title: Noninvasive methods to assess liver disease in patients with hepatitis B or C.
abstract: The prognosis and management of patients with chronic viral hepatitis B and C depend on the amount and progression of liver fibrosis and the risk for cirrhosis. Liver biopsy, traditionally considered to be the reference standard for staging of fibrosis, has been challenged over the past decade by the development of noninvasive methodologies. These methods rely on distinct but complementary approaches: a biologic approach, which quantifies serum levels of biomarkers of fibrosis, and a physical approach, which measures liver stiffness by ultrasound or magnetic resonance elastography. Noninvasive methods were initially studied and validated in patients with chronic hepatitis C but are now used increasingly for patients with hepatitis B, reducing the need for liver biopsy analysis. We review the advantages and limitations of the noninvasive methods used to manage patients with chronic viral hepatitis B or C infection.
authors.affiliation: Department of Hepatology, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, Inserm U773 CRB3, Université Denis Diderot Paris-7, Clichy, France. laurent.castera@bjn.aphp.fr
authors.forename: Laurent
authors.initials: L
authors.lastname: Castera
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D018450:Disease Progression; D004548:Elasticity; D054459:Elasticity Imaging Techniques; D019694:Hepatitis B, Chronic / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000517:prevention & control / Q000821:virology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers