Liver biopsy

[aon]

Hello every one. I have known that I have the hep c since two year but I have not done any treatment yet.
last 3 month I have check my blood test at the hospital in my city which shown the viral load 78059 IU/ml and the doctor A recommended me to do the treatment without the biopsy but the cost to do that is so expensive and i do not have any health benefit yet because I am still a student. So I went to the hospital in Bangkok which is belong to the government university and there they have some research project about liver disease so I might could join the research project and do the treatment for free . I met the doctor B there he said at the moment is no the research project so he help me by let me order the vaccine and pill by myself then I will get it with the lower price. So I have two choice is other Peg-in tron or Pegasis (sorry it i wrote it wrong), anybody have an idea that which one is better ?

and doctor B also  recommend me to do the liver biopsy while the doctor A recommended  me to do the treatment with out biopsy.  so I worry about doing that.  why the doctor B  he make a decision without knowing the genotype. I have read in some journal said for type 2 and 3 are not necessary to do the liver biopsy. I scare about the painful from biopsy.

Thank you every one.

[gonzogirl]

I found this YouTube Video and it is very helpful in determining whether or not to do the liver biopsy.  Everyone who has Hep C can benefit from watching this video.  It answered some of my questions.  http://www.youtube.com/watch?v=kfIu9uQODgQ  Hopefully this will post and not be omitted.  If it is omitted go to YouTube and searh for Hep C Everything from A to Z...also the presentation is presented by UCDavis.  University of California...Davis

[aon]

Thank you very much. For a very useful in formation. Ok first I will check my genotype hopefully my one is a mild genotype.

Now I feel better about doing the biopsy.

I will let you know my treatment progress.

Thank you again.

Aon  

[Trinity4]

Correction:

"because you do not start someone on antiviral therapy without knowing the GENOTYPE.

Lupette,
Nice concept and would be a common practice with the standard of care if it were effective but I don't think it quite works that way.

Trinity

[lupette]

I agree with Trinity. The Pegasys had fewer side effects for me. If you are going to pay for this treatment yourself and your doctor will prescribe it . . . I would even consider using both combos. I would start with one and then half-way through . . .swithch to the other. I don't have any evidence to back up this opinion but my hunch is that you would limit the wild type replication by switching half way through. Best of luck to you!

[Trinity4]

You must know the genotype prior to starting treatment because it will determine whether 24 wks or 48 wks of treatment is needed.  24 wks for genotype 2 and 3) and 48 wks for genotype 1 and 4).  Despite geographic location and what genotype is prevalent in your country genotype must still be established.  

In the past, biopsy for genotype 2 ad 3 has not been considered an absolute because it is an easier geno to cure with less treatment time as opposed to genotype 1.  However, that line of thinking has changed because treatment may not be necessary immediately and no need to expose someone to interferon and ribavirin if liver disease is minimal.

Pegintron and Pegasys are the same medication, just a different molecular structure and the cure rate for both is equal depending on which drug company is listing its success rate :)

Biopsy in not painful and most people are do not have any problems during or after the procedure.  As a matter of fact after the procedure is done they often wonder why they were so stressed about it to begin with.

If you are want to start treatment because you have decided the time is right and you just want to try and eradicate the virus now it doesn't matter about biopsy, just go for it.
However, I don't think Doctor A knows about hepc and is competent in that area because you do not start someone on antiviral therapy without knowing the viral load.  I understand different parts of the world have better or worse levels of care but establishing genotype is a must.

If you feel watching and waiting is the best for you, biopsy is a critical part of that approach.

Good Luck
Trinity

[FlGuy]

Both doctors are correct, sort of.  If resources (money) are an issue and you have Geno 1, 2 or 3 and are committed to the treatment than a biopsy does not really serve a purpose.  A biopsy would be a good idea to understand exactly what your liver condition is in case you want to decide IF you are going to do the treatment.

You at least need to have a test to determine what Geno type you have.  The Geno type makes a difference in the treatment process.

Biopsy is not painful.

I used both PegIntron and Pegasys for 2 treatments.  If I had to choose again, I would choose Pegasys.