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Author Topic: Liver Biopsy  (Read 10099 times)

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Offline Mixer

  • Member
  • Posts: 19
Liver Biopsy
« on: November 18, 2016, 09:17:30 pm »

Is a liver biopsy needed to get approved for HARVONI, i had the elasticity test but it was incunclusive it said NONDIAGNOSTIC LIVER STIFFNESS ASSESSMENT and the doctor says I need a biopsy so they can make a treatment plan but I don't want one......I don't need to know if i have cirossis it doesn't matter....I know I have HepC why do I need a biopsy to make a treatment plan.....there is only one treatment plan cure HepC.......I just don't understand
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Offline BillT

  • Member
  • Posts: 573
Re: Liver Biopsy
« Reply #1 on: November 19, 2016, 10:23:16 am »
Hi Mixer,
            I'm assuming you had the Firboscan done.I would ask your doctor about having a FibroSure test done and see what they say.
Logged
Contracted 1973 Military
Diagnosed 1980
Pegintron treatment 2004 unsucessful
Genotype 1b
FibroScan 10 (F2)
Start Viekira 10.17.2015

AST 40 ALT 69
VL 440k
10.31.2015/Week 2 Labs : AST 14/ALT 17
No VL done
10.14.2015/Week 4 labs : AST 14/ALT 14
VL UNDETECTED!!!
12.11.2015/Week 8 Labs : AST 12/ALT 13
No VL done
01.05.2016/EOT labs : AST 15/ALT 13
VL UNDETECTED!!!

12 WEEK SRV:UN-BLOODY DETECTABLE !!!!!!!!

24 WEEK SVR:UNDETECTABLE!!!! Thank You God.

Fibroscan 6Mo. Post Treatment 7.15.2016-5.3(F1)

Offline Mixer

  • Member
  • Posts: 19
Re: Liver Biopsy
« Reply #2 on: November 19, 2016, 05:06:40 pm »
Thanks I was just looking at my insurance and they will only approve Viekira Pak, Not sure I like that
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Offline BillT

  • Member
  • Posts: 573
Re: Liver Biopsy
« Reply #3 on: November 19, 2016, 06:37:14 pm »
There's nothing wrong with Viekira Mixer.It worked for me and a lot of others.What genotype are you?
Logged
Contracted 1973 Military
Diagnosed 1980
Pegintron treatment 2004 unsucessful
Genotype 1b
FibroScan 10 (F2)
Start Viekira 10.17.2015

AST 40 ALT 69
VL 440k
10.31.2015/Week 2 Labs : AST 14/ALT 17
No VL done
10.14.2015/Week 4 labs : AST 14/ALT 14
VL UNDETECTED!!!
12.11.2015/Week 8 Labs : AST 12/ALT 13
No VL done
01.05.2016/EOT labs : AST 15/ALT 13
VL UNDETECTED!!!

12 WEEK SRV:UN-BLOODY DETECTABLE !!!!!!!!

24 WEEK SVR:UNDETECTABLE!!!! Thank You God.

Fibroscan 6Mo. Post Treatment 7.15.2016-5.3(F1)

Offline Mixer

  • Member
  • Posts: 19
Re: Liver Biopsy
« Reply #4 on: November 19, 2016, 07:48:50 pm »
Genotype 1a
Viral Load 40700 IU/mL
AST 66
ALT 93
Liver Stiffness Assessment:
Mean: 2.80 m/s
Median: 2.65 m/s
IQR / Median ratio: 0.46
IMPRESSION:

NORMAL SONOGRAPHIC APPEARANCE OF THE RIGHT UPPER QUADRANT.

3 FOCAL GALLBLADDER LESIONS CONSISTENT WITH POLYPS MEASURING UP TO 4 MM.

NONDIAGNOSTIC LIVER STIFFNESS ASSESSMENT.


Same like you I think I got it in the army 1975
« Last Edit: November 19, 2016, 07:52:48 pm by Mixer »
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Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,546
  • Get tested, get treated, get cured, fight Hep c!
Re: Liver Biopsy
« Reply #5 on: November 20, 2016, 08:16:19 pm »
 Was that maybe an abdominal ultrasound result? It doesn't look like a Fibroscan test result  yes treatment can very depending upon degree of liver damage also some insurance will not provide any medicine unless you have an F3 or F4 test result.  Does your doctor have access to a fibroscan machine?  Another option is the Fibrosure blood test.  Also if you have more liver damage that might allow you to take Harvoni instead of Viekira Pak

Edit I just checked and normal sonographic is a term used in ultrasound testing that may be the test you had.

You do need to know if you have liver damage as you would need to possibly make some lifestyle changes if you do have F3 or F4 levels of fibrosis like no more alchol ever and restrict the amount of salt you take in to no more than 1200 mg/day and being very careful with medications you take some are not safe to take if you have advanced liver disease like Advil, aleve, or aspirin as an example.

 I probably became infected in 1978. On my fourth liver biopsy I was diagnosed Cirrhosis in  January 2008 

Good luck to you
« Last Edit: November 20, 2016, 08:40:59 pm by Lynn K »
Logged
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline Mixer

  • Member
  • Posts: 19
Re: Liver Biopsy
« Reply #6 on: November 20, 2016, 11:03:34 pm »

 I live a really healthy life style since diagnosed over 20 years ago and all my levels being so low for having it probably 35-40 years I would have to think things aren't that bad.
I thought the elasticity test was a Fibroscan but yeah it was done along with the with the Ultra Sound machine
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Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,546
  • Get tested, get treated, get cured, fight Hep c!
Re: Liver Biopsy
« Reply #7 on: November 21, 2016, 12:41:57 am »
My ALT and AST have always been only very slightly elevated and my Bilirubin is in normal range but my cirrhosis continued to progress with time. That's the thing with hep c and cirrhosis they are silent illnesses by the time you feel something you are very far advanced. You can't tell by liver function tests the condition of the liver.

But not everyone does advance only about 20% of those with hep c over 20 years time will develop cirrhosis however as more time passes more people will develop cirrhosis. It might be bad it might not be. The only way to know is with either the gold standard of liver biopsy or the other less invasive tests of Fibroscan  or Fibrosure. A Fibroscan is similar to an ultrasound except you will have a thump produced by the devise that is used to determine liver stiffness.

http://www.hepatitiscnewdrugresearch.com/fibroscan-results-the-scoring-card.html

Not all doctors will have access to the equipment but there is also the fibrosure blood test that can be used.

« Last Edit: November 21, 2016, 12:44:07 am by Lynn K »
Logged
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline andrew90

  • Member
  • Posts: 71
Re: Liver Biopsy
« Reply #8 on: November 22, 2016, 10:45:43 am »
find a new doctor imo many other tests and hes jumping to liver biopsy? scary

i was approved with just a Fibrosure blood test.
Logged
5/1/17 UNDETECTED!

EOT Blood Testing 1/25/17
UNDETECTED!

Five week blood testing 12/8/16
DETECTED
Viral Load: 35(IU/mL)
AST: 34

Started Epclusa 10/2/16

Genotype 3a

9/19/16
Fibrosis: F2/3
ALT: 459
AST: 189
Viral Load: 6415894 (iU)/mL

Offline Luna7

  • Member
  • Posts: 179
Re: Liver Biopsy
« Reply #9 on: November 22, 2016, 11:43:37 am »
Quote from: andrew90 on November 22, 2016, 10:45:43 am
find a new doctor imo many other tests and hes jumping to liver biopsy? scary

i was approved with just a Fibrosure blood test.

Andrew, indeed!

My doctor said "so you refuse to have a biopsy', and I didn't say anything, just kind of glared.
I mean why would anyone take a test that a percentage of people die from?
I don't care how small that chance is -- why do that if you don't need to?
Gold standard? Sounds like it's more the gold in that clinics pocket.
Logged
Between F2 & F3
Alt & Ast nearly 100
Viral load over 8 million
Gt 3a

Treated 12 weeks with Sovaldi & Daklinza, start date mid-April 2016
Undetected at 4 weeks into treatment
Alt & Ast  normal
Treatment completed July 14
Most likely will be undetected at 12 weeks (mid October 2016) as symptoms are gone

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,546
  • Get tested, get treated, get cured, fight Hep c!
Re: Liver Biopsy
« Reply #10 on: November 22, 2016, 11:52:17 am »
 Well back in the late 80s when I was diagnosed with Hep c there were no other options for liver biopsy. They reason it is called the gold standard is because is most accurate as we know Fibroscan and fibrosure in the mid ranges have limited diagnostic ability

 However is still great that we have these new noninvasive ways to determine extent of liver damage even if they are less accurate
Logged
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline jakas

  • Member
  • Posts: 265
Re: Liver Biopsy
« Reply #11 on: November 23, 2016, 02:05:50 pm »
I refused the Biopsy which the Doc wanted and the fibroscan showed F3-F4 so the European Doc had no choice but follow the law and I got Harvoni for 12 weeks
Logged
M/57 yrs.
Contracted (Unknown) 10-20-30 yrs back ??
Treatment Naive
Geno 1a&1b
VL  17+ million
ALT 200+, AST 170+
Fibroscan F4 ( 26+ kpa ) on 8th Dec. 2105
Started Tx 11th Dec.2015 ( 12 wks. Gilead Harvoni)
7/1/2016 :Viral Load|<25 UND.
23/1/2016: ALT 34 , AST 35, ALP 143
8 week NO labs done
EOT:03.03.2016 ( 84 pills eaten )
ALT 26, ALP 124, BIL .54
V/L <25 UND E.O.T.
4 weeks E.O.T. V/L UND::: SVR 4
SVR 12 and  SVR 24 on 16/8/16
Fibro 24.5kpa 23/05/16
SVR 63 05/17
Fibro 17.03.2020 kpa 6.3

Offline Mixer

  • Member
  • Posts: 19
Re: Liver Biopsy
« Reply #12 on: December 15, 2016, 05:33:23 pm »
 Well got the FibroSure results

Fib
0.63
F 3

Necrooinfiam
0.61
A2-A3
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Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,546
  • Get tested, get treated, get cured, fight Hep c!
Re: Liver Biopsy
« Reply #13 on: December 15, 2016, 07:23:51 pm »
Your fibrosis score of F3 should greatly help you qualify for treatment.
Logged
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline Mixer

  • Member
  • Posts: 19
Re: Liver Biopsy
« Reply #14 on: December 15, 2016, 07:48:42 pm »
 
Good and Bad but yeah it should get me approved
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