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Avatar universal


Hello, Today I go to the doctor. Three weeks ago I was diagnosed geno 2b viral load 8.5 mil. Since that time I have tried to learn as much as possible. With your help I believe I now have an understanding of my situation. But I still have questions. I have not had a biopsy yet. Q:Is it normal for the doctor to suggest treatment BEFORE  having the results of the biopsy? In essence before he knows the condition of my liver? Or do they usually wait until after the biopsy? I ask because I want to begin treatment ASAP if possible. My other question is should I get the Hep A and B vaccinations. I know there has been vigorous debate on this. But If I have to wait until I have the shots (six months I believe) to begin treatment my decision would be to forego them and get on with treatment. Is this a wise decision, or a foolish decision?

I also wanted to congratulate everyone who had great news recently. The forum looked like a celebration yesterday. It was beautiful thaang!


30 Responses
Avatar universal
Hey Lou, welcome!  I too, an 2b, and my hepatologist decided against doing a biopsy.  Here's the reasoning - us 2b'ers have a much better chance of clearing the virus (knock wood) than out genotype 1 counterparts.  Much of the purpose of having a biopsy is to determine if damage is extensive enough to start treatment, or if you can wait a while.  Since genotype 2 people are generally treated for only 24 weeks, and have a much better response rate, there's often no need for a biopsy if there is no obvious signs of extensive liver damage.  If these signs are not there and you're determined to treat, he may not do a biopsy at all.  Ask him/her about this at your appointment.  You seem determined to get started right away.  Best of luck to you!  I was "undetectable" at 4 weeks, and am doing shot 15 tonight.  If I can do it, you can!
Avatar universal
Thanks man, Hey what about sx, How you doing?

Lou  Oh I ask you before once on a different thread, you guys still have a football team or did you blow them up with the vet?
Avatar universal
I disagree completely..Don't you want to know where you stand?? I believe that it is absolutely necessary to have a biopsy to know the severity of YOUR case.. Regardless of gentype, biopsy is necessary..
Anybody with HCV, should have a biopsy, just to have a baseline, no where you started from, see if tx reversed some damage, prevent further damage, by avoiding meds, and proper diet..
Personally, I would request a biopsy, and I'm sure alot of others would also.. You have to know where you stand, just to know what you MIGHT face later in life..
My biopsy was done 3 days after my Dr appointment, CT, next day, and meds where ordered two weeks later.. You'll be on the road to SVR in no time..
As far as the hep A, and hepB vaccines.. Go with your instincts.. If you feel more comfortable with them, get them..If not, start your tx, and put HCV behind you, then worry about the others..
I don't have my vaccines, and I've had this disease 27 years..Unless you work in the medical field, the likelyhood of you getting hep B is slim.. Good luck with whatever you do..
Avatar universal
Lou:  Side effects are going OK.  Everything seems to come or go without much ryhme or reason - I think that's the hardest part, not knowing how you're giong to feel from one day (or hour!) to the next.  The only one that really bothers me is the fatigue.  Strangly, though, it gets better if I keep moving.  I've only missed one day or work since beginning treatment (and even then, I felt better by mid-morning).

Our new fotball field (and baseball field!) is gorgeous - what an amazing facility.  It's a far cry from the Vet!  Where are you located?
Avatar universal
Forgot to mention, that many show no signs of damage from tests..
My liver panels and CT, so nothing at all.. But my damage is stage 2/3.. You can not go by panels or ultrasound as stated above. Many of us here have perfect liver panels, or only sightly elevated, and suffer severe damage.. Biopsy man!!!
Avatar universal
Oh - don't worry about the Eagles being blown up with the Vet.  My Tampa Bay Bucs blew the Eagles up LONG before (and, come to think of it - AFTER) the Vet was gone!!!! (And when we got done with the Eagles, my Lightening took the Flyers to task!)  Hot damn - It's football season again!!!  Life is EXCELLENT once again and all is as it should be.  Unfortunately after waiting 8 months for my beloved Bucs season to start, my first Bucs game is going to probably get canceled Saturday night due to this stupid hurricane!
Avatar universal
Can;t argue with you there!  When you're right, you're right (much to my chagrin!).
Avatar universal
I was told that the vaccines can raise your viral load and like Snook says, If you don
Avatar universal
That's OK.  You guys kicked our butts for so many years, it was about time we got mad and did something about it.  Eagles are still a formidable team and I never assume that we are going to win we play them.  But I hear you Eagles fans sure don't like us very much!  Awwww - come on.  Be nice.  It's just a game.  Right???
Avatar universal
"A liver biopsy may be avoided in the case a patient has chronic hepatitis C and has no other causes of liver disease and is infected with the HCV genotypes 2 or 3 and strongly demands to be treated independently of the liver histology features, provided that no major contraindications to the combined therapy exist."

I think my doctor prescribes to this point of view.  It seems having a biopsy for curiosity's sake is rather unecessary.  I mean, what would I DO with the information?  I would still treat immediately whether I was grade 0,1,2,3 or 4.  However, if I wasn't sure whether to treat, or if I had genotype 1, having that infomation would be helpful in making a decision.  I can see getting a biopsy if I don't achieve SVR this time.  It will help me to decide whether to try again immediately, or if I can wait until something better comes along.  I understand your viewpoint, though, snook. People always seem to have strong opinions about this topic!

Lou, every case and patient is different, and your physician will make recommendations that are right for you and your situation.
Avatar universal
Furbarcat:  Philadelphia fans don't like ANYONE!  We even booed Santa Claus one year, and no one found it odd.  
Avatar universal
Rofl,,,,Or do I mean "Luis"  haha saw the new hat you are wearing now,,,,Medhelps "Ladies Man",,,Can't wait to get you started on the "ride",,,this ought to be fun!!

Ok,,,Biopsy,,,I personally would get one,,,just because I didn't and regret it,  Granted you are a 2 and will clear but if your liver was in bad shape now,,,Wouldn't you want to try to some reversal or extenstion just to try to clear,,,Otherwise,,,no damage,,,its a breeze and YOU KNOW IT,,,24 weeks and you are outta here!
Vac's,,,,I know its been half and half on this subject but I would start your series on hep A & B now,,,only if your dr suggests it of course,,,,I started my first shot before tx and of course its a 6 month deal so finished up,,,No effects on my viral count.  If you get A or B on top of C,,,Could be bad!

Can't wait for you to get back from Dr and tell us what all he says.  He will be impressed with you with all the homework you have done.  Good Luck,,,Luis!!!  LOL  (((hugs)))
Avatar universal
Hey, what the heck is going on with you?  You have come entirely too far to stop now.  If you need to take a break from the Board, that's fine.  You are 43 years old, get a grip.  There are some things that you can change, and some things you cannot change.  You need to know the difference.  I know that you know the Serenity Prayer, do me (and all the others that care about you) a favor and say it a few times until it sinks in.  Your posts make you sound like your going nuts.  Call your doctor and let him know what's going on with you.  Put your foot down and tell him that something isn't working right.  DON'T MAKE ME FLY OUT THERE.

Avatar universal
Forgot to mention that my doctor is keeping me on a few weeks longer than the standard 24.  Without a complete picture of my liver health, he said it's the best way to avoid relapse, since greater damage = greater chance of relapse.  He thought that going a few extra weeks was preferrable to doing a biopsy at this point.
Avatar universal
My doctor insisted on a Hep A vaccination before I started tx; I was already current on the Hep B series.   All my hepatologists have been big on inoculating against other strains of Hep.   Just my 2 cents:  get  a biopsy to establish baseline and become a REAL club member.  Just don't renew your membership card too often...!
Avatar universal
The only good thing my 1st  Dr. did was order a biopsy before  allowing me to start Tx.
I will have a 2nd one in 2006. Then try to  re -TX if my system will handle it.
But hey... I feel great right now and without that biopsy  showing I have no damage, no scarring, zip nadda.. I may have tried to re-TX sooner and caused further damage to my immune system.
Get the Biopsy.
Avatar universal
My Dr, who works in one of the leading GI centers in the nation, and has 12 Dr's and three PA's,and working under the guidlines outlined for tx of HCV by leading Hepatoligist, Dr. Schiff.. She sent me for biopsy, before genotype was done.. First visit, she discussed everything.. Drew blood, for labs, then scheduled CT, and biopsy.. Came back in two weeks, sat me down and gave me a full perspective of where I stand.. She based lenght of tx on geno, not biopsy results..
I believe Newsourjourn was also a 2B, end stage liver disease, and cleared virus in 24 weeks..Genotype, does not determine liver damage.. Wouldn't you like to know what condition your liver is in, as to know how to live out your HCV free life afterwards.. Say you clear the virus, but have stage 2,3,or even 4 fibrosis.. Yes, you do not have hep C to worry about, but there are alot of other things you need to beaware of to avoid further liver progression.. And the only way to know this, is with a biopsy!!!
Best of luck at the Dr...
Avatar universal
buenas suerte, senor Luis
Avatar universal
Hi unico,
I'm pretty much in the same boat as you, genotype 2b, VL 7,000,000. My doc insisted I take the HepA & B series which I started before tx. My last shot is at the end of the month. I'll find out if it affect my VL.

I had the bx and I'm glad I did just to know what shape my liver was in. I would just for that reason. You could have good levels and major damage, I would rather know what's what.

By the way, I truly enjoy your posts and your unique sense of humor and intelligence. I'm going to the doc in 10 minutes so I'll let you know how my 4-week tx progress went.
Peace - Gulfcoast
Avatar universal
TAMPA area???   I am not much of a football fan...however..HOCKEY ???   LIGHTNING?? oh YEAH!!  I cannot wait until Hockey season begins.. and it had better begin..I think there should be a Hockey channel so all the leagues can be shown..  there's a golf channel.. THAT I cannot believe.. (sorry all you golfers out there)  yes.. lying in bed, feeling bad, watchinng hockey.. that will make treatment go alot easier for me!! LOL..
  good luck with Charley!!
Avatar universal
I also am/was 2b. I had a bx. before tx., and am glad. Also my G.I. insisted on A & B vaccinations. I started b4 tx. and just finished as I was finishing Tx. Also I had flu and pnuemonia shots b4 tx. because it was winter. I had no problems w/ any of these, was an early responder and at 3 months post tx., am still undetectable. And now that I've finished tx., I don't have to worry about getting the shots. I'm done and except for 6 and 12 mo. PCR's, I'm done w/ Dr. appts., which makes me very happy. I'll need to eat liver freindly and take my meds, and hopefully I'll live happily ever after.     Joni
Avatar universal
Will you have another biopsy to see if tx reversed any damage because it probably did.  If that was done and had improved greatly,,,you wouldn't have to follow such a tight regimine for liver....right?
Avatar universal
Since I had no insurance, was a 2b and had a near fatal bleed and liver failure, I didn't bx.  I cleared by day 18 28mos ago.  I actually feel a little better all the time. I'm free of the hepc virus that was transfused  in '67.  My problems are now related to the extensive damage caused by the mis-dx hep c, not the meds that cured hep c.  Now its all about preventing any further damage and healing what can be healed.  Avoiding insult to injury!
Avatar universal
What do you mean by damage done by mis/dx hep c?  I saw one of your postings awhile back that you were having some problems and had a call into your dr. I hope everything is ok for you and you are feeling better these days!
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