title: Rebiopsy in patients with untreated hepatitis C: a useful procedure.
abstract: 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.
authors.affiliation: Universidade Federal de São Paulo, Brazil.
authors.forename: Sandra Tuma
authors.initials: ST
authors.lastname: Khouri
authors.forename: Renata M
authors.initials: RM
authors.lastname: Perez
authors.forename: Patrícia Marinho
authors.initials: PM
authors.lastname: de Oliveira
authors.forename: Virginia Maria
authors.initials: VM
authors.lastname: Figueiredo
authors.forename: Denize Vieira
authors.initials: DV
authors.lastname: Barbosa
authors.forename: Valeria Pereira
authors.initials: VP
authors.lastname: Lanzoni
authors.forename: Antonio Eduardo B
authors.initials: AE
authors.lastname: Silva
authors.forename: Maria Lucia
authors.initials: ML
authors.lastname: Ferraz
mesh_terms: 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