Noninvasive Evaluation of Liver Fibrosis in Patients with Chronic Hepatitis C

Only 20% of patients with chronic hepatitis c (chc) progress to cirrhosis (1). progressive fibrosis is the hall- mark of an unfavorable course and is related to several factors such as male gender, contracting the disease at an older age, features of the metabolic syndrome, iron overload, ethanol abuse, and co-infection with hepatitis b or human acquired immunodeficiency viruses. how- ever, the course of the disease is highly variable from individual to individual. liver biopsy remains the gold standard for evaluating necroinflammation (grade) and fibrosis (stage) in chc (2); however, this pre-eminence is currently being examined due to its intrinsic risks and limitations. liver biopsy is an invasive procedure that carries a risk of complications, although rarely severe. the biopsy provides a very small specimen of liver tissue and has both a significant rate of sampling error, espe- cially when the cylinder obtained is less than 25 mm in length, and interobserver variability. the risk-benefit ra- tio of liver biopsy is insufficient to maintain it as a first- line procedure, and new and non-invasive criteria for the evaluation of liver fibrosis are urgently needed (3).