Activity 4B. Understanding Liver Biopsy Results

Given the extremely high cost of new direct-acting antiviral agents for the treatment of hepatitis C, many insurance companies and large health care organizations have prioritized treatment of hepatitis C for those individuals with advanced fibrosis or cirrhosis. Further, documentation of advanced fibrosis or cirrhosis is now often required prior to treatment.  For clinicians who lack experience and expertise in understanding liver biopsy results, see the link to the excellent review—Liver biopsy assessment in chronic viral hepatitis—by Dr. Neil Theise, a pathologist at the Beth Israel Medical Center. In particular, review the brief section Caveats Regarding Specimen Adequacy (near the end of the section, "So What do I do"?) and also note the diagrams (Figures 3 and 5) that conceptually help to explain the difference in liver biopsy necroinflammatory activity and scarring (fibrosis).