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
Abstract
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.