Home Forums Main Forum Experts Corner Fibrosis and Cirrhosis Fibroscans vs Hepascores

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  • #4694
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    So theoretically the Australian Government provided a bucket of money to make sure there were lots of fibroscan machines.

    It has become increasingly apparent that the machines listed here: http://www.hep.org.au/services-directory/ are kept more or less under lock and key and unless you are already a patient of one of the Liver Clinics it is next to impossible to get access to them. Rare as rocking horse shit in the Sahara desert it seems.

    Having a decent guesstimate about your level of fibrosis provisions key decisions around 12 vs 24 weeks treatment and to Riba, or not to Riba.

    So what to do? Fibrosis is a need to know bit of information.

    Enter the Hepascore. So what is that?

    http://www.clinchem.org/content/51/10/1867.full

    So in essence we measure bilirubin, GGT, α2-macroglobulin, and hyaluronic acid, plug them into a magic formula and get an answer.

    I have just double checked with Sonic Pathology and all their labs can do it, so given that patients are having so much difficulty accessing Fibroscans I will be moving over to using this blood test to asses fibrosis.

    If you were one of the two patients recently refused a fibroscan in Sydney by Dr R please ping me and I will do the blood form for a Hepascore so we can make a sensible decision about treament. Sorry he would not give me your names so I can’t contact you directly short of ringing a few dozen patients on spec. One of you had travelled from Canberra, the other from Central NSW. Please accept my apologies to the curious behaviour of my colleagues keeping these machines in pristine like new condition.


    YMMV

    #4695
    Avatar photo2b
    • Guardian Angel
    • ★★★★★
    @2b

    That sounds like what i had but here in the US , but they called it a Fibrosure test, in lieu of a fibroscan. I asked my Dr. about having a fibroscan instead of the fibrosure and she said, “oh there are none of those machines around here, you would have to travel a long ways away and bla bla bla”. So I had the fibrosure and that came up with F2, i think it was a high end F2. I would have travelled the few hundred miles distance for the fibroscan (hell I traveled to Australia for medicine!) but she didn’t really give me the option. Weird.


    GT 2b; since 80’s, no prior tx, sofosbuvir and daclatasvir compounded from API’s at Kingswood Pharmacy in Sydney, started tx nov 6,2015, undetected at 4 wks, UND at 8 weeks, UND at 1 week after EOT, UND at 4 weeks after EOT and UND at 8 weeks after EOT. I feel GOOD!! I knew that I WOULD!””

    #4710
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hi 2b, I live in Arizona, USA and did a web search and found a place in Scottsdale, AZ about 90 miles from where I live, that does fibroscans..I called them and found out I could come in as self pay patient and get the test done. $350.00 US, they had a Dr. there to read the test and consult, even let me come in on a Saturday. I’m so glad I did as the results told me I needed to get treatment ASAP, F4. I could tell something had changed and my body was not handling the virus as before. The name of the place is the Liver Lab and they said people of far as Alaska travel there to get the test done. I have just started generics, second day, and already feel a new sense of hope and feel better. HUGE thanks to this site and all who helped…


    YMMV

    #4711
    Avatar photoLondonGirl
    • Guardian Angel
    • ★★★★★
    @londongirl

    Hello everyone, I have had two fibroscans here in the UK. The first one was fine, good operator and she (a HepC nurse) got a clear reading. However the 2nd one was questionable. The operator (not a medic) couldn’t get a reading and ended up taking the scan from around the back with my arm down. I don’t think the reading was correct. Anyway, they can be rather questionable – I am told especially if you are very large or very skinny and apparently quite reliable at lower and top end of scale but rather vague in the middle. I think you’d possibly need to get a few readings taken to get a true picture. So Dr F’s bloods idea seems like a better option to me and the way my old consultant used to do things, from bloods. He is a top liver specialist, worldwide and very thorough. He would look at fibroscan score, but always be scribbling equations down from blood tests.

    Not sure if I would go miles for one after my last two, but then again I guess it’s helpful for an overall picture. The trouble is NHS England are now treating just on the fibroscan score, so if you have a low reading, even if out of sorts from previous readings, you go back down the list for treatment. At my hospital , it seems there is no ‘moderate’ any more, just ‘high’ and ‘mild’. Lat visit , they didn’t offer me any new tests and I had to ‘push’ for an ultrasound. Such is the way of late…..


    GT1a Dec14 F2/8.7 VL 900000-2.5M
    Jan16 Hepcivir-L MonkMed/Redemption
    Baseline: VL 913575 Alt 76 Platelets low
    Wk2 VL1157 Alt 23
    DET Wk 8 VL 32 Alt19 ‘In the slow lane’
    June16 Fibro 5.7 F0/1 LIF 1.5
    Wk 11 VL<12 Alt 13 Det/Unq
    Extending tx 12 wks Mylan Sofo/Dac MonkMed
    Wk 14 VL <12 Det/Unq
    Wk 16 VL UNDETECTED
    Wk 22 + 4 Wks Sunprevir FixHepC
    Wk 24 UNDETECTED Alt 13
    Wk 12 post tx SVR12 Wk 26 SVR24
    Thank-you Tim, Dr Debasis @ MonkMed & Dr Freeman @ Fix HepC

    #4712
    Avatar photo2b
    • Guardian Angel
    • ★★★★★
    @2b

    I thought i read somewhere that the mathmatical calculation method (heposure/fibrosure) tended to come out showing a little higher level of damage than the fibroscan. If that’s true, and your objective is to get the insurance/govt. to give you medicine based on how bad off you are, then any error tending higher rather than lower would be advantageous at least towards your immediate objective of obtaining medicine.

    and if Dr. Freeman says the method is reasonably accurate then it must be ok
    For me at this point n ow that I’m taking medicine I’m not too concerned with it now, it is what it is and the medicines will do what they do, so I’ll get as good as I get once I’m done taking these, and I’m sure that’s going to be better than I was. Feel much better already.


    GT 2b; since 80’s, no prior tx, sofosbuvir and daclatasvir compounded from API’s at Kingswood Pharmacy in Sydney, started tx nov 6,2015, undetected at 4 wks, UND at 8 weeks, UND at 1 week after EOT, UND at 4 weeks after EOT and UND at 8 weeks after EOT. I feel GOOD!! I knew that I WOULD!””

    #5104
    Avatar photoIRMA88
    • Topics: 2
    • Replies: 39
    • Total: 41
    • Recovery Champion
    • ★★★★
    @irma88

    Hi Everyone :)
    Can anyone tell me if a “Hepascore Test” has to be ordered by a specialist or can a GP get it done? I don’t hold out much hope in getting a fibroscan in the near future as the liver clinic here said not until ” next year” when I called. My request was sent months ago.
    Thank you for any input.


    G2B – DIAGNOSED 2014, STARTED SOF/DAC 11/11/15 VL 6M
    UND @ WEEK4
    FINISHED TREATMENT 26/4/16
    UND @ WEEK 24
    ALT 12 AST 15
    MY ETERNAL GRATITUDE TO GREG JEFFERYS & DR FREEMAN

    #5106
    Avatar photozhuk
    • Guardian Angel
    • ★★★★★
    @zhuk

    Hey IRMA,

    Not being a medical professional I’m ready to stand corrected, but from D J’s link it looks to me like none of these tests (bilirubin, GGT, α2-macroglobulin, and hyaluronic acid) should have any issue being requested by a GP. However I am not sure who would be required to do the computations of those results to obtain the actual hepascore. Maybe the doc or someone else can shed a bit of light on that.


    GT1a since 1988, diagnosed 1990
    F0, tx naive
    VL 262,000 ALT 40 AST 26 GGT 13 Fibroscan 04/12/15 – 2.9
    Started Mesochem sof/dac 12 weeks 01/01/2016
    11/02/2016 – 6 weeks UNDETECTED
    AST 26
    ALT 26

    #19817
    MexicoBound
    • Topics: 2
    • Replies: 5
    • Total: 7
    • Novice
    @mexicobound

    Hi All, I had a Fibrosure test in the U.S. when it first became available. I believe it was a French discovery and was made available to all at the time under some type of use agreement. We are probably talking 20 years ago. I was an F3-F4. What I find very strange is when I started to have liver scans in Mexico they showed 0 Fibrosis. Know I know a ultra sound of the liver is far diferent that Fibrosure in the way of accuracy but it still does’t explain a series of normal liver ultrasounds. One would think it would show some scarring. Can anyone shed some light?
    I don’t have any of my bloodwork with me. I came to the Mountains of Mexico to relax and do the treatment.
    Blessings to all.
    Sarted tx 28 days ago going for blood today.

    #19819
    Avatar photoMatt-Kenney-google
    • Guardian Angel
    • ★★★★★
    @matt-kenney-google

    Fibroscan is also available in Portland, Oregon, USA :)


    GT1a; Got it some time in the 70’s; Diagnosed @1976
    Tx naive
    METAVIR: A2-F2
    SOT May 18, 2016: CMP: AST 162 ALT 241 VL 13000000
    3 weeks after SOT: AST 27 ALT 31 VL 138
    Reached EOT Aug. 10, 2016 / Received svr4 results Sept. 20, 2016: AST 22 ALT 24
    Hep C RNA NOT DETECTED”

    #20844
    Avatar photoStew-H
    • Topics: 2
    • Replies: 28
    • Total: 30
    • Treatment Warrior
    • ★★★
    @stew-h

    Starting my treatment in 2013 I had several Fibroscans which basically said I had fibrosis/cirrhosis
    But after several blood tests and ultra sounds over several years I was diagnosed to have early stage cirrhosis
    Now that im Hep C free its a matter of me looking after my liver – no booze – good food – only necessary prescriptive drugs
    I didn’t find the Fibroscans that effective as it depended to some degree on the persons skill on using it and its not that accurate in pin pointing degree of Fibrosis/Cirrhosis


    Diagnosed Hep C 2013
    Geno Type: 1a
    Treatment: Naïve
    Cirrhosis
    F4
    2015 GGT 227 AST 79 ALT 89 Platelets 88
    2016 Treatment Generic Harvoni Finished 29 March 2016
    GGT 30 AST 19 ALP 67 Platelets 91
    Qualitative Test Results April 12
    Hepatitis C NAT (NA): Not Detected
    P.C.R Test for Hep C 4th July: Negative
    Virus Free
    stewart.henstock@hotmail.com

    #25299
    hubbardalicia
    • Topics: 1
    • Replies: 1
    • Total: 2
    • Novice
    @hubbardalicia
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