John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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How to assess liver disease severity? Volume 16, special issue 2, septembre 2009

Author
Services d’Hépato-Gastroentérologie, Hôpital Saint-André, CHU de Bordeaux, avenue Magellan, 33604 Pessac, France, Service d’Hépato-Gastroentérologie, Hôpital Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac cedex, France

Assessment of disease severity is of critical importance in chronic hepatitis B not only for prognosis but also for treatment indication. Two aims are clinically relevant: detection of significant fibrosis (indication for antiviral treatment); detection of cirrhosis (screening of eosphageal varices and hepatocellular carcinoma). Until recently, liver biopsy was the reference method fro the evaluation of liver fibrosis. Limitations of liver biopsy (invasiveness, sampling error and interobserver variability) have led to the development of non-invasive methods. Currently available methods include serum markers and transient elastography. These methods have been mainly validated in chronic hepatitis C and are still under validation in chronic hepatitis B. This review is aimed at discussing the advantages and limits of non-invasive methods and liver biopsy and the perspectives for their rationale use in clinical practice.