Hi Dallo,

The inflammation and progression will slow and stop but the bridging/scarring that makes the liver stiff and is what the fibroscan measures takes much longer to heal. Similar to scars on your skin, it fades with time but it’s a slow process and probably never totally resolves.

G

In the light of day with a clearer head, I withdraw the question. There’s no doubt in my mind that ALT (in HCV context) is a good surrogate marker for liver inflammation, which means that higher ALT equates probably with higher fibroscan score. However, if you remove the inflammation, or most of it, as would likely occur with a decent response to the DAAs then you might actually get a clearer picture of the true situation re fibrosis if you deploy a fibroscan, and so performing that test during Tx to decide whether liver damage warrants Tx extension is actually a reasonable idea.

Yeah, they were, mate. AST wasn’t too bad but ALT was in the 200s and GGT about 300. I was lucky enough to get into the first AbbVie compassionate access program but there were months of red tape. The TGA had to pass individual treatment plans, something which had never been done in Australia before for HCV+. Seemed clear there’d be no problems (HIV+ had done it), but geez, it was a stressful time. And then there were some problems getting the meds from where they’d been made. It was all a really nervous time and the stress was bad. Sent my LFTs through the roof sky-high at a time when my liver seemed to be transitioning Child-Pugh A —> B. Technically that would’ve made my place in the Access dicey since they were only treating compensated cirrhosis. I lost weight. It was a bad time. I had some edema and ascite which got much worse until I restricted sodium, and numbers of key markers were mostly going south.

Got the drugs and felt unbelievably better within the first week. Mind fog cleared, I had more energy. depression I didn’t even know I had lifted, appetite improved, lots of other stuff. Just turned me around. Not that it really matters but I was UND by week 5. Never panicked about bloods after that because I simply knew the filth had gone. I felt too good, and having relapsed before I know how that feels.

My liver dude is really optimistic, feels that I should experience considerable regression of my situation. Having read a bunch of recent studies I’m not so sure, numbers say it’s about the toss of a coin for significant regression, but hey, I’ll take it

Cheers!

Cluster of tumours? What sort of ablation? Did they get it? I had a HCC resected back in ’06, which was switched on by IFN/riba. Lucky it was really since AFP was high and the cancer was lurking, and when it turned feral I was being closely monitored. AFP started going exponential and they picked it up via U/S when it was about the size of a small pea. Also only a single tumour and fairly peripheral. Lucky all ’round. It was an aggro sucker though, no doubt fed by the iron in my system from riba action on my red cells.

Was so grateful to find the club in Oct and get tx. Three weeks in now and you’re right about the differences. Didn’t realise how down I was, just going through the motions so as not to worry others too much. Still a way to go but I feel alive again and ready to greet each day. Amazing what a bit of hope does.

Awesome. All the best!

Yes, bloods seem to react quickly, and whilst GGT can come down reasonably quickly (though probably the slowest to react) bilirubin can sometimes sharply elevate, confounding the test all over the place.

An interesting one with the AbbVie meds seems to be an almost immediate bounce in platelets, and I know they were claiming it as a sort of surrogate marker for improvement in hypertension. Seemed a ridiculous claim to me given the time frame. Mine have improved a lot from baseline though.

With normal LFTs happening rapidly the Hepascore rapidly becomes inaccurate on treatment.

In a perfect wold you get a Fibroscan before treatment but if it’s not possible and you don’t want to wait…..

Why aren’t they deployed more? I assume inexperienced users can be a problem but why have them sitting around when they are obviously so useful?