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879300 tn?1240452874

Necroinflammat Activity Score

Am I doing this wrong? This is the first time I've been on this site and I was wondering if I'm posting this wrong. I ask a question last night and I haven't recieved an answer. My question is: What is Necroinflammat Activity Score? I had a HCV FibroSURE test and everything was normal except for the Necroinflammat Activity Score. Can someone tell me what that means?
16 Responses
9648 tn?1290091207
You're fine. I saw your question. I don't have an answer for you, though. It may be that no one does. Is there a website for the lab that has any explanations? Or try googling "necroinflammatory" or something.
732047 tn?1236010444
Hi bdeleon

  I may be able to  help you with fibrosure questions. I have had the test and read up on it quite a bit. The "necroinflammatory" score is the amount of inflamation occuring in the liver. It corresponds to the Metavir scoring system of grades A0–A3. If you tell me your score I can elaborate further. Another important score is the fibrosys score.

The lower the score the better.

Here is the scoring chart:

F0–fibrosis  0.74

A0–no activity  0.62
732047 tn?1236010444
Ok well that blows. Half my reply was cut off. Try going to this link and scroll down to page 3. It explains the scoring chart. Or just post the scoress and I can look them up for you.
732047 tn?1236010444
With the link this time.

http://www.cigna.com/customer_care/healthcare_professional/coverage_positions/medical/mm_0296_coveragepositioncriteria_serum_markers_for_liver_disease.pdf
732047 tn?1236010444
Ok. Well that got cut off as well. So I guess just post the score and I'll look it up.
879300 tn?1240452874
Ok, The Fibrosis Score is 0.17
            Fibrosis Stage is F0 - No fibrosis
The Necroinflammat Activity Score is 0.19 High
      Necroinflammat Activity Grade is A0 - A1

Thank you for your help
732047 tn?1236010444
A NA score of .19 is not bad at all.  A NA score of less than .17 is considered no activty at all. A Fibrosis score of .17 is considered to be no damage.

So according to these results you hve no scarring and very little inflamation.

Now. That being said. My results were:

.04 Fibrosis = No Fibrosis
.15 Activity = No activity

However a biopsy I had done about a month later showed Stage 1 fibrosis with Grade 2 inflamation. Not quite as good as the fibrosure results. My hep doc said that the Fibrosure is good at determining the low and high ends of the fibrosis scale. Meaning from minimal damage to cirrhosis. But not as good at pinpointing the amount of damage and inflammation as biopsy would be.

So in your case it's very likely, but not definate, that you have very little if any fibrosis. However only a biopsy can determine this for sure.

Have you had a liver function test (Alt,Ast,ect)? Your platelet count can also offer some information. Low platelet count can often suggest more severe fibrosis.

Hope this helps.


879300 tn?1240452874
Well acually these are my husbands results. The first time he had it done which was 2/10/09, his AST was 46 and his ALT was 59. His CBC was normal. Although he did have blood in his urine. I don't know if that had anything to do with that. He also had a urine culture done and that was normal. He had his liver enzymes checked again on 3/24/09 and they were normal. He also had an ultra sound done and it showed his liver was either fatty or inflammed, I don't remember exactly was it was. The reason our doctor sent him to a Gastroenterologist is because our son has Steatohepatitis with Bridging Fibrosis, (which is a fatty scary liver in the early stages of cirrohsis) and his sister (my sister-in-law) has Autoimmune Hepatitis with Cirrohsis. His Gastro wants to do a biopsy but he doesn't want to. My son was diagnosed with this when he was 9 years old and he is now 21.

So do you think the Gastro will for sure want to do a biopsy?
732047 tn?1236010444
Does your husband have HCV? Or one of the other conditions you mentioned?  The biopsy is not bad. I did not want to do one either. I was terrified at first. But the Doc's here in the Houston medical center made it quick and completely painless. I felt like a big wuss for being so worried about it. The cost of having it done had me worried as well. But luckily I have good insurance.
879300 tn?1240452874
No he doesn't have HCV or any of the other conditions I mentioned, that we know of. I think they are trying to determine if he's getting some kind of liver disease. We think it might be genetic because his sister and our son have it. For some reason his liver is infflamed. I think that's what they are trying to figure out.
732047 tn?1236010444
Ahh. Ok. I see now. There are actually 2 types of fibrosure test. One is for HCV the other is to detect fatty liver or what is refered to as NASH.  Either way your husbands test results do not suggest advanced disease. The liver test from 2/10 show only a slight elavation of enzymes. A biopsy would paint a very clear picture of what is going on. It would rule out or confirm autoimmune hepatitis and probably rule out or confirm Steatohepatitis. All the other tests are indirect markers of what might be going on.
879300 tn?1240452874
Oh ok, so he should have the biopsy done. Because our son and my sister-in-law do have NASH. That's what both of their doctors told them. I guess I'll try to talk him into getting the biopsy. Both my son and sister-in-law told him that it hurts like the dickens and he doesn't like pain. He's a big wuss when it comes to pain. They told him it hurts once the procedure is over with and the numbness goes away.
Thank you so much for all your help. He has been so worried out it. Now I can tell him what is means and maybe just maybe he will get the biopsy done. Again, thanks a bunch.
732047 tn?1236010444
Glad I could help. The biopsy should not hurt if done right. I only experienced some minor tenderness for a day or so. Nothing a couple of Advil did not remedy.

Best of luck to you and your family. Maybe it will turn out to be nothing more then too many cheeseburgers.

Fathom Out
233616 tn?1312787196
the biopsy really isn't as scary as you think. They gave me something to relax..then a tiny shot to numb my side...then the needle biopsy. The needle is not that large..and since the liver has no nerves in it all they have to do is numb the side a little, not the liver..  I barely felt anything, not even much pressure.

The only contraindication would be if your husbands disease was highly advanced...stage 4 or end stage, because then the possibility of bleeding too much becomes a real concern since liver blood pressure is elevated in late stage disease. Sometimes that pressure can be 2-3 times greater than general blood pressure elsewhere in the body...and so if the fibroscan showed him in late stage I would discuss this mire with you liver doctor.

Otherwise, there are many advantages to having a biopsy. Chiefly you will know your state of disease, you can then also qualify for studies with new antifibrotic drugs, many of which want the patient to have a biopsy before and after treatment to see if the new drugs are working.
Also, Knowing his stage of fibrosis or NASH may help in other decisions. Such as, if it is NASH, is it being caused by Insulin Resistance (IR) and not just genetic. In this case, he might be able to take Metformin which is known to correct IR while reducing NASh signifigantly.

In most cases, it is in the patients interest to know as much as possible about the state of his liver, he can use certain antifibrotic supplements, or go into clinical trials, and at very least he can avoid certain food and pharmaceuticals that would contribute to his fibrosis or NASH.  If one takes care of oneself, one can live many years with these conditions, and much more can be done to reverse them than what was known a few years ago. Of course the first thing he will want to do is cut out all alcohol and pot if he smokes it. Both of these contribute to both of the discusses liver diseases.

mb
879300 tn?1240452874
Thank for the information. This isreally helpful.
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What does 0.45 mean?
1 Comments
On what test? The best person to ask would be the doctor who ordered what ever test this was.

Do you have hepatitis C? Do you have liver disease? Are you seeing a doctor?

Also you have added a comment to a post from 2009 you should post a new question
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