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Hep C Discussion Forum -> General Discussion -> Biopsy Questions and other Jibber Jabber
Post Info TOPIC: Biopsy Questions and other Jibber Jabber
Luckydog1953


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RE: Biopsy Questions and other Jibber Jabber
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Insurance will covering two fibroscans a year very soon.

Ask your insurance provider or call a clinic.

Best regards,

Mike



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/Michael Hudnall/
Isiscat2011


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Josh Haynie wrote:

what will the biopsy reveal ??? whther thers cirrosis or not ..scarring .... can they tell if theres any fibrosis or at what level ???? 

A liver biopsy will show the level of fibrosis. It can reveal other things as well such a fatty liver, inflammation, autoimmune hepc, and various liver diseases.  For just measuring fibrosis, however, a non-invasive fibroscan should be the first step, IMO.  This is an area of some controversy but many docs are moving away from considering liver biopsies for hepc patients a gold standard.  

The fibroscan was FDA approved last year.  European and other countries have been using the fibroscan for years.  The problem is that insurance doesn't cover fibroscan and there are not enough fibroscan machines available in the US yet.  Progress takes time and there will always be resistance particularly when there is still money to be made doing it the old way.  

Also, there are 3 different types of biopsies.  All are far from perfect and may have significant error rates ranging from 1-2 stages off.  If your doc has some specific reason for wanting a biopsy as opposed to a fibroscan that is one thing, but if it is simply due to the lack of availability of fibroscan, then you should have a choice.  If you want to pay for a fibroscan yourself  then your doc will probably agree to a fibroscan (my last one cost $300 in the US).  Fibroscan's error margins are in the middle ranges, but if you have little or no fibrosis or if you definitely have cirrhosis, it will detect that.  

Fibroscan can also predict liver disease progression better than biopsy.  http://www.hepmag.com/articles/Fibroscan_biopsy_2501_24237.shtml





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Diagnosed in 2011, Incivek triple in 2011, tx discontinued, Genotype 1a, CT, VL 7mill, cirrhosis dx in 2012, age 67, waiting for new DAAs.
Huey


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TazKat wrote:

i have for some reason pictured Yositme Sam (cartoon guy) with his long beard & long sword in my body hollering "get out of the way varmits" i am here to take you down.."  i do not know why that ever popped in my head, but i have it pictured it like that since 2000..  lol i know this interferon & riba damaged some freaking brain cells.. 

confuseno

 Your beginning to think like me.  It is from sitting too close to the TV set when you were little.

" I sa I say BOY!!!! You have reach the limits of my medication"



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  HCV Genotype 3a , now Psot-Tx was on S/riba. First VL was 5.8 mil on 7-5-13 then "und" at 3.8 weeks. 06/13/14 still und. off meds 3 days back on 7/29 Last pill 08/10/14 SVR+4

 
TazKat


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i have for some reason pictured Yositme Sam (cartoon guy) with his long beard & long sword in my body hollering "get out of the way varmits" i am here to take you down.."  i do not know why that ever popped in my head, but i have it pictured it like that since 2000..  lol i know this interferon & riba damaged some freaking brain cells.. 

confuseno



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TazKat Genotype 1A null responder x 3 riba & iterferon twice, relapsed from Incivek 2012 with only 12 weeks left to do. stage 4 mild cirrhosis 4/25/2014/ started sovaldi riba & interferon.. finished treatment 7/17/14  results 7/25  cleared..

 

 
Josh Haynie


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Thanks for the info :)

''knowing is half the battle'' G.I Joe



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genotype 1  HCV 4,958,318 iu/ml    HCV Log updated soon  iu/ml------5'10 135lbs 9-15-83  genotype 1 since 2002----Pendleton,Oregon
Huey


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The Biopsy is what the doctors and insurance co call the gold standard.  I think the only thing it does is make the insurance co have to pay for it because this is the standard of proof needed for this.  It does make since IF your Doctors needs it .  If the Doctor says he needs one then do it,, But I would not just to make the insurance happy.  The only way my Doctor would ask for one is if he suspected cancer.  



-- Edited by Huey on Tuesday 15th of July 2014 12:51:20 AM

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  HCV Genotype 3a , now Psot-Tx was on S/riba. First VL was 5.8 mil on 7-5-13 then "und" at 3.8 weeks. 06/13/14 still und. off meds 3 days back on 7/29 Last pill 08/10/14 SVR+4

 
Tig


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Josh,

The biopsy provides a metavir score, which provides a number value of liver inflammation or the "A" score and the fibrosis or "F" score.

http://hepatitis.about.com/od/diagnosis/a/Metavir.htm

Fibrosis and scarring are one in the same. The higher your fibrosis, the more scarring is present. A fibrosis score of F4 is considered "Cirrhosis".

Tig



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Tig

68yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 9+ years!

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Josh Haynie


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    may as well since im here as i pa-rOOse the forum for insight once a day or more .......

 

um so you get a biopsy then im guessin you wait a week or two for results..... 

 

what will the biopsy reveal ??? whther thers cirrosis or not ..scarring .... can they tell if theres any fibrosis or at what level ???? 

basicly what does a biopsy tell you ????  mine in scheduled for a week or two from now is what i was told no call yet but told they would call to schedule 1 ....damn waiting game... :) 

no treatment till november or december .... seems so far away :) oh well.... the ball is in motion.....finaly....   confirmed sovaldi with peg interF and riba but theres talk of new things comin out in October.... so hopefully interF free stuff like Declastavir or sumthin she said Gillead sumthing or other .. I was like cool .... hell i dont care interferon riba and sovaldi sounds good enough to me ....

maybe she was pertaining to ledaspivir....thats a gillead....

specialy at only 3 months assuming dragon goes down in flames on intial round ... relapse is always possible ..hopefully not :) guarenteed to stop slow and damage virons them and thier damn RNA hijacking ....... Sovoldi shall ruin thier day ..... unleash the hounds :) Optimism says even if it dosent work the virus will be beaten back then iLL just go on sum other super combo ..... so I am not worried about it.... be gone Hep C...... this based off of reading on the forums about relapsers none responders... who after 2 or 3 tries on various tX were able to rid them selves of it ....

that article from JCI bothers me...... if i become SVR i will say test levels again... i know theres a test the can do that can check for minute traces of virus ...  will see :) 

Anyway thanks again :) I shall keep every1 in the loop .... have a good monday :)

Successful hepatitis C virus (HCV) treatment is defined as the absence of viremia 6 months after therapy cessation. We previously reported that trace amounts of HCV RNA, below the sensitivity of the standard clinical assay, can reappear sporadically in treatment responders. Here, we assessed the infectivity of this RNA and infused 3 chimpanzees sequentially at 9-week intervals with plasma or PBMCs from patients who tested positive for trace amounts of HCV RNA more than 6 months after completing pegylated IFN-/ribavirin therapy. A fourth chimpanzee received HCV RNAnegative plasma and PBMCs from healthy blood donors. The 3 experimental chimpanzees, but not the control chimpanzee, generated HCV-specific T cell responses against nonstructural and structural HCV sequences 610 weeks after the first infusion of patient plasma and during subsequent infusions. In 1 chimpanzee, T cell responses declined, and this animal developed high-level viremia at week 27. Deep sequencing of HCV demonstrated transmission of a minor HCV variant from the first infusion donor that persisted in the chimpanzee for more than 6 months despite undetectable systemic viremia. Collectively, these results demonstrate that trace amounts of HCV RNA, which appear sporadically in successfully treated patients, can be infectious; furthermore, transmission can be masked in the recipient by an extended eclipse phase prior to establishing high-level viremia.



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genotype 1  HCV 4,958,318 iu/ml    HCV Log updated soon  iu/ml------5'10 135lbs 9-15-83  genotype 1 since 2002----Pendleton,Oregon
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