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Chronic hepatitis C and liver fibrosis

World Journal of Gastroenterology 2014年第32期20卷 11033-11053页

作者： Giada Sebastiani konstantinos gkouvatsos Kostas Pantopoulos Division of Gastroenterology Royal Victoria Hospital Montreal Quebec H3T 1E2 Canada konstantinos gkouvatsos Kostas Pantopoulos Department of Medicine McGill University MontrealQuebec H3T 1E2 Canada Lady Davis Institute for Medical Research Jewish General Hospital

Chronic infection with hepatitis C virus(HCV) is a leading cause of liver-related morbidity and mortality worldwide and predisposes to liver fibrosis and endstage liver complications. Liver fibrosis is the excessive accumulation of extracellular matrix proteins, including collagen, and is considered as a wound healing response to chronic liver injury. Its staging is critical for the management and prognosis of chronic hepatitis C(CHC) patients, whose number is expected to rise over the next decades, posing a major health care challenge. This review provides a brief update on HCV epidemiology, summarizes basic mechanistic concepts of HCV-dependent liver fibrogenesis, and discusses meth-ods for assessment of liver fibrosis that are routinely used in clinical practice. Liver biopsy was until recently considered as the gold standard to diagnose and stage liver fibrosis. However, its invasiveness and drawbacks led to the development of non-invasive methods, which include serum biomarkers, transient elastography and combination algorithms. Clinical studies with CHC patients demonstrated that non-invasive methods are in most cases accurate for diagnosis and for monitoring liver disease complications. Moreover, they have a high prognostic value and are cost-effective. Non-invasive methods for assessment of liver fibrosis are gradually being incorporated into new guidelines and are becoming standard of care, which significantly reduces the need for liver biopsy.

关键词： Hepatitis C virus Liver fibrosis Cirrhosis Biopsy Fibroscan

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