Jul 22, 2002
Dear Doctor, my father is diagnosed with Hep C. I'd like to run his biopsy result.
Chronic Heptitis with Moderate Activity (grade II) and focally bridging fibrosis (Stage III) Liver Architecture is well preserved. The portal areas are showing moderate chronic inflamnatory infiltrate with focal piecemeal necrosis. The bile duct and portal vessels and central veins are unremarkable. My question to you is the staging/grade in a reasonable shape? what is the lowest to the max grade? One last question, does the VL fluctuate or is it held steady. I know at one pt my father's vl was undetecatable and now it is 2M b/c of interruption.
Thanks again for your answer.
| Response from Dr. Rodriguez-Torres
Firs of all ,I do not understand the report of the Viral load.It should be reported in copies per cc ,or by IU per cc.Please check this ,as this may mean that the blood level is below the cut-off of the test,or negative. If indeed your father has Hepatitis C,the inflamatory process in the liver is mild to moderate and the fibrosis component is moderate to severe,depending on the score used.I suspect that this report was done using the Metavir score.Based on the fibrosis ,and if your farher is confirmed to have active hepatitis C,and has no medical contraindication,he should be considered for therapy against hepatitis C.The maximum level in fibrosis as well as the necroinflamatory ,depend on the score that was used.If it was metavir ,it is 4. ,if Knodell, 4.if Ishak, 6.The levels of viral load fluctuate ,but as mentioned before ,you need to be sure if the report is positive for active disease.
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