Trends in the indication and method of liver biopsy for hepatitis B and C.
OBJECTIVE
Liver biopsy plays a crucial role in assessing inflammation and fibrosis in chronic hepatitis. The aim of this study was to compare the indications and methods for performing a liver biopsy over a 15-year period when there were evolving strategies and increasing therapeutic options for the treatment for chronic hepatitis B (HBV) and C (HCV).


METHODS
We reviewed all percutaneous liver biopsies performed at our center from 1992 to 2007 using a pathology database. Variables collected included indication for biopsy, use of real-time ultrasound (US) guidance, and complications associated with the biopsy.


RESULTS
A total of 3,572 total liver biopsies were performed between 1992 and 2007 with a gradual increase in annual liver biopsies from 1992 to 2001. After a peak in 2003, there was a gradual decline in liver biopsies performed. The number of liver biopsies done for HCV peaked in 2003, followed by an annual decrease until 2006, while the number of annual biopsies done for HBV increased during the same period. In addition, the proportion of liver biopsies performed with real-time US-guidance increased steadily since 1997.


CONCLUSIONS
Changes in liver biopsy trends at our center may be related to several factors, including the evolving treatment strategies for HCV and HBV. Percutaneous liver biopsies were increasingly performed using real-time US-guidance over the past decade, a change that may reflect practice patterns around the country.
Lipp
Michael J
MJ
Division of Digestive Diseases, Beth Israel Medical Center, New York, NY 10003, USA. lipp50@gmail.com
D'Souza
Lionel S
LS
Clain
David J
DJ
Bodenheimer
Henry C
HC
Min
Albert D
AD
D001706:Biopsy / Q000009:adverse effects / Q000706:statistics & numerical data* / Q000639:trends*; D016208:Databases, Factual; D005762:Gastroenterology / Q000639:trends; D019694:Hepatitis B, Chronic / Q000000981:diagnostic imaging / Q000473:pathology*; D019698:Hepatitis C, Chronic / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D018084:Ultrasonography, Interventional