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Diagnosis and staging of fibrosis in patients with chronic hepatitis C: comparison and critical overview of current strategies

Authors Mendes LC, Stucchi RSB, Vigani AG

Received 1 September 2017

Accepted for publication 20 February 2018

Published 3 April 2018 Volume 2018:10 Pages 13—22

DOI https://doi.org/10.2147/HMER.S125234

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication: Dr Gerry Lake-Bakaar


Leandro César Mendes, Raquel SB Stucchi, Aline G Vigani

Department of Infectious Diseases, State University of Campinas, Campinas, SP, Brazil

Abstract: In the past years, what has always been considered undisputed true in liver fibrosis staging has been challenged. Diagnostic performance of histological evaluation has proven to be significantly influenced by sample- and observer-related variabilities. Differentiation between lower levels of fibrosis remains difficult for many, if not all, test modalities, including liver biopsy but, perhaps, such a distinction is not indispensable in light of current therapeutic approaches. Biomarkers and elastography offer, nonetheless, high predictive values for advanced fibrosis and cirrhosis and correlate well with liver-related outcomes. Necroinflammation, steatosis, and hemodynamic changes may significantly interfere with elastography-based techniques, and longitudinal follow-up strategies must be tailored in light of these findings. Knowledge of different test modalities and diagnostic performance indicators can allow for better clinical decision-making and resource allocation.
Keywords: chronic hepatitis C, fibrosis, staging, elastography, biomarkers

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