Understanding My Results

[jab1979]

So I went and had some lab work ran and need some input and help understanding everything.

I tx'ed for 24 weeks (Geno3a 180Pegasys 800mg Riba), May-Nov 06, cleared the virus by week 12, and reamined cleared until I relapsed during a 3 month follow up test in February 07. The redone the test to confirm and had some other tests as well.

They done a Fibrosure - I told my docs don't do it because the requirement was at least 6 months post therapy, but they done it anyway and the test came back adnormal. I don't have the actual values, but  working on it.

Q) Will the test come back abnormal 3 months post treatment? Is it an accurate measurement of real damage?

Today's test shows:
ALT - 168
AST - 119
Bili - 1.1
PLTS - 174k
Albumin - normal range

Last Vist results (Feb 23rd 07)
ALT - 79
AST - 73
Bili - 1.1
PLTS - 174k
Albumin - normal range

Q) If the Fibrosure is "accurate," and I do have abnormal/cirrhosis, wouldn't I be show evident signs all along? I know the symptons with Cirrhosis and what to look for in values, physical signs and sheer evidence. Based on my labs, which are ALL normal ranges except ALT & AST, would these be a little off? I have no signs or symptons of cirrhosis at all, just a questionable Fibrosure.

I am a hemophiliac, co-infected with HIV and HCV around age 3. I can't get a bx due to bleeding, so they ordered a ultrasound in Jan. 06. It said mild diffusion with diffused liver disease. My doc said something about fatty liver.

Q) What does that mean?

Since I can't get a biopsy, they are going to do several test including a repeat ultrasound, CT scan and a TechneScan to see full liver function in April. They are also going to check my gallbladder and kidneys while I'm at it, even though everything is normal.

Q) Will gallstones make LFT's go up?

[jab1979]

The result was 0.8, I guess that means .80, not .08. I copied that figure directly from the result sheet.

[copyman]

i think you meant 0.80 not 0.08
have you ever had a fibrosure before to compare this reading with? the only thing i have read about when not to take the fibrosure test is during tx. i would try and get a fibroscan since you can not get a bx. or maybe re-test with another fibrosis blood test from a different lab. best of luck to you.

[jab1979]

Fibrosis Grade   0.8 or F4

Necroinflammatory Activity Score is 0.66

Yeah, I no physical signs. Not even the slightest indication of cirhosis, not even the red palms or spidery vein thingies. No abdominal swelling, nothing, which has docs even more puzzled. Could the fact that I relapsed and the virus is somewhat regenerating have a role in the test?

[Kalio1]

It's my understanding the Fibrosure tests are very accurate once fibrosis has advanced.
Here is a link about Fibrosure.

http://bmc.ub.uni-potsdam.de/1476-5926-3-8/

I would think that the drugs you are taking might be contributing to your raised enzymes somewhat since you know they can impact your liver and I agree with those who say that fatty liver could be a contributor too, 3a's like us have shown in studies to have a higher incidence of it but I don't know if that would skew the FIbrosure results. I'd speak to your doctor about it and see if he thinks those factors are giving you a wrong reading. I would think not.

I was floored when I found out the news about my liver damage too. I guess I figured if my liver was that bad off I'd have somehow known it, but that just isn't the way it is. Most people who find out they have cirrhosis had no clue until a test came back indicating it.

[jab1979]

I got my results back from the Fibrosure, and they are scary. The actual numbers I now have, and they are scary. Like the worst you could get scary. I find it hard to believe that this test was an accurate measurement of my liver status.

[bobbyullc]

sorry, very sorry. i was stage 3-3 with a biopsy and never felt better in my life. it is a **** shoot. some do some do not. good luck.

[jboyhk]

Maybe someone on this site can direct you to get a Fibroscan (non invasive but better than Fibrosure).

[copyman]

i also had a fibrosure test and did alot of research on it. i found out that it is fairly accurate about 80%,  on the low end F0-F1 and high end F4  but not that accurate for the middle stages F2& 3. the biopsy is about 90% at best. what was your fibrosure result? i would think you would have some indication of cirrhosis like spider veins on chest, red palms, etc.

[mikesimon]

I wouldn't immediately assume on the basis of your test and labs that you're cirrhotic though fatty liver is often associated with genotype 3 so that might be something to consider. I will post 2 links that may help you understand some possible features that might be at play. Stetosis is fatty liver. You must be registered to view these links but it's free, quick and easy and well worth the time. Just copy and paste if you're so inclined.

Impact of Hepatic Steatosis on Viral Kinetics and Treatment Outcome During Antiviral Treatment of Chronic HCV Infection
http://www.medscape.com/viewarticle/553011?src=mp


Early HCV Response Predicts Outcome in HIV+ Patients
http://www.medscape.com/viewarticle/553670

Mike

[nygirl7]

Hi.  I'm sorry you've been having SUCH a rough time of it.  It's just not fair.

None of us on here are doctors - and your situation sounds very very complicated so I would definitely talk to a good heptologist and take their word over anyone in here. All we could do is take our very limited knowledge and guess.

Honestly, I wouldn't even know where to start!

I wanted to make sure that you know we are here to support you and give you advice on things that we can.

What did the doctor have to say?  What was your liver damage level before you treated? If it wasn't too bad I can't imagine why you would be thinking you have cirrhosis now?  Most of us who have had HEPC for any amount of significant time all do have liver damage.  I didn't even know I had the disease and have stage 3 damage - but I do not have cirrhosis.

Can you have been mistaken in the results and the abnormality be just fibrosis?

Good luck with everything.

[jab1979]

A year and a half ago, my HIV dov changed my cocktail because I developed a resistance to one of them. Before the med change, everything was normal in my life. After the med change, everything got worse. He put me on two pills that are pretty hard on the liver, especially for HCV patients (Viramune and Reyataz).

Q) Could my LFT increase be a chemical reaction rather than a viral?

I was also regeno-typed and the antibody test ran. The Genotype came back 3 (sub typed undetermined), was 3a.

Q) The antibody test came back positive, but does this actually mean that I still have the virus? Today the run the PCR to determine the viral load since I supposedly relapsed.

I feel great, no signs, symptoms, complications, issues or anything other than my hemophilia related matters which is far from HCV and HIV. I am just getting all these tests ran, and all this data is pointing to so many things. The Fibrosure, if trusted shows I am pretty bad off. My labs show a far different story being everything normal ranges with exception of ALT & AST. It's been a nightmarish year and half psychologically. As far as suffering physically, I have no signs of any of my 3 diseases. How can I feel so well, but be so worried?

Thanks everyone, and AMERIBOI, Where are you bro? I have phoned several times, and I am really beginning to worry about you.