Assessment of hepatic fibrosis

CHC may progress to cirrhosis (in approximately 20% of patients,
with a mean duration of 20 years) and subsequently,
decompensation and complications, including HCC, develop in
about 30% of cases over a period of approximately 4 years
(DiBisceglie 2008). Histologically significant liver disease can be
also present in patients without symptoms and with normal ALT
levels. In theses cases, deferring treatment until liver function is
depressed (low albumin, altered PT) may decrease SVR rate and
increase the risk of AEs (Pradat 2002). Evaluation of liver fibrosis
is thus compulsory (Table 2.3).