TOPIC: F3 to F1 in 12 years while still HCV positive?

I had a very surprising result on a fibroscan last Monday which I thought i would share

In Dec 2003 I had a pre tx liver biopsy which gave me an F3 result
I'm sure the biopsy result was F3 and I know that a biopsy is the gold standard procedure (apparently)
But Mondays fibroscan resulted in a median stiffness of 6.4 which is an F1!
The doctor taking the probes took 26 measurements and said that my liver was not stiff at all
I was dumbfounded and told her I was F3 in 2003
She said I have no body or liver fat and in her experience the 26 readings were good and was certain that the results were accurate
My wife who happened to be present said the scans were taken from the exact same spot as the scar from the biopsy

I don't want to get too ahead of myself patting myself on the back and I'll take the result with gratitude but I'm curious

Previous to 2003 I was a model dirtbag. I would regularly drink spirits and pass out as a result. I was a regular drug user and had a very poor diet. I never did any exercise, had a very bad attitude and was generally out of control. I consider myself lucky to be alive.

Post 2003 my lifestyle was vastly different. My HCV diagnosis led me to focusing on my health with as much vigor as I focused on my death wish previously. I had a diploma of naturopathy which led me to my new 'let food be your medicine' mantra.. Over the last 12 years I have not been concerned by my HCV and suffered no effects, but have kept current with herbs and foods that aid liver function and cleansing. I exercise regularly and drink socially (very occasionally antisocially lol) I smoke a tiny amount of pot 2 or so times a week with a break of a couple of months each year - so moderation in all things is my goal.

Could this dramatic change of lifestyle have resulted in the dramatic change in liver scarring?
If i were to choose, I would say the original biopsy was incorrect, only because the tx and hospital experience back then put me off the whole health system until now (and I'm only back in it because of the help from the buyers club anyway)
But can a fibroscan be that incorrect - the first thing she said was 'your liver is quite soft'.

Anhoo, it's a good result and I'm still dumbfounded and I even purchased 24 weeks of tx believing that my liver would have remained at F3 at best.
I have decided to continue with the tx for 24 weeks despite the good result. I would prefer this than to abandon it early and then then relapse.

Hi Bloot, how ya goin?

That sounds like a great result on the fibroscan! I think there is reasonable cause for optimism that in your case the results may be fairly accurate.....but understand your caution and wish to keep to the original Tx plan.

Judging from the tale above, and some previous ones we have heard from you, you made some very significant changes to your lifestyle upon diagnosis. I imagine your liver was extremely....and eternally....grateful when you stopped beating the living crap out of it at every opportunity.
So when it suddenly didn't have to defend itself against its owner on a daily basis, it was able to fend off the HCV a little better and at the same time it had enough reserve capacity to make use of its marvellous ability to regenerate, enough to regress the worst of what was probably largely self inflicted damage rather that from the hepatitis.

OTOH bad attitudes don't regenerate so you are out of luck there mate.

(better point out here that I'm not having a go at Bloot, my attitude and behaviour was not too dissimilar to his. It was just a bit too late for my unfortunate liver by the time I was diagnosed. )


On the subject of fibrosis measurement accuracy, I like the summary provided by the specialist assigned for my initial consultation after diagnosis. A very funny man with a wicked sense of humour.

- Autopsy is the gold standard.....but due to the significant risks he didn't recommend them for most of his patients.

- Biopsies were definitive but really only for the immediate area around the sample sliver due to the size of the liver and the fact that fibrosis was not necessarily an uniform process. Safer than the first option but still some risks.

- Fibroscans were indicative but with sufficient readings across a larger area did give a pretty good idea of of the level of fibrosis although with a margin of error that was difficult to fully quantify. Much safer and these days (2012) his recommendation in most cases.

I had a fiber scan in May 2015 I was 9.9 and a F3 I started treatment Oct 29 for 12 weeks
I had a Fiber scan last week it was 7.4.

The consultant said the last reading probably had some inflammation this reading was
accurate. Same guy also said the margins can change over time from F3 -F2-F4........

In your case, you had one done a long time ago, I don't think its odd you have no come back with
a lower score you state you changed how you lived your life I would assume it helped to keep
your liver in decent condition.

Yes, I think its very feasible your live healed some what in the time period your describe.

Good news all round for you.

biopsy is not very accurate. I have heard people doing biopsy at different times and places with different results, it depends on where the cells are taken, liver is relatively large. Fibroscan is more accurate

Can't disagree more. Research fibroscan and see the percentage of accuracy compared to biopsy.

I'm with you Tommy if Fiber scans are so accurate how can you explain so many
patients going from examples of F3 too F2 within months often without treatment.

I would think its down to a fiber scan is a much simpler procedure as opposed to a biopsy I believe
the offer of treatment on your fiber scan is a crude method to use.

I would love to know the answers, if you depend on a Fiber Scan for treatment you could be
waiting for ever.

Fibroscan does one thing good. It can usually distinguishing hepatic cirrhosis from non-cirrhosis. It measures liver stiffness. Some will do the fibrosure test(serum marker tests) but it's considered experimental and investigational for detecting or monitoring hepatic fibrosis in persons with hepatitis c.
A friend had a Fibroscan which showed definite cirrhosis (F4). The FibroTest 3 months later came in at 0.54, or F2.
Biopsy is a best bet. IT DOES NOT HURT.

"Biopsy is a best bet. IT DOES NOT HURT. "

On what planet would that be?
It's true that the liver does not feel pain but the liver sac which contains it sure does. When that biopsy needle punches through it you know.

Don't mean to scare anybody here who is going to get a biopsy. Just - if you are offered pain meds, valium, etc. - take it.

dt

I had a liver biopsy, can't remember how many years ago, and it did not feel good., It was a weird, very un-natural jolt of pain and did not feel good afterwards. Needed pain meds, I would not want to have one again if I could avoid it.

Boot....Your story is interesting. My frame of reference is my viral load. It went from 9 mil in 2008 to 1.2 mil
last year. Never had a fibroscan, but had a biopsy done by someone who had done thousands. He is a
professor at a local university. He knew what he was doing. Anyhow, he went to the worst part of my liver
for samples. My results came out fairly decent after 40 years of infection....F1 or 2 I think. I partied hard for
several years but did not turn into a dirtbag .

Yes, I firmly believe your lifestyle change can help in liver scarring. I won't go into details and derail your
thread. I'll post mine later. In the back of my mind, I still want the fockers out of my body. Therefore, I would
continue with TX to be sure. Continued success, man. A little of this and a little of that is not going to kill
you, IMHO. Good luck.

Mine went from 14 to 27 kpa in 6-7 months. Now is that possible when I dont drink ?
The guy who did the fibroscan said there is a 30% + or - in fibroscans but from 14 to 27 is nearly an 85 % increase in 6-7 months. Fibrosis is slow progression so I dont really know how to interpret this. The more the inflammation more the kpa rises thus on treatment or EOT is swelling is reduced so does the kpa measurement. Many have reported this but not a doc so dont know.

I had a biopsy done twice. I had to ask the doctor both times if the needle was in yet and "when are you going to take a piece of the liver". He said I already did, I'm done". I hear some feel pain but it it less then a milli second
Some have pain afterwards if you can call it that. It is a "uncomfortableness" for a bit in the shoulder area. I had that. It was annoying but very bearable. They call it viscerosmatic pain as it's felt in the shoulder rather then where you would expect. Basically another area of the body feels the brunt. Even gallbladder pain can be felt in the shoulder.
I had untrasound guided biopsies done so pretty much no chance of missing. Still the BEST way to go. Not a must though but for piece of mind and seeing if waiting another year or two to save money etc it may be worth it.
I will post results of my last one 2011 one soon.

It takes about 10 years or more to progress a another grade f you don't drink etc. I wouldn't take stock in the results. Maybe get another oe if you can every few months or whatever the insurance allows for piece of mind or try it with another doctor. I think resluts may depend on the doctor or technician doing the test. ESPECIALLY in a biopsy.

Have not drank in 15 years, no drugs. Will get one done in the next 2 weeks again in India

The point being made by the doctor I mentioned at the bottom of my post was that there was no "best" as all methods carry some risk and all (except the first) have varying levels of accuracy. Your decision needs to be based on how important is it to be totally accurate compared with the risk. The decision process for HCV does not require total accuracy to make decisions. If your fibrosis level is low by any of those methods then short treament should be fine, if it is high then long treatment. If it is close to requiring long treatment or varies wildly from a previous one then either retest, use another method or consider treating for longer.