[Role of liver biopsy in chronic hepatitis C]

At the present time liver biopsy is the most reliable method to determine the grade of necroinflammatory lesion and the amount of fibrosis in chronic hepatitis C. Therefore the liver biopsy should always be performed before initiating therapy. It is suggested to use the METAVIR histological activity to grade chronic hepatitis because it is simple, the reproducibility has been validated, the criteria used to define different lesions has been clearly stated, and there is a significant association between ALT levels and this index. The use of semi-quantitative systems in routine reports of liver biopsies is unnecessary. In these cases the schematic diagrams from Batts and Ludwig can be used, as visual analogue scales, in order to grade and stage chronic hepatitis.