The safe (sequential algorithm for fibrosis evaluation) biopsy: A new approach to stage fibrosis in chronic hepatitis C

Sebastiani, Giada; Halfon, P.; Castéra, Laurent; Pol, Stanislas; Thomas, D.L.; Mangia, Alessandra; Marco, V. Di; Pirisi, Mario; Voiculescu, M; Bourlière, Marc; Alberti, Alfredo

doi:10.1016/j.dld.2007.12.028

Cited by 1 publication

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“…Overall, liver biopsy could have been avoided in around 50% and 80% of cases for the diagnosis of significant fibrosis and cirrhosis, respectively. These results have been recently confirmed in a large‐scale, multicenter international validation study in more than 2000 patients with chronic hepatitis C [126]. Other groups have proposed alternative algorithms combining Fibrotest and APRI [111] either with Forns index (Fibropaca) [127] or Hepascore [128].…”

Section: Serum Noninvasive Markers Of Liver Fibrosismentioning

confidence: 83%

Transient elastography and other noninvasive tests to assess hepatic fibrosis in patients with viral hepatitis

Castéra

2009

Journal of Viral Hepatitis

152

110

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The limitations of liver biopsy (invasive procedure, sampling errors, inter-observer variability and nondynamic fibrosis evaluation) have stimulated the search for noninvasive approaches for the assessment of liver fibrosis in patients with viral hepatitis. A variety of methods including the measurement of liver stiffness, using transient elastography, and serum markers, ranging from routine laboratory tests to more complex algorithms or indices combining the results of panels of markers, have been proposed. Among serum indices, Fibrotest has been the most extensively studied and validated. Transient elastography appears as a promising method but has been mostly validated in chronic hepatitis C with performance equivalent to that of serum markers for the diagnosis of significant fibrosis. The combination of both approaches as first-line assessment of liver fibrosis could avoid the performance of liver biopsy in the majority of patients with chronic hepatitis C, a strategy that deserves further evaluation in patients with hepatitis B or HIV-HCV coinfection. Transient elastography also appears to be an excellent tool for early detection of cirrhosis and may have prognostic value in this setting. Guidelines are now awaited for the use of noninvasive methods in clinical practice.

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