Liver biopsy in hepatitis C: reassessing its role in 2001

Ian F Yusoff, Lindsay Mollison, Leanne Totten and John Olynyk
Med J Aust 2002; 176 (2): . || doi: 10.5694/j.1326-5377.2002.tb04305.x
Published online: 21 January 2002

To the Editor: Chronic hepatitis C (HCV) infection affects more than 200 000 Australians.1 As the degree of hepatic fibrosis is the best predictor of morbidity, liver biopsy has a central role in management. Biopsy is also carried out to exclude additional pathology. However, because liver biopsy carries real risks and is expensive,2,3 debate exists as to whether liver biopsy should be performed routinely.3,4 Despite controversy surrounding the need to treat patients with minor histological changes,4 our impression is that many informed patients request treatment irrespective of liver histology. In Australia, liver biopsy is a prerequisite for antiviral therapy under the Pharmaceutical Benefits Scheme Highly Specialised Drugs Program (Box).5

  • Department of Medicine, University of Western Australia at Fremantle Hospital, PO Box 480, Fremantle, WA 6959.


  • 1. Law MG. Modeling the hepatitis C virus epidemic in Australia. J Gastroenterol Hepatol 1999; 14: 1100-1107.
  • 2. Janes CH, Lindor KD. Outcome of patients hospitalized for complications after outpatient liver biopsy. Ann Intern Med 1993; 118: 96-98.
  • 3. Saadeh S, Cammell G, Carey WD, et al. The role of liver biopsy in chronic hepatitis C. Hepatology 2001; 33: 196-200.
  • 4. Poynard T, Ratziu V, Benmanov, et al. Fibrosis in patients with chronic hepatitis C: detection and significance. Semin Liver Dis 2000; 20: 47-55.
  • 5. National Health Act 1953 (Cwlth), s 100.
  • 6. Imbert-Bismut F, Ratziu V, Pieroni L, et al. Biochemical markers of liver fibrosis in patients with hepatitis C virus infection: a prospective study. Lancet 2000; 357: 1069-1075.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.