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Author Topic: Fibrosure and Fibroscan  (Read 7862 times)

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Offline Baxter

  • Member
  • Posts: 87
Fibrosure and Fibroscan
« on: September 08, 2016, 08:18:15 pm »
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?
« Last Edit: September 08, 2016, 08:32:18 pm by Baxter »
Gen 1a
Inf. '85
Dx '98
'98 biopsy - Grade 2, Stage 2, VL 7 mil
'01 biopsy - Grade 1, Stage 1, VL 1.5 mil
'08 biopsy - Grade 1, Stage 1, VL 3.5 mil
'12 biopsy - Grade 1, Stage 1, VL 3.5 mil
'16 Fibrosure - Grade I, Stage 3, VL 6.4 mil and 4.8 mil
4/23/16 - ALT 89, AST 50, pltlts 120k. Started 12 wks Harvoni
4/31/16 - ALT 30, AST 21, pltlts 125k
4/14/16 - ALT 25, AST 16, pltlts 126k, VL 69
5/11/16 - ALT 28, AST 21, pltlts 140k,VL <15
6/7/16 -EOT, UNDETECTED!
9/7/16 - cured. Low Stage 2 fibrosis

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,543
  • Get tested, get treated, get cured, fight Hep c!
Re: Fibrosure and Fibroscan
« Reply #1 on: September 08, 2016, 11:10:16 pm »
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.
« Last Edit: September 08, 2016, 11:14:00 pm by Lynn K »
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 Baxter

  • Member
  • Posts: 87
Re: Fibrosure and Fibroscan
« Reply #2 on: September 08, 2016, 11:30:45 pm »
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.
« Last Edit: September 08, 2016, 11:36:38 pm by Baxter »
Gen 1a
Inf. '85
Dx '98
'98 biopsy - Grade 2, Stage 2, VL 7 mil
'01 biopsy - Grade 1, Stage 1, VL 1.5 mil
'08 biopsy - Grade 1, Stage 1, VL 3.5 mil
'12 biopsy - Grade 1, Stage 1, VL 3.5 mil
'16 Fibrosure - Grade I, Stage 3, VL 6.4 mil and 4.8 mil
4/23/16 - ALT 89, AST 50, pltlts 120k. Started 12 wks Harvoni
4/31/16 - ALT 30, AST 21, pltlts 125k
4/14/16 - ALT 25, AST 16, pltlts 126k, VL 69
5/11/16 - ALT 28, AST 21, pltlts 140k,VL <15
6/7/16 -EOT, UNDETECTED!
9/7/16 - cured. Low Stage 2 fibrosis

Offline FutureThinker

  • Member
  • Posts: 711
  • Onward and upward!
Re: Fibrosure and Fibroscan
« Reply #3 on: September 09, 2016, 12:37:48 am »
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
Treatment naive
Likely contracted mid-70s
Diagnosed 1a, 2011
F1-2
Harvoni X 12 weeks, completed 5/17/16
Pre-treatment: VL 3 mil, AST 64, ALT 84
4 week labs: VL 30, AST 21, ALT 14
8 week labs: VL UD!!!, AST 22, ALT 16
12 week labs: VL UD, AST 23, ALT 14
2 wk EOT: VL UD
12 wk EOT: VL UD, AST 22, ALT 13 =  SVR 12! Yay! 
Last hep appointment: VL UD, AST 19, ALT 12 = SVR 39! I AM DONE!

Offline jakas

  • Member
  • Posts: 265
Re: Fibrosure and Fibroscan
« Reply #4 on: September 09, 2016, 05:39:35 am »
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.
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 Baxter

  • Member
  • Posts: 87
Re: Fibrosure and Fibroscan
« Reply #5 on: September 10, 2016, 08:21:32 pm »
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.
Gen 1a
Inf. '85
Dx '98
'98 biopsy - Grade 2, Stage 2, VL 7 mil
'01 biopsy - Grade 1, Stage 1, VL 1.5 mil
'08 biopsy - Grade 1, Stage 1, VL 3.5 mil
'12 biopsy - Grade 1, Stage 1, VL 3.5 mil
'16 Fibrosure - Grade I, Stage 3, VL 6.4 mil and 4.8 mil
4/23/16 - ALT 89, AST 50, pltlts 120k. Started 12 wks Harvoni
4/31/16 - ALT 30, AST 21, pltlts 125k
4/14/16 - ALT 25, AST 16, pltlts 126k, VL 69
5/11/16 - ALT 28, AST 21, pltlts 140k,VL <15
6/7/16 -EOT, UNDETECTED!
9/7/16 - cured. Low Stage 2 fibrosis

 


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