[Value of liver puncture-biopsy for diagnosis, classification and treatment of chronic hepatitis]

In the assessment of chronic hepatitis, the liver biopsy serves the following purposes: 1) to confirm the fact that it is chronic. 2) to evaluate its degree of activity. 3) to check if there is cirrhosis or not. 4) to seek morphological proofs for the presence of viral, drug-induced or other aetiological agents. 5) to follow the evolution (in the natural course or during treatment) of the disease by comparing repeated liver biopsies. The initial classification of chronic hepatitis--proposed in 1968--has been reviewed by numerous authors; at the moment, it seems necessary, in order to correlate clinical and histological results better, to emphasize two important facts: 1) the spreading of liver necrosis if there is chronic active hepatitis. 2) the presence--or not--of cirrhosis. Some morphological arguments could be useful in order to diagnose the aetiology of chronic hepatitis. Empirical and specific immunological methods have become available for demonstrating HBsAg. If a chronic active hepatitis with multisystem involvement and/or abnormal serum antibodies is diagnosed, corticosteroid therapy is indicated. In others cases, especially those with virus B disease, the treatment differs according to medical teams.