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Results of abdomen ultrasound question.
Oct 24, 2010

I have Hep C and have been HIV positive for 22 years. My ultrasound shows a "mildly coarsened echotexture"of the liver with no hepatic lesions. In 2007 I had a normal echotexture. Should I start treatment for my hep c. My HIV doctor has said I can wait because I don't have a high hep c viral load. But a previous GI doctor says I should think about it. What do you recommend? What does a mildy coarsened liver mean? I want to wait for the new treatments to come out but will start now if I have to.

Response from Dr. McGovern

All excellent questions....A few comments....

1. There is absolutely no correlation between the level of virus in your blood and disease in your liver.

2. A coarsened look on the ultrasound could mean fibrosis (scarring). I would advise a non-invasive marker of liver disease (Fibrosure or Fibrotest for example) and/or a liver biopsy to stage your disease. The ultrasound is not helpful for staging.

3. I agree that it would be great to wait for better therapies. Keep in mind however that if you have a low viral load (eg, less than 400,000) your chance of responding just to dual therapy with PEG and ribavirin is high. You will know if you are responding as soon as 4 weeks of treatment. If your disease stage is more advanced you might want to push on...

4. Also keep in mind that the new therapies will be combined with the old (PEG and RBV).



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