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Post Info TOPIC: liver biopsy
greenqueen


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RE: liver biopsy
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Moved to General Discussion

Love Steff xx



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Geno 3a. 24 wks tx 20/10/05 - 06/04/06. Achieved SVR.
davesf


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http://www.hcvadvocate.org/hcsp/articles/Keeffe-1.html

Good article on whether a biopsy is necessary or not.



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All Done Poisoning the Dragon that Used to Poison Me

Genotype 1b  Incivek Combo
52baddog


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Thank Mallani, I guess incivek is used in the US. It is extremely expensive, but covered by insurance, and the drug company has some programs as well. Can you still work when you are on treatment?



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Geno type 1b, F1 vl 640,000 enrolled in Gilead's sofosbuvir/ledipasvir -week 1 66, week 2 <25
chatterbox


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I had a liver biopsy in 2005.  No big deal at all.

Had one again in 2012.  Again ..no problem.

Doctor chose Victrellis for me because I already was experiencing diarrhea and he said Inv only would make that symptom worse.  

Had 9th shot on Monday.  Will know about 8 week labs next week.



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Debra

 

Geno type 1a1b

Began Peg/Rib 4/16/2012  

Began Victrelis May 14, 2012            4 week and 8 week labs undectable

12 weeks und. 16 weeks und. Week 17 Cut peg, added Neopogen 5+months und.!
mallani


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Hi baddog, Victrelis is an protease inhibitor, similar action to Incivik. Both inhibit the viral replication in hepatocytes. Why one or the other? Both have pretty similar SVR rates in the trials. The Incivik people seem to have more problems with rash and rectal discomfort. With Incivik there is no leadin with 4 weeks of Peg and Riba, and it is only taken for 12 weeks, followed by Peg and Riba. With Vict. there is a leadin for 4 weeks, then all 3 drugs are taken for the treatment duration. Incivik is more expensive but is taken for a shorter time.

In Australia, the trials have finished, and my hepatologist did not have access to Incivik, so I'm on Vict. for 48 weeks.



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Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
Shep


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I have had 2 biospyes over the years--the first right after I was diagnosed 16 years ago--it was not a good experience. The needle malfunctioned --it felt like I had been punched by a heavyweight boxer--then they sent me down to have another done under ultrasound. So it was like getting 2 done in one day. Ended up in the ER 3 days later with sevre pain in the area of the bx. They could not find anything and said it was "hysterical" pain--it had me laughing! The 2nd was about 8 years ago and went much smoother. I think they had perfected the procedure by then. There had not been much change during the years between--so I have not opted for another.

I do think that biospy is pretty routine these days--so if that is what you decide --it should be fine.

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Diagnosed 1996 genotype 1b VL alot tx starting 12/23/11 Victrelis UND week 8!!! 28 weeks of tx

Completed tx 7/6/12--still UND!!!!
krowdog


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In case I wasn't clear, I opted for a biopsy.  I think knowing your liver status is WAY important.

Brad



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(Geno 1a, Incivek Triple Tx, 6 month post TX - 9/20/2012 = SVR!!!)
K2


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This has been an interesting and helpful thread. I too have the option of a biopsy or a 2nd fibroscan.  Last fibro was 12.8 which is just below Chirrotic and to determine treatment duration I now have the choice. I was a little over weight last one and that can skew results slightly. There is debate on the accuracy of the scan but it is widely used. What to do scan/biopsy????

 

Good luck baddog, this IS bloody scary but it is the scary things in life which prove to us our strength. You can do it!



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genotype 1a. started pegasus and riba on 25/03/2012 added victrelis after 4 weeks, treatment naive. CHC. 4 weeks UND & continue to be so far. Finish tx 6/10/12. Fingers crossed for SVR.
52baddog


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Mallani--is victrelis similar to incivek? why are some people on victrelis and some incivek? Do you know about a new drug from Glead that is a stand alone pill. no interferon needed. also, can you work when you are on treatment? I am terrified.



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Geno type 1b, F1 vl 640,000 enrolled in Gilead's sofosbuvir/ledipasvir -week 1 66, week 2 <25
Iris Dragonfly


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Back when I had it done you used to have to spend the night. After the proceedure they make you lie on your side on a rock of a sand bag (don't know if they still do this). For me, the pain was pretty horrible, felt like all my insides went into that needle, very strange sensation. And Ryan says as bad as a rotator cuff injury????, That's next to childbirth.

A CT scan might be enuf, A biopsy is an invasive proceedure you might not have to endure (sorry to stir things up) and as Brad said, one member had a nightmare of a biopsy. Having said that,... Indeed it is a best test for a baseline. Best wishes in your descision, Blessings, Iris



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in the silence of the woods, you will not be alone- Chief Seattle

60 years on planet, Female, diagnosed 1978 as non-a non-b, VL 8mill+, Fibro f-1f-2, Genotype 1a, treatment naïve....UNTIL 7-01-18  !!!! started Harvoni 12 weeks. :)

4 weeks=UND, 8 weeks=UND, 12 weeks=UND (EOT= 09-23-2018)
52baddog


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Thanks Ryan, everybody is so helpful. Thank God.



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Geno type 1b, F1 vl 640,000 enrolled in Gilead's sofosbuvir/ledipasvir -week 1 66, week 2 <25
52baddog


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Thanks bauhaus, did you finish your treatment. was it hard, do you need someone to take care of you.



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Geno type 1b, F1 vl 640,000 enrolled in Gilead's sofosbuvir/ledipasvir -week 1 66, week 2 <25
52baddog


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Thanks Mallani, I am so blessed that I found this forum. You are all great.



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Geno type 1b, F1 vl 640,000 enrolled in Gilead's sofosbuvir/ledipasvir -week 1 66, week 2 <25
52baddog


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thanks for all your help, and advise.



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Geno type 1b, F1 vl 640,000 enrolled in Gilead's sofosbuvir/ledipasvir -week 1 66, week 2 <25
bauhaus76


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i have 1 biopsy done before i started treatment to stablish damage on the liver because its the only way to know it for shure,so its contraditory to say i would not have i biopsy if i knew i had no cyrossis,actualy if you have one you may have more risk from it than if you dont....,my opinion is DO IT and try not to make it harder than it is already....be strong!!



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hep c 1a on triple therapy with incivek UND at week 12 ,week 24...going for 48 weeks.
mallani


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You have a low Viral Load, but VL's and blood tests do not really reflect the condition of the liver. Even with advanced cirrhosis, as I have, the liver can look remarkably normal on Ultrasound, MR or CT. I had a CT today to check for liver cancer ( every 6 months). Apart from a slightly enlarged liver and spleen, my liver looks normal. I know I have cirrhosis from a biopsy in 2000, and fibroscans in 2006 and 2009. Before starting treatment, I would want to know what condition my liver was in. If there is no or little damage, you will probably only need 24-28 weeks of treatment.

Just my opinion, but a liver biopsy is no big deal, and is very useful to have as a baseline.



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Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
Ryanbighead


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Don't stress about the biopsy.

You can't feel a damn thing. It's a strange feeling to say the least but pain is not a factor.

Ok, I might have lied a little. Due to the needle having to go through the intercostal muscles(muscles between ribs) and peritoneum(Lining of the abdomen) there is a level of discomfort after the procedure, which is mentioned below. This pain radiates through the right shoulder and is similar to a bad ache if one slept on the wrong pillow etc. Nothing some pain meds don't kick.

I suffer from a destroyed rotator cuff in my right shoulder, from a motorbike accident, and I would say the pain is similar to that which I occasionally have due to this injury.

It is a quick in out thing. I walked in and walked out of hospital in a matter of hours and drove myself home. I didn't take any pain meds after the surgery so I could function as I hate driving while intoxicated.

All in all I would say that the scariest thing for me was how nonchalant all the staff where about the whole thing. I was freaking out much like you are and was upset that the staff kept telling me to stop being a baby. As I was lying on the bed asking the Prof. when he was going to start and he informed me that "I have been done for about a minute, do you want to see what liver looks like?" that I realised that it really was a non-issue.

Don't over think it. I would take a liver biopsy over hitting my small toe on the corner of my couch anyday.

:D



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krowdog


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I can't say what should or shouldn't be done.  Many folks have stated they would not get a biopsy.  If I had KNOWN I didn't have cirrhosis, I would have skipped it.

As it turned out, I was only grade 2, stage 2.  (not too much scarring...kind of mild/moderate).

You've got a lot going for you.  You're a bit younger than many here.  And your V/L is one of the lowest I've seen.

It's normal to be scared, but hang around, and talk to the folks here, and you will be surprised how quickly you get a handle on this. 

I found that once I started, all the fear gave way to a fierce determination to get this thing done.  In fact, I was kind of excited about starting.

Every one of us has been "there and done that".  There is nothing you'll run into that someone here hasn't dealt with, and is willing to help you with.

Good luck on your quest,

Brad

 



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(Geno 1a, Incivek Triple Tx, 6 month post TX - 9/20/2012 = SVR!!!)
52baddog


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so if you don't have cirrosis you shouldn't get liver biopsy. I have gone to two different doctors, and one wants to do a biopsy and the other wants to start treatment. I am so terrified I cry every night. I am a genotype 1b with 307000 viral load



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Geno type 1b, F1 vl 640,000 enrolled in Gilead's sofosbuvir/ledipasvir -week 1 66, week 2 <25
52baddog


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so if you don't have cirrosis you shouldn't get liver biopsy. I have gone to two different doctors, and one wants to do a biopsy and the other wants to start treatment. I am so terrified I cry every night. I am a genotype 1b with 307000 viral load



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Geno type 1b, F1 vl 640,000 enrolled in Gilead's sofosbuvir/ledipasvir -week 1 66, week 2 <25
krowdog


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I got a liver biopsy done too, and I had no problem.

They iv'd Versed (a benzodiazapine tranq) then gave the local just before they went in for the sample.  That Versed is STRONG stuff!  I slept like a baby for about 3 hours before I could leave.  Good thing I had a driver.

As Mallani said, these biopsies  are routine, and I wasn't worried.  I wanted the biopsy, since it can change treatment times if you are cirrhotic. I wanted every bit of info possible before I started Tx..

However, we DID have someone on the forum who did have internal bleeding, and spent a few scary days in the hospital, so complications are possible.

Good luck 52B-dog,

Brad

 

 



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(Geno 1a, Incivek Triple Tx, 6 month post TX - 9/20/2012 = SVR!!!)
52baddog


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did anybody get a liver biopsy? is it dangerous?



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Geno type 1b, F1 vl 640,000 enrolled in Gilead's sofosbuvir/ledipasvir -week 1 66, week 2 <25
mallani


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Hi Nancy, I have had 3 liver biopsies over the years. They are not a problem. Before the biopsy you need to have your bleeding profile checked. Usually the biopsy is done as an outpatient, but you need to rest for 6 hours after, while you get your obs done, then able to go home with supervision.

The liver is imaged by ultrasound, some local is injected, and a Thru cut biopsy needle is inserted into the liver under ultrasound guidance. This is to make sure the needle doesn't hit any big blood vessels. A core of liver tissue is obtained and sent to Pathology. Depending on the quality of the core of tissue, it may be necessary to do an extra biopsy. You need to hold your breath during the biopsy. There is usually no pain.

After the procedure you rest on a bed until the staff is happy for you to go. In the old days, these were not done under ultrasound guidance, and R. shoulder tip pain was common due to a small amount of bleeding irritating the diaphragm.

In cirrhotics, interpretation of the biopsy is often difficult. Fibroscan has virtually replaced biopsy in cirrhotic followup.

Don't be worried. These are routine.

 

 

Geno 1b, cirrhotic, Undet. at 8 and 12 weeks on Victrelis.



-- Edited by mallani on Wednesday 13th of June 2012 01:47:23 AM

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Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
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