can BX tell how long infected?

[copyman]

i asked NYGirl this question but she never responded so i'm asking you all:

nygirl wrote : ...I "thought" i was infected in 2004 when I was diagnosed but after my biopsy it turns out I was infected sometime in the 80s......

my question: can a biopsy tell how long you been infected? i have never heard that but would be great if so. thanks

[jmjm530]

Circumstantial evidence (IV drug use, blood transfusion, etc) combined with a biopsy result, might help pinpoint date of infection, but biopsy result alone cannot distinguish say if you were infected ten or thirty years ago. A minority of those infected have a symptomatic acute stage which will pinpoint date of infection. I know I was infected 39 years ago because I had a symptomatic acute stage. BTW, everything being equal, the younger you're infected, the slower the rate of fibrosis progression. Some studies use the cut-off age of 40 in that regard.

-- Jim

[jmjm530]

Seems that the age of infection data would be built into the age 65 juncture. For example, if someone like myself was infected at age 20, by this model that would give me 45 years from infection to cirrhosis, i.e slower progression. However, someone infected at age 50, might only have 15 years, i.e. faster progression. Don't know if this is how the model works but just some thoughts. In any event, peroidic monitoring (biopsy, fibroscan, etc) seems the best way to follow any given individual. These studies were with HCV mono-infected inviduals. Apparently, fibrosis progresses much faster with HIV/HCV co-infected individuals.

-- Jim

[copyman]

what i think jim meant was that if you get infected after 40 it progresses much faster. i'm sure jim will clarify this.

[jmjm530]

As stated, age of infection is one of the important indicators of fibrosis infection. Other indicators are heavy alcohol consumption, obsesity, male sex, having a symptomatic acute stage and I believe geno 3 may progressive faster but not sure. Here's a snippet from just one study, abstract here: http://tinyurl.com/38yswk

"Three independent factors were associated with an increased rate of fibrosis progression: age at infection older than 40 years, daily alcohol consumption of 50 g or more (5 beers), and male sex."  

Elaine, unfortunately your doctors are correct and there is no way to tell (other than periodic biopsies/fibroscan, etc) how fast fibrosis will progress in a given individual. That said, studies do help us understand better why fibrosis may progress faster than in some and not others per the population in general. I'm sure there are some obsese, male, heavy drinkers who with little or no liver damage, but they would not be the norm.

All the best,

-- Jim

[jmjm530]

First sentence should have read: As stated, age of infection is one of the important indicators of fibrosis *progression*.

[jmjm530]

Here's one of the more recent papers on the subject: http://www.medscape.com/viewarticle/554637

"Age at infection above 37 years was independently associated with fast progression".

The article also goes on to state that absolute age may be even more important, and they use age 65 as the projected age when most will reach cirrhosis if untreated " http://www.medscape.com/viewarticle/554637  

[antman]

that's interesting. and in my case anecdotal with the evidence presented here. i beleieve i was infected in the 70's, for me mid teens. i am now 51 and am st. 1. i have been st. 1 for at least several years. i am now treating. so, if left untreated who knows how long ot would have progressed to cirrhosis? 65 doesn't seem unreasonable though.