FW: NATAP: Noninvasive Tools for Fibrosis in Clinical Practice
Use of Noninvasive Tools to Evaluate Liver Disease in Clinical Practice
".....A number of non-invasive tests have been commercialized and are being
used more and more in practice. Their use varies widely depending on
practice setting and the individual physician's management style. For
example, some physicians would treat all patients with HCV, with the
possible exception of those with genotype 1 virus and minimal structural
disease (fibrosis stage 0/1). For these, a non-invasive test that detects
the absence of fibrosis with acceptable accuracy suffices and, moreover,
saves the cost and morbidity of liver biopsy. Other physicians (and many
patients), weighing the toxicity, limited efficacy, and cost of current
interferon-based regimens, would reserve treatment for significant disease
(fibrosis stage 2/3) or clear evidence of fibrosis progression.
Decision-making in this case requires a test that differentiates minimal
disease (stage 0/1 fibrosis) from intermediate fibrosis (stage 2/3). For
this purpose, the current generation of non-invasive tests falls short, and
liver biopsy still is needed for definitive staging. Fewer clinical data are
available in patients with non-HCV chronic liver disease, and use of
non-invasive tests is even more variable...."
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