Liver biopsy in chronic hepatitis – why do it?
Dr P Scheuer, London, UK, provided strong arguments for the continued use of liver biopsy in diagnosis, pre- and post-treatment assessment, follow up, and research, in chronic hepatitis. Biopsy adds much to liver function tests in diagnosis, and is essential for total assessment. Although HCV RNA in serum is now often used for diagnosis of hepatitis C, biopsy can give more insight into the nature of disease, showing extent of inflammation and cirrhosis. Biopsy can also illustrate which disease is responsible for liver damage in cases of e.g. hepatitis plus thalassaemia. In assessing patients’ need for treatment, biopsy is also useful. Originally, pathologists had difficulty in classifying hepatitis by histology alone, but a number of grading and staging systems have been used over the years. Clinicians require a numerical evaluation to assist their decisions to treat, and the simple algorithm of the METAVIR group has been very useful. This has a range of 0-3, and does not detect minor
