Fibrosure Turn Around Time and Accuracy

[fitandsick]

Hello all, my doctor originally did not test for my fibrosis stage. He told me I didn't need to worry because all of my hepatic function panels looked normal. However, today I demanded a test. He informed me that in this area (Boston, MA) the easiest test would be a Fibrosure blood scan. I do have the option to go into the city and get a Fibroscan done, but he recommended I go with the Fibrosure.

How accurate are these tests? Typically how long did it take for your results to come back? I'm pretty anxious as my insurance company has denied my Harvoni treatment twice already. If it comes back F3 or above I'll likely get approved ASAP. (not that I'm hoping I have fibrosis... but I figured it would be good to know.)

[lporterrn]

They are as accurate, and sometimes more accurate than a biopsy. Either is fine. However, if you are denied treatment, you can still appeal, esp if you have F2 or symptoms or think you are at risk to transmit hep C to others, or unduly anxious about it...

[lolacme]

Hey fitandsick. Its good to see you advocating for your health. I demanded a fibroscan and was told the fibrosure would be the easiest. I just had my blood drawn 3 days ago and wonder the same thing regarding how long it takes to come back. My dr. prescribed 12 weeks of Harvoni for my F3 stage 4 but my biopsy was 2.5 years old and I feared I had slipped into an F4. I was afraid the treatment would not be sufficient so I also asked him to add Ribavirin which we did 10 days into my Harvoni. If I come back an F4 I am going to asked for 24 weeks of Harvoni. I want this enemy out of my body like yesterday. I will do everything I can to make it happen even if that means asking for tests the Dr. himself may not have deemed necessary to order in the first place.

[dragonslayer]

They are as accurate, and sometimes more accurate than a biopsy. Either is fine. However, if you are denied treatment, you can still appeal, esp if you have F2 or symptoms or think you are at risk to transmit hep C to others, or unduly anxious about it...

Lucinda, is there a change of thinking on this? Ive always read that the noninvasive tests were pretty good at identifying no damage or Cirrhosis, but not accurate/reliable in the middle ranges, and that biopsies were more accurate in the middle. Is this not true anymore?

[motor]

I've always questioned the value of the biopsy, you're getting a sample of one spot.  Whereas the FibroScan is measuring all of liver and coupled with Fibrosure blood work would seem to give a more complete picture.  Just a layman observation, is the liver homogeneous in damage?

[dragonslayer]

I've always questioned the value of the biopsy, you're getting a sample of one spot.  Whereas the FibroScan is measuring all of liver and coupled with Fibrosure blood work would seem to give a more complete picture.  Just a layman observation, is the liver homogeneous in damage?

It may 'seem' like that, but I dont think it 'is' like that.   

http://www.ncbi.nlm.nih.gov/pubmed/20850886

"Conclusion:
The diagnostic accuracy of non-invasive tests was high for cirrhosis, but poor for significant fibrosis. A clinically relevant gain in the likelihood of diagnosis was achieved in a low proportion of patients. Although the diagnosis of cirrhosis may rely on non-invasive tests, liver biopsy is warranted to diagnose intermediate stages of fibrosis."

[lporterrn]

Dragonslayer - As you have probably seen, for every study that says one thing, there is another that says the opposite. You are correct about the middle ranges, however, let's put it in context. On one hand, you have an invasive procedure, that is fairly unpleasant and 20% of pts are staged incorrectly. Compare this to a blood test. If the goal is to qualify for treatment, and the results from a blood test support that goal, then you are done. If the results are in the gray area, then you can request further testing.

What was not discussed by fitandsick's doctor was the choice of imaging, such as FibroScan. To me, this would be a good choice, or a good confirmatory test should the blood test yield murky results.   

Here is a link that really describes the choices:http://www.hepatitisc.uw.edu/go/evaluation-staging-monitoring/evaluation-staging/core-concept/all