Today, they have started to see my biopsy, they still need to do more tests for the B virus, but they told me that I should not worry about my liver. There is no fibrosis there and is quite "healthy". But there is injury to the hepatocytes, but they still need to know if they are infected with hepatitis B virus, which could cause the injury.
In Pathology, they normally look at 3 parameters, in the first two I have a zero rank, which means I am okay. In the third one, which is the "hepatocyte necrosis" I rank 1 (range 1-3). So there is injury, but the liver is not really damaged as for today, therefore I have no prognosis for cirrhosis at all.
Nevertheless it could potentially explain part of my symptoms, because the liver lesion is present, but that's better to wait for the final report and the interpretation of my liver specialist.
Hepatocyte necrosis is closely linked to apoptosis (programmed cell death), and that is what I have seen in the many analysis that I have done since I fell sick in 2006 - 2006 RNase-L, elastase and high PKR = programmed cell death -> immunity to fight against something (Redlabs-Belgium) - 2009 free circulating DNA Very high = programmed cell death -> immunity to fight against something (Acumen-UK) - 2010, abnormal levels of the ligands FAS = programmed cell death -> immunity to fight against something (Irsi Caixa, Barcelona) - 2011, elevated Granzyme B = programmed cell death -> immunity to fight against something (Gregorio Marañón, Madrid)
So, apparently it does seem that whatever I have in the liver is related to my CFS history.
It was not easy at all to detect the damage in my liver -All the blood work on liver enzymes came normal -All liver function came normal (GPT/GOT) -All B & C serologies came negative -Even a PCR DNA on B virus came NEGATIVE! But that is because PCR has limitations in the number of copies per ml that they can detect, normally starting from 120 copies, and I only have 13 copies of B virus per ml.
Using a super sensitive PCR DNA utracentrifugated, I finally came positive for B virus, then the biopsy was the next step, and bingo, there is injury in the hepatocytes, therefore "something" has infected the hepatocytes and is causing inflammation and lesion to the liver. The question now is: Is it a mutant version of Hepatitis B, that is what they find out next week... Will keep you posted.
Bear in mind that both "autoimmune chronic hepatitis" and "chronic hepatitis by a mutan B virus of the Pre-core region" are not present in common serologies. Autoimmune hepatitis is treated with immunosupression, and chronic Hepatitis B is treated with retrovirals. That could potentially explain why Tenofovir or Rituximab have been effective in different subsets of CFS patients.