Treatment of patients with HCV infection with or without liver biopsy

[Guest guest]

Journal of Viral Hepatitis

Edited by:

H.C.

Print ISSN: 1352-0504

Online ISSN: 1365-2893

Frequency: Bi-monthly

Current Volume: 11

ISI Journal Citation Reports® Ranking: 2003: 12/47 (Gastroenterology &

Hepatology); 8/41 (Infectious Diseases); 7/23 (Virology)

Impact Factor: 3.258

Volume 11: Issue 6

Treatment of patients with HCV infection with or without liver biopsy

A. Iacobellis

D. Di Salvo

A. Spadaccini

F. Ventrella

A. Andriulli

G. Leandro

A. Mangia

M. Persico

G. Maio

D. Bacca

Abstract

Expert consensus recommends liver biopsy before therapy for chronic

hepatitis C. A cost effectiveness analysis suggested that the best strategy

in the management of patients was to treat without biopsy. We compared

therapy in patients who did, or did not undergo biopsy. Hepatitis C virus

(HCV)-positive patients (78) who did not agree to (n = 57) or with

contraindications to liver biopsy (n = 21) (group A) were matched for age,

sex and genotype with those who consented (group . Before therapy

(interferon/ribavirin for 12 months), a clinical diagnosis of chronic

hepatitis, on the basis of standard biochemical and ultrasonographic

parameters. The two groups showed similar baseline characteristics. A

noninvasive, diagnosis of chronic hepatitis was made in 75.6% of group A,

and in 83.3% of group B (P = 0.26). Concordance between clinical and

histological diagnosis in group B amounted to 91%. End-of-therapy

virological response was 52.6% in group A, and 57.7% in group B (P = 0.63).

Sustained virological response was 41.0% [95% confidence interval (CI)

30.1-51.9] and 43.6% (95% CI 32.6-54.6) in the two groups (P = 0.87).

Predictors of sustained response were noninvasive diagnosis of chronic

hepatitis (P = 0.006), lack of portal hypertension (P = 0.037), platelets

>105/mm3 (P = 0.007), prothrombin >70% (P = 0.02), and genotype 2 or 3 (P <

0.0001). At multivariate analysis, genotype (P < 0.0001) and platelets (P =

0.004) maintained their predictive power. In most patients with HCV

infection, virological clearance after therapy can be achieved irrespective

of whatever a liver biopsy might show.

Article Type: Original Article

Page range: 536 - 542

[Guest guest]

Journal of Viral Hepatitis

Edited by:

H.C.

Print ISSN: 1352-0504

Online ISSN: 1365-2893

Frequency: Bi-monthly

Current Volume: 11

ISI Journal Citation Reports® Ranking: 2003: 12/47 (Gastroenterology &

Hepatology); 8/41 (Infectious Diseases); 7/23 (Virology)

Impact Factor: 3.258

Volume 11: Issue 6

Treatment of patients with HCV infection with or without liver biopsy

A. Iacobellis

D. Di Salvo

A. Spadaccini

F. Ventrella

A. Andriulli

G. Leandro

A. Mangia

M. Persico

G. Maio

D. Bacca

Abstract

Expert consensus recommends liver biopsy before therapy for chronic

hepatitis C. A cost effectiveness analysis suggested that the best strategy

in the management of patients was to treat without biopsy. We compared

therapy in patients who did, or did not undergo biopsy. Hepatitis C virus

(HCV)-positive patients (78) who did not agree to (n = 57) or with

contraindications to liver biopsy (n = 21) (group A) were matched for age,

sex and genotype with those who consented (group . Before therapy

(interferon/ribavirin for 12 months), a clinical diagnosis of chronic

hepatitis, on the basis of standard biochemical and ultrasonographic

parameters. The two groups showed similar baseline characteristics. A

noninvasive, diagnosis of chronic hepatitis was made in 75.6% of group A,

and in 83.3% of group B (P = 0.26). Concordance between clinical and

histological diagnosis in group B amounted to 91%. End-of-therapy

virological response was 52.6% in group A, and 57.7% in group B (P = 0.63).

Sustained virological response was 41.0% [95% confidence interval (CI)

30.1-51.9] and 43.6% (95% CI 32.6-54.6) in the two groups (P = 0.87).

Predictors of sustained response were noninvasive diagnosis of chronic

hepatitis (P = 0.006), lack of portal hypertension (P = 0.037), platelets

>105/mm3 (P = 0.007), prothrombin >70% (P = 0.02), and genotype 2 or 3 (P <

0.0001). At multivariate analysis, genotype (P < 0.0001) and platelets (P =

0.004) maintained their predictive power. In most patients with HCV

infection, virological clearance after therapy can be achieved irrespective

of whatever a liver biopsy might show.

Article Type: Original Article

Page range: 536 - 542

[Guest guest]

Journal of Viral Hepatitis

Edited by:

H.C.

Print ISSN: 1352-0504

Online ISSN: 1365-2893

Frequency: Bi-monthly

Current Volume: 11

ISI Journal Citation Reports® Ranking: 2003: 12/47 (Gastroenterology &

Hepatology); 8/41 (Infectious Diseases); 7/23 (Virology)

Impact Factor: 3.258

Volume 11: Issue 6

Treatment of patients with HCV infection with or without liver biopsy

A. Iacobellis

D. Di Salvo

A. Spadaccini

F. Ventrella

A. Andriulli

G. Leandro

A. Mangia

M. Persico

G. Maio

D. Bacca

Abstract

Expert consensus recommends liver biopsy before therapy for chronic

hepatitis C. A cost effectiveness analysis suggested that the best strategy

in the management of patients was to treat without biopsy. We compared

therapy in patients who did, or did not undergo biopsy. Hepatitis C virus

(HCV)-positive patients (78) who did not agree to (n = 57) or with

contraindications to liver biopsy (n = 21) (group A) were matched for age,

sex and genotype with those who consented (group . Before therapy

(interferon/ribavirin for 12 months), a clinical diagnosis of chronic

hepatitis, on the basis of standard biochemical and ultrasonographic

parameters. The two groups showed similar baseline characteristics. A

noninvasive, diagnosis of chronic hepatitis was made in 75.6% of group A,

and in 83.3% of group B (P = 0.26). Concordance between clinical and

histological diagnosis in group B amounted to 91%. End-of-therapy

virological response was 52.6% in group A, and 57.7% in group B (P = 0.63).

Sustained virological response was 41.0% [95% confidence interval (CI)

30.1-51.9] and 43.6% (95% CI 32.6-54.6) in the two groups (P = 0.87).

Predictors of sustained response were noninvasive diagnosis of chronic

hepatitis (P = 0.006), lack of portal hypertension (P = 0.037), platelets

>105/mm3 (P = 0.007), prothrombin >70% (P = 0.02), and genotype 2 or 3 (P <

0.0001). At multivariate analysis, genotype (P < 0.0001) and platelets (P =

0.004) maintained their predictive power. In most patients with HCV

infection, virological clearance after therapy can be achieved irrespective

of whatever a liver biopsy might show.

Article Type: Original Article

Page range: 536 - 542

[Guest guest]

Journal of Viral Hepatitis

Edited by:

H.C.

Print ISSN: 1352-0504

Online ISSN: 1365-2893

Frequency: Bi-monthly

Current Volume: 11

ISI Journal Citation Reports® Ranking: 2003: 12/47 (Gastroenterology &

Hepatology); 8/41 (Infectious Diseases); 7/23 (Virology)

Impact Factor: 3.258

Volume 11: Issue 6

Treatment of patients with HCV infection with or without liver biopsy

A. Iacobellis

D. Di Salvo

A. Spadaccini

F. Ventrella

A. Andriulli

G. Leandro

A. Mangia

M. Persico

G. Maio

D. Bacca

Abstract

Expert consensus recommends liver biopsy before therapy for chronic

hepatitis C. A cost effectiveness analysis suggested that the best strategy

in the management of patients was to treat without biopsy. We compared

therapy in patients who did, or did not undergo biopsy. Hepatitis C virus

(HCV)-positive patients (78) who did not agree to (n = 57) or with

contraindications to liver biopsy (n = 21) (group A) were matched for age,

sex and genotype with those who consented (group . Before therapy

(interferon/ribavirin for 12 months), a clinical diagnosis of chronic

hepatitis, on the basis of standard biochemical and ultrasonographic

parameters. The two groups showed similar baseline characteristics. A

noninvasive, diagnosis of chronic hepatitis was made in 75.6% of group A,

and in 83.3% of group B (P = 0.26). Concordance between clinical and

histological diagnosis in group B amounted to 91%. End-of-therapy

virological response was 52.6% in group A, and 57.7% in group B (P = 0.63).

Sustained virological response was 41.0% [95% confidence interval (CI)

30.1-51.9] and 43.6% (95% CI 32.6-54.6) in the two groups (P = 0.87).

Predictors of sustained response were noninvasive diagnosis of chronic

hepatitis (P = 0.006), lack of portal hypertension (P = 0.037), platelets

>105/mm3 (P = 0.007), prothrombin >70% (P = 0.02), and genotype 2 or 3 (P <

0.0001). At multivariate analysis, genotype (P < 0.0001) and platelets (P =

0.004) maintained their predictive power. In most patients with HCV

infection, virological clearance after therapy can be achieved irrespective

of whatever a liver biopsy might show.

Article Type: Original Article

Page range: 536 - 542