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2030686 tn?1351692148

insist on biopsy?

I went to the hcv dr today and I'm not sure how I feel about things.    He told me that if I'm gonna do tx in the next year, biopsy is an unnecessary risk.  He told me my liver was just as healthy as his and I didn't need to worry about any meds I was taking.  He did say he had to clear it with the neuro I saw for my seizures but didn't say I needed to check anything else.  Don't you usually have to get an eye exam and other tests before actually starting tx?  My reg dr called him and got the blood tests ahead of time.  He basically said take care of the cervical dysplasia then call him and we can "get trained" and start tx.  What things do they usually check before starting tx?  What is the eye dr looking for in the eye exam?  
13 Responses
1765684 tn?1333822768
How does your doctor know the condition of your liver if you haven't had a biopsy?  Have you had a FibroScan?
163305 tn?1333672171
Is your hcv doc a hepatologist ? A liver specialist? It's hard to imagine one wouldn't want a biopsy unless you have cirrhosis.
You don't need one to do treatment but if you know you liver's true health, you have more options available to you.

However, I have no idea how your other health problems may be affecting his decision. You need to ask him specifically why. It is an invasive procedure and though very slight, there is always the chance of risk.

Because treatment can affect your vision, the only way to know is to first have your eyes tested.

I've started a list of questions which I'll provide for you:
Questions for the doctor:

How experienced are you in dealing with Hep C ?
Do I need a biopsy before treatment?
How often will I be doing labs during treatment?
What is your protocol for dealing with low wbc or rbc?
What about other side effects?
How often will I be seeing you during treatment?
2030686 tn?1351692148
No, just blood work.  He said it didn't matter if I'm getting ready to tx anyway, but he would do it if I wanted.
Avatar universal
You have the chance to see one of the best Hep-C doctors there is and he's also very much up to date on the new PI's. Was the principal investator. I treated with him and it doesn't get much better... I would see him... Good luck
87972 tn?1322664839
Many doctors don’t feel that risk of biopsy is warranted for GT-2 patients. He’s probably taking into account your age, stated lifestyle history and biochemical results from recent labs. If you treat soon, you’ll clear the virus; this can’t historically be said for other genotypes.

A doctor can discern cirrhosis from fibrosis using platelet counts and other, common labs. If you had developed severe liver disease to date he’d have notified you. For what it’s worth, I agree with your doctor.

Good luck-

Avatar universal
There seems to be 2 schools of thought in the medical community on need for biopsy.
On the one hand with the possibility on newer treatment possibly coming to market in the next 3--5  years( projected).. patients and doctors alike would be  interested  in knowing the degree of liver damage(fibrosis)  in order to converse about  whether it may be better to to treat currently or possibly the option of waiting
.Also if one has cirrhosis the time frame of therapy may be different that  with less extensive damage

On the other hand ,,if  along with the recommendation from their doctor  a patient is going to treat currently regardless of amt. of fibrosis ..then there may be no need to subject the patient to the invasive procedure of biopsy.

Always best to be guided by a physician knowlegable with treating HCV..
Best ..

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