Spotlight Series on Hepatitis C

2014 HIV/Hepatitis C Coinfection Update

February 7, 2014


Difficulties With Monitoring

Difficulties With Monitoring

Meanwhile, liver monitoring and HCV disease staging have typically meant conducting a biopsy -- which, though it can be helpful for diagnosis of other forms of liver disease, can inform the need for HCC screening and can effectively predict end-stage liver disease development, is also expensive, invasive and quite painful. "We don't find a lot of patients particularly eager to undergo that."

The validity of a biopsy can also sometimes be a matter of debate, due to the risk that the liver sample taken may -- depending on the cross section of the organ obtained -- misrepresent the total amount of fibrosis. Due to the discomfort involved in the procedure, repeated testing is often less than ideal for many patients.

Meanwhile, other typical forms of non-invasive tests have limited value when it comes to determining HCV disease stage, Cox said. Measuring HCV RNA levels can have important prognostic value; determining HCV genotype is key to informing the type and duration of therapy to use; and CT scans or MRIs can spot evidence of cirrhosis. But none of these methods are effective at staging a patient's disease, Cox said, which has historically been critical for gauging whether treatment should be initiated.

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