Biopsies For Mild Liver Disease Need Four-Year Intervals
- J Hepatol 2003 Mar;38(3):307-14 Related Articles, Links
Rate of natural disease progression in patients with chronic
Zarski JP, Mc Hutchison J, Bronowicki JP, Sturm N, Garcia-Kennedy R,
Hodaj E, Truta B, Wright T, Gish R.
Departement d'Hepato-gastroenterologie, CHU de Grenoble, BP 217,
38043 Cedex 9, Grenoble, France
BACKGROUND/AIMS: The interval at which liver biopsy should be
repeated in untreated patients with chronic hepatitis C is not
defined. We examined fibrosis change by METAVIR scoring in these
patients in whom two or more liver biopsies were available.METHODS:
One hundred and eighty patients with histologically proven chronic
hepatitis C were studied. Mean delay between biopsies was 3.67+/-2.69
years and 3.08+/-1.43 in the 16 patients having three biopsies.
Univariate and multivariate analyses were performed to determine
factors associated with liver fibrosis progression.RESULTS: Median
rate of fibrosis progression per year was 0.04 (0.00-0.55) to first
biopsy, 0.00 (-0.84-1.02) between first and second biopsy (NS), and
0.17 (0.00-1.50) between second and third biopsy (P<0.05). In
multivariate analysis, only age at first biopsy >40 years (OR=5)
(2-12) and alcohol consumption of 1-50 g per day (OR=4) (2-12) and
more than 50 g per day (OR=8) (3-23) were associated with severe
fibrosis. The number of patients who increased in fibrosis stage was
significantly higher after 4 years (P<0.02).CONCLUSIONS: An interval
of at least 4-5 years is needed between liver biopsies to measure
change in patients with mild liver disease.
PMID: 12586296 [PubMed - in process]
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