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With Hep C treatment a key determinant of treatment outcome is liver fibrosis. Less is definitely more.
Measurement of the amount of fibrosis is called staging. There are five stages:
- F0: no scarring (no fibrosis);
- F1: minimal scarring;
- F2: scarring has occurred and extends outside the liver area (significant fibrosis);
- F3: fibrosis spreading and forming bridges with other fibrotic liver areas (severe fibrosis);
- F4: cirrhosis or advanced scarring.
In the studies patients are divided into 2 groups – have cirrhosis, don’t have cirrhosis. This is actually not realistic because you start with no fibrosis, get more and more fibrosis along the way and end up with cirrhosis.
Most HCV patients, if untreated, are expected to develop cirrhosis at about 65 years, irrespective of the age at infection. Thus, age itself seems even more important than age at infection for predicting the occurrence of liver cirrhosis.
Progression to Cirrhosis in Hepatitis C Patients: An Age-dependent Process
If you have cirrhosis or even perhaps are simply very close to having it consideration needs to be given to extending treatment from 12->24 weeks and adding Ribavirin.
Unless a liver biopsy is performed we can’t measure fibrosis directly. Instead we look to the elasticity of the liver and report the results in terms of pressures (kPA). You can see how a kPa value correlates to F
You will find more details on this at http://hepatitiscnewdrugresearch.com/fibroscan-results-the-scoring-card.html
The Hepa Score is described here: http://www.jcdr.net/articles/PDF/1136/1444_2..pdf
A hepascore value ≥ 0.50 indicates significant liver fibrosis , whereas if the result is < 0.50 significant fibrosis is absent. If the value is ≥ 0.84 , cirrhosis of the liver is likely present and if the value is < 0.84 cirrhosis is absent
My AST/ALT score is F1 and my APRI score is F4?
Hey Sabrecat, Mine too!
Had the amazing new LiverMultiScan and I was overall F1 with small ‘spots’ of higher fibrosis in the center & left lobe area (F3/4?) , but not joining up, just small spots. However, instinct tells me small spots can cause some problems, they seem to be where there are other organs eg heart and a lot going on in that area, maybe easier for the virus to hide in? and harder for the meds to reach possibly? Again, just my instinct. I can see why exercise is helpful, looking at my LIF scan. One thing I really learned after this new scan, is fibrosis is not necessarily evenly spread.
Added LIF image below as my blog is long and it’s hard to find; this is a mix of 4 scans :
ps green is good, red is bad
Hi Sabre
I made LG a t shirt and flares ages ago
They’re on her blog and on mine
Ariel
Here are screenshots of what you missed for a laugh
Hi London Girl – that is an amazing MRI imaging. It looks so much more accurate than Fibroscan as it can check all areas of the liver. My lay assumption is that even if scored F1 (my case) on Fibroscan or conventional Ultra-sound, we might be missing those red (bad) spots where it is more difficult for the DAAs to reach. Cool pants by the way.
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