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Gastro will not do another biopsy because of low platelets
Dear Dr. Chung,
I have had HCV for 30 yrs. Biopsy 6 yrs ago indicated moderate fibrosis. IFN 18 mo. non responder. Platelets low at 70,000. WBC low at 2.8. They have been stable at those values since diagnosis. ALT/AST in the 50s. Endoscopy recently revealed esophageal varices mild to moderate. Gastro will not do another biopsy because of low platelets, but say based on the lab numbers and test results I probably have cirrhosis, and there is no need to do another biopsy. He wants me to start on the PEG Combo. Is there much value in that if I have cirrhosis? I would rather wait for a more effective treatment.
  Dr Chung Writes-  
They are probably right that picture is consistent with cirrhosis. PEG combo may be reasonable to pursue given this picture assuming you have no overt signs of hepatic decompensation (discuss this with your doctor). might also consider HALT-C trial (NIH-sponsored) -- also ask your doctor.
  Dr. Chung      
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