icon-folder.gif   Conference Reports for NATAP  
  37th Annual Meeting of the European Association for the Study of the Liver
Madrid, Spain, April, 2002
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  Aurelie Fabre 1 ,JaniceMain 2 , Howard Thomas 2 , Graham Foster 2 , Robert Goldin 1 1 Department of Histoapthology, ICFM at St Mary's, London; 2 Department of Hepatology, ICFM at St Mary's, London, UK
Liver biopsy in the management of patients infected by the hepatitis C virus (HCV) is recognised as the gold standard to assess fibrosis (stage) and inflammation (grade) which are recognised predictors of disease progression and response to treatment. A 5 year retrospective analysis of 751 liver biopsies in 651 HCV infected patients identified the presence of additional histological features which triggered alterations in patients' management, the latter assessed by review of clinical data. Using a computerised data collection system, additional features on liver biopsy which were unrelated to HCV (e.g., iron deposition [n = 14], alcohol-related damage [n = 17], drug-related changes [n = 10], plasma cell infiltrate [n = 2], features of diabetes/obesity [n = 5], evidence of IV drug abuse [n = 3], granulomas [n = 5], and others [n = 11]) were present in 101 (13.4%) (excluding 3 transplant cases, dysplasia [n = 15] and hepatocellular carcinoma [n = 6]). The additional findings were regarded as informative if therapeutic action was taken following the histological assessment. Informative findings led to management changes in 32.7% of patients including mutational analysis for hereditary haemochromatosis [n = 3], venesection [n = 2], advice to reduce alcohol consumption [n = 6], investigation for granulomas [n = 4], auto-antibody screening or diabetic control assessment. This study indicated that liver biopsy in patients with HCV has an important role in identifying co-existent causes of liver disease and this frequently alters patient management.