Stages of Fibrosis Questions

[lolacme]

Hello everyone,
I am hoping you can help me understand the stages of fibrosis. Is F4 the same as early cirrhosis or can I be F4 without cirrhosis? I thought F4 and cirrhosis were the same thing? I was F3 Stage 2 on my last biopsy 2.5 years ago. My doctor is only giving me 12 weeks of Harvoni and I am wondering if it should be 24? I can't slow my doctor down long enough to discuss these things. I am wondering if I am an F4 and need the 24 weeks. Knowledge appreciated.

[dragonslayer]

>> I was F3 Stage 2 on my last biopsy 2.5 years ago<<

Isnt  a Metavir staging score of F3 the same thing as 'Stage 3'?   Can you even have an F3 be the same thing as stage 2?

[sabre]

F4 can indicate cirrhosis OR advanced fibrosis.

Instead of guessing, why not ask for a fibroscan? If your doctor does not listen to you, I'd recommend seeking one out who does. It's your health at stake.

DS, maybe stage 2, grade 3...?

[lolacme]

Stage 3 fibrosis grade 2 is what I read on the copy of my biopsy report that I picked up. My Dr. told me that was not cirrhosis at the time. I am thinking Stage 4 fibrosis is the same as cirrhosis. I asked my Dr. if i needed another biopsy since I was stage 3 fibrosis 2.5 years ago and he said No. I am thinking I do and probably should have 24 weeks of Harvoni but my insurance would only approve 12 weeks and I had to fight for that. My Dr. said he would not take blood until the 12 weeks because he does not want to give the insurance to come back and refuse to fill the meds based on my viral count if I have not cleared yet. I have read some who took 2 months and the insurance refused to refill for the 3rd month based on stories like that..insurance companies making up the rules as they go along.

[dragonslayer]

Stage 3 fibrosis grade 2 is what I read on the copy of my biopsy report that I picked up. My Dr. told me that was not cirrhosis at the time. I am thinking Stage 4 fibrosis is the same as cirrhosis. I asked my Dr. if i needed another biopsy since I was stage 3 fibrosis 2.5 years ago and he said No. I am thinking I do and probably should have 24 weeks of Harvoni but my insurance would only approve 12 weeks and I had to fight for that. My Dr. said he would not take blood until the 12 weeks because he does not want to give the insurance to come back and refuse to fill the meds based on my viral count if I have not cleared yet. I have read some who took 2 months and the insurance refused to refill for the 3rd month based on stories like that..insurance companies making up the rules as they go along.

Biopsy is still the gold standard for scoring liver damage.  Generally, doctors will do the procedure at 5 yr intervals..  Being invasive and considering the generally slow progression of liver disease, they seem to concur that this is the best repeat interval to use.   F3=Stage 3.   The Grade 2 you received is a measure of inflammation.. Together, the stage and grade scores give doctors the truest indication of your liver condition that they can get.. Its more accurate than fibroscan and the other non invasive measures, especially in the middle range where the non invasive tests are the least accurate.

It wouldnt be a terrible to request a  Fibroscan if he has access to the hardware to see if your F3 has progressed to cirrhosis in the 2.5 yrs since the biopsy prior to selecting a treatment interval.

Have you failed HCV treatment in the past?  If youre treatment naive, 12 wks is the recommended Harvoni treatment duration for you if youre genotype 1

[lolacme]

Hey drangonslayer. Thanks for the input. I have been on treatment twice before. The first was a clinical trial whereas interferon was going into me 23 hours a day via an infusion pump in small doses and I was given ribaviran. Lasted about 6 weeks. Second treatment was triple therapy with Incivek-lasted about 7 weeks and I had to quit because of interferon induced psychosis. I was responding to the treatment though. So I would not exactly say I am treatment naive. I started the Harvoni today at 3pm. I am just going to do the 12 weeks and remain positive. I have this nagging feeling I will never feel free of Hep C because of the damage its already done. But there is nothing I can do about that now but move forward.