Fibrosure and Fibroscan

[Baxter]

I'm not sure what forum to post this in, but since I'm no longer on treatment, I may as well post in "Post."

6 months ago, at the start of my 3-month Harvoni treatment, I had a Fibrosure test that read .73 - very high end of Stage 3, borderline Stage 4 (for which the cutoff is .75, as I recall.) I never trusted that result, because it seemed like an outlier when considered in the context of my other bloodwork, my symptoms, and just how I felt. My feeling was that the result was too high.

But I didn't really care, because I was about to start treatment, and I figured I'd just wait and see what it was at the end. Especially given how unreliable the Fibrosure test is in many cases.

Yesterday I had my 12-week post TX bloodwork done, and they also administered a Fibroscan test. My score on that was 7.9, which according to the PA (and everything I've been able to google) indicates a low-range Stage 2. Well, obviously that beats the heck out of a Stage 3/borderline 4, so of course that's good news.

But isn't it odd to have so much change in just 6 months, and really only 3 months after completing treatment? It seems logical to assume that at least one of those tests was not accurate, possibly even both. What should I make of this?

[Lynn K]

both the fibroscan and fibrosure are of limited use for mid range damage. However if they indicate significant liver damage i.e. cirrhosis they are more accurate.

Liver Biopsy is still considered to be the "Gold Standard" for accuracy but it is also an imperfect tool for staging liver damage but it is more accurate than either Fibroscan or fibrosure.

[Baxter]

This might serve as a reassurance to some people who are concerned because their test results are higher than they expected. When you figure it took a few weeks for the Harvoni to start working, you have to assume that whatever happened only took about 5 months. So in about 5 months, I went from high Stage 3 on the Fibrosure to low Stage 2 on the Fibroscan. That may represent a pretty good reason to take the tests with a grain of salt.

I've had 4 biopsies, and am less than eager to have a 5th. So chances are, I'll never really know for sure. And I can live with that. Long as all the other measurables are good, and long as I feel good - well, I'm good.

[FutureThinker]

Hey Baxter, for what this is worth, I just had a conversation w/ my hepatologist at my SVR12 appt last month.  I asked re: a very high alpha-1 m...... number on the test.  I was told "not to worry about that, it can go a lot higher" and that "many clinicians do not use this test as it is not considered that accurate."  It was ordered for me when my insurance co. denied my treatment.  I had a biopsy in '12 and they did not feel the need to do another, so chose the FibroSure test as that was what was available.  Now that the Fibroscan is here, I suspect it will be used more as it is supposedly more accurate than the FibroSure. 

From my reading, Lynn is correct in that these tests are not as good for mid-range fibrosis, so keep that in mind. At any rate, glad you're done with treatment!!  FT

[jakas]

Anyway what is important here is atleast it shows there is improvement in the state of the liver. The exact score IMHO is not so important.

[Baxter]

Yep. My feeling as well. With results in that range, it could be off by quite a bit and still be good. I'm happy with where it seems to be at.

I'll be a lot happier when I find out my final results on Monday or Tuesday, though. Got a bottle of champagne chilling in the refrigerator, and a jar of moonshine in the cabinet. I plan to have a sip of one or the other if I hear what I expect to hear.