The role of liver biopsy in chronic hepatitis C

Abstract

Hepatitis C virus (HCV) is a major cause of chronic liver disease worldwide, affecting 175 million people globally. Over 80% of acutely infected patients go on to develop chronicity, but only 20% to 25% will develop end-stage liver disease and its complications. The sequelae of HCV-induced chronic liver disease accounts for 8,000 to 10,000 deaths annually in the United States and is currently the leading indication for liver transplantation. To date, there are no accurate noninvasive markers of disease activity and fibrosis. Liver biopsy is indicated to exclude other forms of liver pathologies and to establish the stage of liver disease. In this study, the role of liver biopsy in chronic hepatitis C was evaluated. Additionally, we calculated a discriminant score to predict cirrhosis in chronic hepatitis C infection. Our results showed that additional diagnoses or unsuspected diagnoses are less frequent than clinicians' suspected. We confirmed that the discriminant score for predicting cirrhosis is inferior to liver biopsy. In conclusion, the majority of patients with chronic hepatitis C will require a liver biopsy, which has an important implication on staging of the liver disease, prognosis, and possibly further management options. (HEPATOLOGY 2001;33:196-200.)

Modern Possibilities of Endosurgical Biopsy in Children with Chronic Liver Diseases

“…Фиброзная ткань труднее втягивается в биопсийную иглу, и поэтому в пунктате может быть представлена в недостаточном количестве. Таким обра-зом, отсутствие признаков патологического процесса в гепатобиоптате не исключает его наличия у пациента [6,71]. E. трактов, в то время как для верной оценки степени вос-паления и стадии фиброза необходим образец ткани, содержащий как минимум 11 портальных трактов [21].…”

Differences between the metabolic profiles of decompensated and compensated cirrhosis patients with Hepatitis B virus infections under high-performance liquid chromatography-mass spectrometry

“…In addition, clinical laboratory measurements and radiologic diagnostic approaches have not been developed to evaluate and further grade the severity of early stage liver cirrhosis, which occurs in most clinical cases. A previous study showed that only a small number of the Hepatitis C virus (HCV)-infected patients with liver cirrhosis could be definitively diagnosed based on clinical signs, as well as laboratory and imaging analyses (Saadeh et al 2001). Many important physiologic and biochemical metabolic processes occur in the liver.…”

Assessment and management of chronic hepatitis C infection

“…If liver biopsy is not contraindicated, it should be offered to all patients who would be considered candidates for antiviral therapy. The large multicentre randomised control treatment trials have included patients with moderate to severe liver damage, and the evidence base for treatment and response rates to therapy are based on this subgroup [7][8][9] . Patients in whom liver biopsy is contraindicated (eg haemophiliacs) must be assessed on clinical grounds alone.…”