New Pain-Free Alternative to Biopsy: evaluation, treatment and follow-up options for Hepatitis C patients
Assessing liver fibrosis in Hepatitis C patients used to lead to a “least worst” decision: would it be better to treat the patient with early generation antiviral therapies, exposing him or her to damaging side effects for a 50/50 shot at a cure, or should the patient be monitored, via regular liver biopsies, as the untreated disease progresses?
New oral drugs have changed this calculus for Hepatologists. These drugs cure the disease in more than 90 percent of patients, have fewer side effects, and can work much faster than earlier treatment options. Since the new therapies are so effective, precise staging is no longer required as a means to triage patients to treatment. Hepatologists no longer have to subject patients to painful liver biopsies to gain the staging information necessary for treatment decisions. The most important determination is the identification of cirrhosis so that appropriate long-term follow-up can be initiated following curative therapy. These developments in treatment dovetail with developments in liver evaluation technology. Instead, using ShearWave™ Elastography (SWE), they can perform a non-invasive test in the office and obtain results about tissue stiffness and the extent of liver fibrosis in real time.
Fig. 1. After treatment, a patient demonstrates a F2/F3 Fibrosis of the Liver with SWE.
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