Rebiopsy in patients with untreated hepatitis C: a useful procedure.
BACKGROUND
The progression of fibrosis in the early stages of chronic hepatitis C virus is variable, and the ideal interval to perform a new biopsy in untreated patients is still unknown.


OBJECTIVE
We evaluated the histologic progression of patients with untreated hepatitis C virus with two liver biopsies and correlated disease progression with demographic, epidemiologic, biochemical, and histologic variables.


METHODS
Untreated hepatitis C virus-infected patients with two liver biopsies at a minimum interval of 1 year were studied. Gender, age, parenteral risk factors, duration of infection, alcohol intake, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase, and histologic findings were analyzed.


RESULTS
Fifty-five patients were included. The first biopsy showed low grades of fibrosis and periportal necroinflammatory activity in 93%. A second biopsy was performed after 39 +/- 14 months; 40% of patients showed a progression of fibrosis and/or periportal necroinflammation. Comparison between groups with and without histologic worsening revealed no differences in demographic, epidemiologic, biochemical, or histologic data.


CONCLUSIONS
Histologic worsening occurred in 40% of untreated patients after 3.2 years. No factor could be established at the first biopsy to predict which patients are at risk of progression. Thus, histologic reassessment between 3 and 5 years seems to be the only approach to document disease progression and establish treatment indication.
Khouri
Sandra Tuma
ST
Universidade Federal de São Paulo, Brazil.
Perez
Renata M
RM
de Oliveira
Patrícia Marinho
PM
Figueiredo
Virginia Maria
VM
Barbosa
Denize Vieira
DV
Lanzoni
Valeria Pereira
VP
Silva
Antonio Eduardo B
AE
Ferraz
Maria Lucia
ML
D000293:Adolescent; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D018450:Disease Progression; D005260:Female; D019698:Hepatitis C, Chronic / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012806:Siderosis / Q000473:pathology