Cirrhosis can be suggested in the ultrasound, and if it's not seen, it's an unlikely diagnosis. That said, the most definitively test would indeed by a liver biopsy. But, given the clinical picture, this does not present like a typical cirrhotic patient.
Non-alcoholic fatty liver, or NASH, is best treated with lifestyle changes, including weight loss.
If the diagnosis continues to be non-revealing, another referral can be sought with a GI physician.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin Pho, M.D.
KevinMD.com
Twitter.com/KevinMD
Facebook.com/KevinMDblog
My brother has Hep C and is not overweight, but has a lot of vomiting, fevers, chills, night sweats, etc. He has a lot of pain in his upper right quadrant as well. He doesn't have a fatty liver, but more of a scarred liver. He is being put on an experimental thing involving Milk Thistle in large quantities at a hospital in Philadelphia. Milk Thistle is supposed to help cleanse the liver, maybe talk to your doctor about it, and speak with someone specializing in hep c who knows all the ins and outs.