liver biopsy?

[missa1123]

Hello im new here. Was just diagnosed in may been to the dr twice today i found out i have genotype 1b my vl was 87,889. My alt was 330. Dr wants to do a liver biops. Is this standard?  I just assumed after my blood work that i would start treatment?  Im sure that i just contracted this within the last six months. My only symptoms are fatigue and abd pain intermittently. What has everyone else's regime been for gettin treatment. 

[Lynn K]

Liver damage helps to determine length of treatment. Also having more liver damage can have an influence on if your insurance will approve treatment and is probably required by your insurance company to determine your eligibility for treatment.

For reference my ALT AST have always been below 100 and I have had hep c for 37 years

[missa1123]

Thank you for your insight. Do you think since my alt was so high that i have more liver damage?

[Lynn K]

ALT and AST don't indicate level of liver damage only that something is bothering your liver.

People can have low ALT and AST scores and have a lot of liver damage myself as an example. My numbers as I said have always been below 100 really below 80 but I have liver cirrhosis. While other people can have high numbers and little to no liver damage.

ALT and AST only show your liver is being injured not how bad the injury is.

Liver biopsy is considered the "gold standard" for determining the extent of liver damage. I have had 4 over the years of being infected with hep c.

And you insurance may require a test for liver damage before they will prescribe the medicine.

Good luck
Lynn

[Jorah]

Its no longer the standard around here, they do a fibroscan and blood tests. (although the biopsy is more precise) not that I'm a specialist but if you contracted it only 6 months ago I doubt it could have done that much damage ask him if you can do a fibroscan unless you're ok with a biopsy. (could be like Lynn says its because of insurance issues)

[Lynn K]

The blood tests (Fibrosure) and the fibroscan are less accurate for mid range liver damage and not every one has access to a fibroscan machine.

But yeah with a short time infection it is not likely you would have a lot of damage but you may have been infected earlier in life and not known. A few here were infected since birth.

I would ask your doctor about the fibrosure blood tests or if they have a fibroscan machine. But if you don't have access and insurance needs some indication of liver damage before the will allow a prescription that leaves the liver biopsy as the only option

Good luck

[Jorah]

Lynn, I noticed on your sig that you've tried treatment several times, and then showed cirrhosis in 2008, I was under the impression that even Treatments that failed to kill the virus still slow down or benefit us or is that a myth?

Thanks

[Lynn K]

Hi Jorah

Dunno it didn't help me any.

They did have the HALT-C study which my doctor did talk to me about but as I recall the results were mixed.

I treated many times but with each biopsy in 1993 F1, 1998, F2, 2003 F3 and 2008 F4.

I remember my doctor saying they though it could "cool off" the virus but didn't seem to do any good for me is all I can say.

But anyway interferon is a thing of the past for most in the US at least and most of us are being cured so really kind of a moot point now

Good luck

[rainbowray]

Hi missa1123,

Having a biopsy is not really a nice experience, even if your told it is not "that" bad.
They cost Thousands of dollars. A fibrosure blood test is about $300.00 and insurance is ok with that for a standard to qualify for treatment. That is all I needed to get treatment going. I too am 1b.   The veikera pak treatment is suppose to be close to 100% cure rate if you do not have cirrohsis.
My opinion, is make the biopsy your last resort. "I would never do it again"
Your alt is kind of high but it only indicates the liver is having some kind of issue, damage needs other tests to prove level. The fibrosure or fibroscan can do this.
YOur viral load is low, but that does not mean there is no damage to liver. Sometimes if there is low damage, and low viral load  it can be difficult to get ok for treatment from insurance. Appeal if you get denied, cause the sooner hepc is treated the better.