[Mechanisms and cofactors of hepatitis C fibrosis]

The development of quantitative methods to measure the degree of necrosis, inflammation and fibrosis in liver biopsies favored the knowledge of the natural course of liver fibrosis. Two of the most important methods are the Knodell index and the Metavir index. These indexes are also useful to monitor the effects of the diverse therapeutic alternatives. There are no satisfactory studies that confirm why progression of fibrosis is slower in women, or why it's faster when the diagnosis is made at an older age. All the therapeutic schemes decrease the progression of fibrosis, in at least one degree compared with the degree of fibrosis before the treatment. Moreover, combination therapy with pegylated interferon and ribavirin reduces the progression of fibrosis even more in patients with hepatitis C.