Hep C Discussion Forum

Hi Matt,

Good article. I worry that patients are being followed by Fibroscan only. Obviously it is easier to get patients to agree for Fibroscan followup, rather than biopsy.

My problem with Fibroscan is that inflammation itself plays a part in the reading. An influx of inflammatory cells increases the score. After SVR, inflammation should be minimal, apart from when cirrhotics are resorbing and remodelling necrotic nodules. In my case, a reduction in the Fibroscan from 30.1 to 8.8 after 18 months is unrealistic. I'm hoping that researchers can get more SVR patients to agree to biopsy followup.

The figure of about ~50% improvement in at least 1 Fibrosis stage in cirrhotics confirms earlier studies, but it takes at least 2.5 years.

I was always told that the F3-4's and maybe the F3's still need screening for HCC after SVR. The risk is greatly reduced, but some cases do occur which is a shame. I still regard myself as cirrhotic, so the 6 monthly Ultrasound is required. As I said earlier, I'll get a biopsy next year and that will give a more accurate picture of how my fibrosis is going.

Cirrhotics should get a good indication from the platelet level, albumin level and liver enzymes. Normal (or improving platelets) and a normal albumin indicate a normally functioning liver and spleen. Normal (particularly low normal) enzymes show the liver is working well, with little inflammation. Cirrhotics with these parameters have every reason to feel confident. Cheers.

I'm sure this is part my brain fog, part senility, part bad hearing, but what does she say at marker 2:21? "With many of the patients actually going back to normal liver after ________"?

Good information Matt. Thanks! This information generally coincides with what my hepatologist has told me. I was told my cirrhosis was decompensated in Jan 2014. One of my recent HCC MRI final reports stated "mildly cirrhotic". This may be due to a difference in interpretation but considering I have been actively treating with either Sov / riba or Harvoni for 22 1/2 months of the time since and have also been alcohol free, my liver has likely regenerate somewhat before my actually achieving SVR. If I indeed achieve SVR after this round of Tx is done then I may be in line to live quite a while with the liver I have and with less chance of HCC. Cool!

Excellent information, Matt. The video should give all of us with advanced fibrosis, renewed hope for fibrosis regression. I recommend those with these questions, to take a few minutes and watch the summary video. It's worth your time!