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Medical Forum / Diseases and Disorders / Hepatitis / March 2007Fibrotest and/or Ficroscan reliability after Liver Surgery
I have had in the past a serious accidebt and part of my liver right segment had been cut off, still I have some shrapnels within the liver, I have also got HCV from the blood donations. Do you think that FibtoTest and/or Fibroscan can provide reliable conclusion under my circumstances ? >I have had in the past a serious accidebt and part of my liver right >segment had been cut off, still I have some shrapnels within the >liver, I have also got HCV from the blood donations. >Do you think that FibtoTest and/or Fibroscan can provide reliable >conclusion under my circumstances ? Interesting question. If not for the HCV, one would normally expect the liver to very quicky regenerate sufficient volume and architecturally viable structure to meet the body's requirements, and to more closely perform as "normal/healthy" tissue in biopsy as well as the alternatives. The constant inflammation of the HCV vs immune system battle clearly inhibits the liver re-building process - much of what is produced is essentially non-functional (ie: scar tissue). Assuming the HCV infection was virtually concurrent with the liver injury, it seems probable that much of the right lobe will not exhibit "normal" results under such tests. I doubt these biopsy-alternatives have ever been adequately tested to determine their accuracy in such cases. How long ago did the accident occur? And how long were you infected before being diagnosed? Do you know your HCV genotype/subtype? Are you considering therapy? fwiw, I was also infected in-hospital from transfusions while being saved from a rather gruesome car accident. As this was decades ago, nobody knew what it actually was, just that it was "non-A/non-B hepatitis". A decade later they had a test for HCV. I failed ;-) Genotype 1b, it was 35 years from when I caught it before I sought treatment in 2004-2005. Got lucky, got cured... Cheers - and good luck. /greyhackles > >I have had in the past a serious accidebt and part of my liver right > >segment had been cut off, still I have some shrapnels within the [quoted text clipped - 32 lines] > > /greyhackles Thank you for the answer. Some data about myself: Accident was in 1982, at that time in hospital I have recieved a lot a blood, and part of the liver right segment cut off. I think that only anout 4-5 years later I had been diagnosed for something like Non-A-Non-B virus known later as HCV. I did a biopsy in 1995 that found moderate inflamanation. My genotype is - 1b. I do consider therapy. I didn't do biopsy lately, I did Fibroscan and Fibrotest that both say that I have significiant fibrosis, according to the Fibrotest it is - F4. I wonder if the last test are really reliable in my case. And I also wonder how effective would be the Peg Intrfrn treatement ? What do you think ? Jack Hi Jack. The Fibrotest and Fibroscan tests are new. I have read that they may be as reliable as biopsies when liver damage is mininal or severe, but that they are not so reliable for measuring the middle stages of disease. In other words, if the tests say minimal or maximal fibrosis, they are more likely to be accurate. I wonder if you have had any ultrasound imaging done. I believe an ultrasound (sonogram) would tell you if your liver structure and color are normal. Liver tissue can regenerate and fibrosis is reversible. Cirrhosis may also be reversible - reviews are mixed. Although mine wasn't, many liver biopsies are conducted now with the guidance of real time ultrasound imaging. I would choose that option if I were you. The current standard tx for geno 1b is 48 weeks of Interferon and Ribavirin in combination. I would think you have the same chance as anyone else to clear the virus, which is very generally a 50/50 chance. What does your doctor say? Kathy J >> >I have had in the past a serious accidebt and part of my liver right >> >segment had been cut off, still I have some shrapnels within the [quoted text clipped - 50 lines] > >Jack Again, I would expect there to be correlation problems with these two tests in your case - unless, I suppose, they were performed on the left lobe alone (which presumably is "original equipment" in your case ;-). I think only a biopsy is going to give you a reliably accurate picture of your liver condition. There are many factors that contribute or detract from HCV therapy success rates. Liver fibrosis staging is only one of them. There is plenty of data showing successful treatment results for F4s, as well as subsequent reversal of fibrosis (no, not complete, but as long as it's moving in the right direction and you are not impaired to begin with, it's all good). Don't let any doctor tell you it's pointless to pursue treatment! There's no telling what may happen with a tx-naive patient... Cheers /greyhackles > >> >I have had in the past a serious accidebt and part of my liver right > >> >segment had been cut off, still I have some shrapnels within the [quoted text clipped - 71 lines] > > - Show quoted text - I can understand why Fibroscan is not accurate in my case since it is based on ultrasound waves sent to several points of the liver, also thay told me in the hospital that have had 1 case where the Fibroscan said Fibrosis F4 and later Biopsy found that the situation is much better, that was for a man after a serious abdominal surgery. But, about Fibrotest, it is a set of blood tests, isn't it ? Jack >I can understand why Fibroscan is not accurate in my case since it is >based on ultrasound waves sent to several points of the liver, also [quoted text clipped - 5 lines] > >Jack What with "Fibrotest", "Fibroscan", "Fibrospect", "Fibrosure" and others, I can easily get them mixed up ;-) Yes, Fibrotest is an algorithmic oredictor based on "haptoglobin, 2-macroglobulin, apolipoprotein A1, bilirubin, and -glutamyltransferase activity". While in theory this test is less likely to go wrong compared to Fibroscan in such cases, I don't believe this particular test carries a very high intrinsic value (as compared to biopsy) for *any* patient, based on my interpretation of a number of articles published that tried to validate Fibrotest results with actual biopsy data, and showed "FibroTest could not accurately predict the presence or absense of significant liver fibrosis". http://www.clinchem.org/cgi/content/abstract/49/3/450 for example... The gold standard is biopsy. /greyhackles > >I can understand why Fibroscan is not accurate in my case since it is > >based on ultrasound waves sent to several points of the liver, also [quoted text clipped - 23 lines] > > The gold standard is biopsy. > /greyhackles Doey anybody know what is BreathID ? I understand that this is another non-invasive way to finf what is the status of the Fibrrosis. Jack |
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