... Does it mean that F4 is worse? Or does it go as far as F-6? And, if not is F4 the end stage of liver cirrhosis and therefore untreatable? And, does anyone know how this all fits in with being the hep c genotype of 1a or 1b? I know that Harvoni favors 1a patients for using the drug, which I am 1a. But, I read my lab work results before I started taking Harvoni and I determined that I was a F-4 ... yet, the head nurse in my doctor's office had told me over the phone that I was beginning stages of cirrhosis, F-3. I think she got it wrong or simply she was not looking at my paperwork. I don't know. It's all confusing for me
Does anyone understand the symbols F-1, F2, F3 or F4, as it relates to Hepatitis C and or Cirrhosis?
Question posted by zenn211 on 4 March 2015
Last updated on 23 April 2018
The information on this page reflects personal experiences shared by our community members. It is not reviewed for medical accuracy and should not replace professional medical advice.
7 Answers
artisticsence
23 April 2018
Was just diagnosed myself and F4 is end stage. Not sure how long that lasts but I'm sure there's no F5 or 6 ... just F1 thru F4
Must stan d for final level !
I'm spinning..want to have ongoing garage sales, throw stuff away ruthlessly.
God has always come first , but is becoming ALL to the expense of daily chores and Doug should be in there somewhere big. Like tomorrow is his birthday and I have NOTHING PLANNED .
I should be doing something BIG for him. He's my only friend, my comfort. He has accepted me and all my illness with a grace and dignity I admire. Payback time !
Happy4now
23 April 2018
Hi artisticsence, I would talk to a doctor and confirm your diagnosis before you start thinking the worst. Hopefully things are not as bad as you think. There are so many new treatments these days. Lots of hope for better health. Wishing you the best!
stargate500
26 April 2016
Hi zenn211, The F ratings are fibrosis ratings one being the least. It is basically a cirrhosis rating. For insurance to pay for the extremely expensive drugs most are treating F-2 or higher. Not to scare you, but with an F-4 rating I would certainly start the Harvoni. I require the Daklinza/Sovaldi meds thus I will never get to be cured. with an $85,000 price tag it"s been turned down by the insurance. Good luck with your treatment!
Magdy Wasif
2 Jan 2016
F0-F1 none to low fibrosis
F2-F3 moderate to extensive fibrosis
F3-F4 mild cirrhosis
F4 is extensive fibrosis
Magdy Wasif
2 Jan 2016
Sorry F4 is extensive cirrhosis
John19993
26 Dec 2016
I,m Hep C+ For about ten yrs.And i,m HIV + for all most 27 yrs. I,m still on my initial hiv regimen of meds. Since being diagnosed with hep C i,m extremely tired.I eat healthy with loads of anti oxidants.I exercise regularly.And i don't drink alcohol. I,v been undetectable hiv for 16 yrs.
This August i was referred to a specialist and had a liver biopsy done and the results were F.1 and the viral load of the Hep C was Low-high range.
The Momentum Support had contacted me after the biopsy and are waiting to hear from Nova Scotia Pharma Care( Family Care) There has been no response from the Nova Scotia Pharm Care and the Momentum club can not act until i hear from the NSPC.it has created great anxiety b/c of the uncertainty... My primary Dr,knows little about the process.I live on Cape Breton Island with Extremely limited resources... So much so, that they have to bring in medical mobile units with Nurse Practisioners
I,m still waiting to hear if i will be a candidate for the Harvoni medication
The liver specialist re sent the forms to NSPC and told me at the last apt to go through my primary Dr after i begin Tx??? My last apt was on Dec 21 with the liver specialist.
When i was informed about this.It created more anxiety.It is very difficult for me b/c i live alone and live in isolation.I have no one to talk with regarding all my concerns and little knowledge about the process.I,m also anxious with all of the uncertainty.Because i live in a rural area i have to maintain confidentiality.That presents a lot of barriers as well.
If some one can assist and guide me through this process it would be Greatly Appreciated!!!
The situation here on the island is dire in that, they have to bring in a medical mobile unit for many without Drs and i have no specialist for my HIV.he left the area in July
ClaimIt
31 Oct 2017
My Dr said I'm between 3 & 4, but he specially said I have liver fibrosis not cirrhosis. Due to Hep C, which he said indicates I've had for a long time, but there's abosulety no alcohol damage to my liver. Caused from Hep C. Which I was at extremely low risk of getting & they still have no idea who I was exposed to, to get it. I'm on Harvoni for 12 wks & he said there was 98% cure rate for both Hep C & liver fibrosis with med treatment. Yes, if not cured could lead & most likely will, to cirrhosis. But, I'm rebuking that. Don't understand where you're getting that between 3 & 4 is cirrhosis. Not what my GI Specialist said. And, I thought cirrhosis wasn't treatable, meaning being totally cured from. Why would he put me on Harvoni & say there was 98% chance I'd be completely cured if I had cirrhosis? Just asking.
learjet2112
17 March 2015
You as written are 1A. 1B. Which are basically the same and the most responsive to harvoni treatment with a high percent svr rate. Are you being treared with Harvoni?
F1 is lower damage of that F4 which means higher damage than f1 for instance. If i were you,i would get in person with your dr and have spell out where you are clearly. I am not sure that the google search had anything to do with drug molecules. They were most likely your damage scres. Were you a heavy drinker etc? If you are not avoiding alcohol,drugs,etc i would be watching foods erc, all i can say based on the original post, i hope you are bejng treated,and abstaibg from fat,alcohol drugs etc and sit down with your dr and find out whats going on, if you get additional info please post so we can help you get your status. Ok? Habg in there and post back
RHK
1 July 2015
I have had elevated liver counts since1987,then it was NonA nonB,then hep c(1a). I am now on third tx Harvoni,just starting. I have been lucky, I have no cirrhosis,but starting to show some damage. I have used milk thistle on and off for years,I personally believe it has helped me.I can bring my liver counts down to almost normal and they have been in the hundreds once or twice.I do not take these when under tx.My liver doctor thinks it's a waste of money,my family doctor has seen it work and couldn't believe it.Does it help my hep c count, don't really know.I also eat a lot of all kinds of beans, food to feed the liver and try to stay away fried food as not to clog up the liver.yes you can clog the liver like you arteries.I guess what I'm trying to say is milk bristle couldn't hurt when off tx. Wishing you well!!
learjet2112
1 July 2015
Do NOT take ANY "supplements while on treatment. especially milk thistle !!!
Bsr4810
28 March 2016
So having fibrosis stage 4 will Harvoni cure hepatitis C with fibrosis stage 4 ?
Chic1956
14 March 2015
Chronic liver diseases affect the liver tissue in various ways: fibrosis and steatosis.
Fibrosis
Any chronic attack on the liver will cause inflammation, which then leads to the formation of fibrous scar tissue in the liver, creating hepatic fibrosis. This fibrosis is therefore a scarring process that will replace damaged liver cells. The extent of this fibrosis can vary, and it is described in several stages. A normal liver is at a stage between F0 and F1. Stage F2 denotes light fibrosis, and F3 is severe fibrosis. 'Cirrhosis' is defined from stage F4, when scar tissue exists throughout the liver.
Fibrosis therefore disorganises the architecture of the liver both anatomically and functionally. When fibrosis reaches the cirrhosis stage, it is initially completely asymptomatic; this is the compensated cirrhosis stage, i.e. not complicated. It can be discovered fortuitously during scheduled examinations. The cirrhosis then decompensates, and liver complications appear.
-Portal hypertension which is secondary to liver fibrosis; this impedes venous circulation and causes the pressure in the portal vein to rise. It can promote haemorrhaging by bursting oesophageal varicose veins.
-Ascites which is the formation of a liquid effusion in the abdominal cavity, which can become infected.
-Icterus (jaundice).
-Hepatic encephalopathye which corresponds to neurological disorders by the accumulation of toxins that are not broken down by the liver.
-Primitive cancer of the liver, which is a final complication, and can also be called hepatocellular carcinoma.
Fibrosis is reversible if the cause of the disease is treated and if the lesions are not too severe. The liver can then resume a normal structure. The degree of fibrosis therefore constitutes an important prognostic parameter. The extent of the fibrosis is one factor affecting the diagnosis and decisions concerning therapy, and a criterion for tracking the progress of the illness and the effectiveness of therapy..
RFitz
14 March 2015
So I have Stage 4 Cirrhosis ,are you saying that I can still regain better liver function over time with good diet and exercise in spite of scarring now say my Hep C
zenn211
14 March 2015
Hello FRitz,
It is my understanding that cirrhosis is a hardening and scaring of the liver that cannot be reversed with healthy diet and exercise. I have cirrhosis (F-4) and I do wish that I am wrong, but I've been told that only fibrosis can eventually be reversed.
By all means, tell me what you have been told. I still remain hopeful.
Good luck and stay in touch.
zenn211
14 March 2015
Hello Chic1956,
Your piece was very well written and I appreciate your comment.
Is there any more that you can add.
You said that there were two disfunctions of liver tissue besides cirrhosis: fibrosis and steatosis. You explained fibrosis, but not the other one, steatosis.
Can you tell us more?
And, is there any known documentation of a person with cirrhosis having their liver eventually healed of that cirrhosis ... to your knowledge?
Thank you and have a nice day.
RFitz
14 March 2015
So what your saying (and what I have been led to believe) is that scarring is scarring but you may still experience some improvement in liver function as dead or damaged cells recover ??? I am stage 4 but the hep c is gone now so hopefully there is some room for improvement.Thanks for your feed back.
zenn211
14 March 2015
FRitz,
Yes, to the possibility of damaged cells having a chance of rejuvenating themselves, however, no to dead cells, in other words, not if the cells are dead they don't come back. I believe that you will agree that dead is dead.
Nonetheless, miracles still happen everyday ... and everyone is different; therefore, anything is possible. One must believe!
Plus, science and research, along with new medical technologies have skyrocketed in recent years and continue to grow, evolve and have new drugs approved, all the time. So, all is not lost my friend. There is always hope. In fact, it's really all that we have.
RFitz
15 March 2015
The liver is a very big organ and if I have 20 % that stays as is or even I get 10 % improvement I have been told that is enough to live out a healthy long life. Its having a life style that will not make it worse that counts I would think. Thanks again for the feedback.
zenn211
15 March 2015
FRizt,
Like I said, I'm stage F4 cirrhosis too. So, I'm curious about exactly what you meant. Are you saying that the 20% that stays as is ... is the damaged portion or the healthy portion? So, would the 10% improvement put you at 30% normal function allowing you to live a healthy existence for years to come or did you mean 80% functionality of the liver allowing you to live a healthy life? Would you explain that a little more?
And, yes I agree with you when you say that the real key to slowing down the progression. As not to cause any additional hardening of the liver by worsening the cirrhosis.
We both know that this means not to drink alcohol or engage in other liver threatening activities or harmful eating habits. For example, processed foods, cold cuts, shell fish, black teas, fried foods, high fructose corn syrup. Then, we must limit refined carbohydrates, such as white bread, white rice, white potatoes, fast foods and packaged foods, to name a few.
So, please hit me back and I hope this is helpful.
RFitz
15 March 2015
Yes that is what I meant. I have 80% damage so that means 20% functioning. Hopefully there will be some slight improvement over time. The various enzyme levels and other indicators from blood work can gauge that a little. I have been on a low fat/sugar and sodium diet since being first diagnosed with Hep C almost 3 years ago. I never drank but had NAFLD.I take a vitamin concoction to keep the immune system strong and take milk thistle which is thought to help protect existing healthy liver tissue. I also exercise everyday (walking /aerobic/light weights)
zenn211
15 March 2015
FRitz,
I'm proud of you and your discipline. You sound like you have a good doctor who is quite devoted to your care and to keeping you informed or rather educated about your condition. I wish that my doctor was that vigilent. And, that he sat down and explained my lab results. I had to figure most of it out on my own through research and phone calls to CVS Caremark. He never advised me to be on a low sugar, low fat, low salt diet.I figured everything out independently. Wow, your doctor is the best. Mine is a high raking physician who does very little.
Well, I am not excersizing very often, and I am eating whatever I want including bubble gum from time to time. Yet, I do eat a lot of vegetables and very little meat. Nevertheless, I keep telling myself that I gotta get outta this bed ... fatigue or no fatigue, body aches or no body aches. Plus, I know that I must start to use the excersize equipment we have in our basement rec. room. I gotta do better ... but, I sure am proud of YOU!
zenn211
15 March 2015
FRitz,
I'm proud of you and your discipline. You sound like you have a good doctor who is quite devoted to your care and to keeping you informed or rather educated about your condition. I wish that my doctor was that vigilent with me. And, I wish that he had sat down and explained my lab results. I had to figure most of it out on my own through internet research and phone calls to CVS Caremark. He never advised me to be on a low sugar, low fat, low salt diet.I figured everything out independently. Wow, your doctor is the best. Mine is a high raking physician who does very little.
Well, I am not excersizing very often, and I am eating whatever I want including bubble gum from time to time. Yet, I do eat a lot of vegetables and very little meat. Nevertheless, I keep telling myself that I gotta get outta this bed ... fatigue or no fatigue, body aches or no body aches. Plus, I know that I must start to use the excersize equipment we have in our basement rec. room. I gotta do better ... but, I sure am proud of YOU!
zenn211
15 March 2015
Hello Chic1956,
Your piece was very well written and I appreciate your comment.
Is there any more that you can add.
You said that there were two disfunctions of liver tissue besides cirrhosis: fibrosis and steatosis. You explained fibrosis, but not the other one, steatosis.
Can you tell us more?
And, is there any known documentation of a person with cirrhosis having their liver eventually healed of that cirrhosis ... to your knowledge?
Thank you and have a nice day.
RFitz
15 March 2015
You probably know but stick to chicken and fish instead of red meat and whole wheat or brown rice bread and pastas versus regular white flour products. I don't know if your interested but I can give you a run done on the vit/minerals. I break them up over 3 different times in a day.Exercise is just what you can tolerate.If you just start slow.I have trained all my life and the biggest thing to exercise is developing the routine or habit of setting aside the time. Even if you only do 10-or 15 minutes for the first week or two you will get the habit.Exercise will also start to put endorphins in your blood which will help with positivity.Best of luck and good health.
zenn211
16 March 2015
FRitz,
Yes, I am interested in having a rundown on safe vitamins and minerals that will help my hep c virus.
You did say whole wheat bread is good along with brown pasta and brown rice right? Because this is what I've always known, yet, I have a hard time following through sometimes. And, I do have and crave a small thin porterhouse or t-bone once a month, plus, pizza. And, I do try to avoid sugar, but I do love bubble gum and a little candy from time to time.
However, I will take your advice about excersize. I will start off slow and try to incorporate a routine. :-)
So, what your doctor told you about people like us having the ability to live a full life even with cirrhosis or less liver functioning, seems to be contingent on giving up so much comfort food. LOL :- )
Yet, I will do it. I must!
Please hit me back.
Chic1956
16 March 2015
Steatosis (fatty liver) is an accumulation of fat in the liver. Steatohepatitis is when this progresses to become associated with inflammation.
Fatty liver disease is divided into:
Alcohol-related fatty liver disease.Non-alcoholic fatty liver disease (NAFLD).
zenn211
16 March 2015
Chic1956,
So non-alcoholic fatty liver is the result of the hep. c virus?
Can a person live a full life with 20% functionality of the liver if the hep.c virus is still active in their system or can one function with 20% function only if the virus has been rendered inactive?
Does a cirrhosis liver "ever" stand a chance of rejuvenating itself?
What percentage of the liver is needed to be functioning in order to sustain life.
I want to let you know that I appreciate you and your time.
Thank you so much!
Chic1956
17 March 2015
Only a minority of patients with hepatitis C infection progress to cirrhosis. Once cirrhosis develops, patients usually live for decades without complications. Successful treatment of the hepatitis C infection will decrease the chance of developing complications from cirrhosis. Patients with cirrhosis should take steps to maintain good health, receive adequate immunizations and regular medical care. Close monitoring by your primary care physician as well as a gastroenterologist or hepatologist is important for the early detection of possible complications.
RFitz
17 March 2015
Very good advice. I have just been notified of a gray area and my Dr will want to institute radiation asap. If dealt with early your quality of life can be maintain with 20% virus free liver. I also wanted to add something on the diet front. I have discovered that coconut water is a great juice replacement for your blended drinks. No sugar. Best of luck to all.Remember even a 20 minute walk everyday helps.
RFitz
17 March 2015
Also NAFLD can be familial.(inherent) Not just from Hep C
zenn211
18 March 2015
Thank you guys, I appreciate the insight. Please keep it coming!
learjet2112
21 March 2015
Exactly
learjet2112
21 March 2015
Exactly
jxmummy
21 May 2015
Please forgive me if I am asking questions that have been previously addressed I am new to all of this (which is very asinine because I've known about my hep c for 13+ years) I am a recovering alcoholic/addict have been in recovery for 3 yrs. I am finally seeing one of the very best docs and they are starting my testing. I've had extensive blood testing, a colonoscopy, EGC and am scheduled for a biopsy early June. The PA in my docs office is my main contact and after looking at my blood tests she said she would say I was a 3-4 regarding cirrhosis. I had no idea what it meant so I said OK and hung up. I see her again in a week to discuss things. Should I be worried about this? Or eating differently? What exactly am I looking at? Answers please!!!
jxmummy
21 May 2015
I am totally confused. I am currently striving to do whatever is necessary to lengthen my life but if I am a 3 possible 4 is it even possible? I need a list of questions that will give me the correct answers but at this point I don't even understand the terminology. Scared even more from talking to my docs PA
chuck1957
11 March 2015
Zenn211 by the way all of the different parts of the chemical structures started just like the f but they start with A1,B1 JUST like the F but went all the way up to G4 So i am sure then it changed to mouses and adsorbing of that part of the chemical. so it has to have something to do with after marketing best of luck my friend...
zenn211
11 March 2015
Hi Chuck 1957,
You are a gem! Thank you for caring enough to research the matter. I am still searching. I don't know the letter F, but I do know that the numbers indicate the degree of liver damage. My pharmacist told me that F4 is cirrhosis and F3 is not. So, I think F3 is fibrosis.
Which number are you and what did your doctor say about your number?
The fact is that the only thing that really matters is that we're now getting the treatment we need to save our lives. And, for this I am full of graditude!
Take care of yourself my friend and please stay in touch.
chuck1957
12 March 2015
ZENN211 GO to the search bar and ask at what stage is f1,F2 GO UP TO F4 AND SEE IF IT does come up just try a few word ect until hopfully it well come up under that one it started coming up on i think page 7 prior to that were different letters and numberes hope this works for you let me know this was all to do with a single part of of the liver like like micardes??? f1 stands for this and the percent that F2,F3 F4,,, WORTH a try these days we have to get involved in our own health care. good luck worth a try..chuck1957
zenn211
14 March 2015
Good afternoon Chuck1957,
You are sooooo right, we must take responsibility for our own health. I will follow your advice and look that up on the net. I will then get back to you soon.
Thanks
Braindead NY
31 Aug 2016
When HCV is involved F-1,F-2,F-3,F-4 are stages of liver fibrosis. F-4 is the 1st stage of Cirrhosis or scarring of the liver. The are several stages of cirrhosis. This score usually used on biopsy of the liver is now used by the Fibroscan scoring system. A Fibroscan measures hardness of the liver by a color code used during an abdominal sonogram and is considered extremely accurate, so they say. A Fibroscan uses a kilopascal score more involved but scarring none the less. This test is only a few years old in the USA and more people have undergone liver biopsy so the F-1 through F-4 is easier to understand. Take care of your liver and don't let it get you down.
chuck1957
11 March 2015
Zenn211 All the F numbers under google have to do with the drug are chemical structures it has nothing to do with the conditions of the liver took a long time to find it like the 7th page because it is from the manufacturer i could find nothing to do with rating of the liver There is a possibility that when it went on the market they changed it for lab work and such but i have never seen that done but it only has to do with one part of the drug so if that is the best i can do or find unless it is something the office us's call them again and get your answer good luck this drug has cured a lot of people Chuck1957.
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cirrhosis, hepatitis c, liver cirrhosis, liver
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