title: Willingness to undergo a repeat liver biopsy among HIV/hepatitis C virus-coinfected and hepatitis C virus-monoinfected patients.
abstract: BACKGROUND
  Guidelines for chronic hepatitis C virus (HCV) management have recommended that a liver biopsy be repeated at 3-year intervals for HIV/HCV-coinfected patients and 5-year intervals for those with HCV monoinfection to assess fibrosis progression. However, it is unclear if patients are willing to repeat this procedure.
  
  
  OBJECTIVE
  To determine the prevalence and factors, particularly HIV coinfection, associated with willingness to repeat a liver biopsy.
  
  
  METHODS
  A questionnaire was administered to 235 HCV-infected patients (113 with HIV coinfection) between January 2008 and June 2011 who previously underwent liver biopsy. The main outcome was self-reported willingness to repeat the biopsy. The questionnaire collected data on other hypothesized determinants of willingness to repeat the biopsy. These were evaluated by logistic regression.
  
  
  RESULTS
  Among 235 subjects who completed the questionnaire, 32 (14%) reported unwillingness to repeat the biopsy, most commonly because of a perception that it was unimportant for care [13(41%)], concerns regarding pain [12(38%)], and a poor experience with the prior biopsy [7(21%)]. Considering biopsy to be safe [odds ratio (OR), 4.45; 95% CI, 1.50-13.27], important (OR, 4.87; 95% CI, 1.83-12.95), and knowing a person who underwent liver biopsy (OR, 3.45; 95% CI, 1.16-10.23) were associated with willingness to repeat the biopsy. HIV was not associated with willingness to repeat the biopsy (OR, 1.42; 95% CI, 0.67-3.03).
  
  
  CONCLUSIONS
  Eighty-six percent of chronic HCV-infected patients were willing to repeat a liver biopsy. HIV was not associated with unwillingness. In patients in whom a repeat liver biopsy is indicated, education on the utility and safety of the biopsy is important to its acceptance.
authors: Philadelphia Veterans Affairs Medical Center, Philadelphia, PA 19104, USA. valerianna.amorosa@uphs.upenn.edu
authors: Valerianna K
authors: VK
authors: Amorosa
authors: Omowunmi
authors: O
authors: Aibana
authors: Norah J
authors: NJ
authors: Shire
authors: Zachariah
authors: Z
authors: Dorey-Stein
authors: Thomas
authors: T
authors: Ferrara
authors: Joanne
authors: J
authors: Gilmore
authors: Jay R
authors: JR
authors: Kostman
authors: Vincent
authors: V
authors: Lo Re
mesh_terms: D001294:Attitude to Health; D001706:Biopsy / Q000706:statistics & numerical data*; D060085:Coinfection / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000150:complications* / Q000473:pathology; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000150:complications / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires