#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Viral hepatitis at the beginning of the 21th century – value of liver biopsy in the context of development of new non-invasive diagnostic methods and in relation to the modern therapy of chronic viral hepatitis


Authors: J. Hobstová 1,3;  A. Vitouš 2,3
Authors‘ workplace: Infekční oddělení, Fakultní nemocnice v Motole, Praha 1;  Infekční oddělení, Krajská nemocnice Liberec 2;  III. klinika infekčních a tropických nemocí, Univerzita Karlova v Praze, 1. lékařská fakulta a Fakultní nemocnice na Bulovce, Praha 3
Published in: Čes.-slov. Patol., 47, 2011, No. 2, p. 44-49
Category: Reviews Article

Overview

The rapid progress in the development of virostatic agents over the past 15 years has changed chronic viral hepatitis from causally incurable diseases to diseases that may be treated or even cured. But, the treatment is a long-term process and it remains very expensive. Therefore, it is important to establish the correct diagnosis with the exact stratification of the disease (in terms of serological findings, regarding the activity of the inflammation and alterations of liver parenchyma) to determine the appropriate treatment schedule.

The text includes an overview of histopathological classifications of chronic hepatitis from the clinical perspective; we discuss the contribution of liver biopsy in the era of the development of non-invasive diagnostic methods for determining the degree of alteration of liver parenchyma (elastography in particular). Furthermore, the principles of modern therapy of the most common chronic viral hepatitis (i.e. B and C) are summarized with emphasis on situations where the histopathological examination of liver tissue plays a role in the indication or affects the treatment schedule.

Keywords:
viral hepatitis – diagnostics – treatment of chronic hepatitis – fibrosis – liver biopsy – elastography


Sources

1. De Groote J, Desmet VJ, Gedigk P, et al. A classification of chronic hepatitis. Lancet 1968; 2: 626–628.

2. Knodell RG, Ishak KG, Black WC, et al. Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis. Hepatology 1981; 1: 431–435

3. Scheuer PJ. Classification of chronic viral hepatitis: a need for reassessment. J Hepatol 1991; 13: 372–374.

4. Ishak KG. Chronic hepatitis: morphology and nomenclature. Mod Pathol 1994; 7: 690–713.

5. Batts KP, Ludwig J. Chronic hepatitis. An update on terminology an reporting. Am J Surg Pathol 1995; 19: 1409–1417.

6. Ishak KG, Babtista A, Bianchi L, et al. Histological grading and staging of chronic hepatitis. J Hepatol 1995; 22: 696–699.

7. Bedossa P, Poynard T and the French METAVIR Cooperative Study Group. An algorithm for grading activity in chronic hepatitis C. Hepatology 1996; 24: 289–293.

8. Bain VG, Bonacini M, Govindarajan S, et al. Usefulness of liver biopsy. J Viral Hepat 2004; 11(4): 375–382.

9. Denzer UW, Lüth S. Non-invasive diagnosis and monitoring of liver fibrosis and cirrhosis. Best Pract Res Clin Gastroenterol 2009; 23(3): 453–60.

10. Patel K. Noninvasive tools to assess liver disease. Curr Opin Gastroenterol 2010; 26(3): 227–33.

11. Friedrich-Rust M, Müller C, Winckler A, et al. Assessment of liver fibrosis and steatosis in PBC with FibroScan, MRI, MR-spectroscopy, and serum markers. J Clin Gastroenterol 2010; 44(1): 58–65.

12. Sebastiani G, Vario A, Guido M, et al. Comparison of Performance of Noninvasive Markers for Liver Fibrosis in Normal Alanine Aminotrasferase and Elevated Alanine Aminotrasferase Groups. J Viral Hepat 2008; 15(3): 212–218.

13. Wai CT, Greenson JK, Fontana RJ, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology 2003; 38: 518–526.

14. Poynard T, Munteanu M, Imbert-Bismut F, et al. Prospective analysis of discordant results between biochemical markers and biopsy in patients with chronic hepatitis C. Clin Chem 2004; 50: 1344–1355.

15. Scott DR, Levy MT. Liver transient elastography (Fibroscan): a place in the management algorithms of chronic viral hepatitis. Antivir Ther 2010; 15(1): 1–11.

16. Hobstová J, Vitouš A. Virové hepatitidy na začátku 21. století - “State of the Art”. Cesk Patol 2011; 47(Suppl1): 1–7.

17. Chien RN, Liaw YF. Nucleos(t)ide analogues for hepatitis B virus: strategies for long-term success. Best Pract Res Clin Gastroenterol 2008; 22(6): 1081–92.

18. Jafri SM, Lok AS. Antiviral therapy for chronic hepatitis B. Clin Liver Dis 2010; 14(3): 425–38.

19. Hynicka LM, Yunker N, Patel PH. A review of oral antiretroviral therapy for the treatment of chronic hepatitis B. Ann Pharmacother 2010; 44(7–8): 1271–86.

20. Shimakami T, Lanford RE, Lemon SM. Hepatitis C: recent successes and continuing challenges in the development of improved treatment modalities. Curr Opin Pharmacol 2009; 9(5): 537–544.

21. Michaels AJ, Nelson DR. New therapies in the management of hepatitis C virus. Curr Opin Gastroenterol 2010; 26(3): 196–201.

22. Flisiak H, Horan A, Gallay P, et al. The cyclophillin inhibitor Debio-025 shows potent anti-hepatitis C effect in patiens coinfected with hepatitis C and human immunodeficiency virus. Hepatology 2008; 47: 817–826.

23. Lanforf RE, Hildebrandt-Eriksen ES, Petri A, et al. Therapeutic silencing of microRNA-122 in primates with chronic hepatitis C infection. Science 2010; 327: 198–201.

Labels
Anatomical pathology Forensic medical examiner Toxicology
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#