Periodic Liver Biopsy for Mild Hepatitis C
Authors: John B. Wong, Raymond S. Koff
Journal: Annals of Internal Medicine (2001)

Letters4 September 2001Periodic Liver Biopsy for Mild Hepatitis CJohn B. Wong, MD and Raymond S. Koff, MDJohn B. Wong, MDTufts-New England Medical Center; Boston, MA 02111 (Wong)University of Massachusetts; Worcester, MA 01655 (Koff)Search for more papers by this author and Raymond S. Koff, MDTufts-New England Medical Center; Boston, MA 02111 (Wong)University of Massachusetts; Worcester, MA 01655 (Koff)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-5-200109040-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:The articles to which Dr. Kisloff refers (1, 2) were published after our article had been submitted. Neither study performed systematic liver biopsies on all patients to determine the presence of clinically undetected cirrhosis, so our projections for cirrhosis are not synonymous with mortality or risk for end-stage liver disease. A meta-analysis found a 27.9% progression from chronic hepatitis C to cirrhosis after 8 to 12 years (3). With 20-year likelihoods of 27.5% and 9.5% for compensated cirrhosis, risks for decompensated cirrhosis were 6.2% and 1.1%, respectively, and risks for liver disease-related death were 5.6% and 1.0%, respectively.... References1. Thomas D, Astemborski J, Rai R, Anania F, Schaeffer M, Galai N, et al . The natural history of hepatitis C virus infection: host, viral, and environmental factors. JAMA. 2000;284:450-6. [PMID: 10904508] CrossrefMedlineGoogle Scholar2. Seeff L, Miller R, Rabkin C, Buskell-Bales Z, Straley-Eason K, Smoak B, et al . 45-year follow-up of hepatitis C virus infection in healthy young adults. Ann Intern Med. 2000;132:105-11. [PMID: 10644270] LinkGoogle Scholar3. Pagliaro L, Peri V, Linea C, Cammà C, Giunta M, Magrin S. Natural history of chronic hepatitis C. Ital J Gastroenterol Hepatol. 1999;31:28-44. [PMID: 10091101] MedlineGoogle Scholar4. Wong JB. Understanding the natural history of hepatitis C: can decision analysis help? [Abstract]. Hepatology. 2000;32(Pt 2):426A. Google Scholar5. Johnson M. The doctor in the family. Ann Intern Med. 1999;130:859-60. [PMID: 10366378] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: John B. Wong, MD; Raymond S. Koff, MDAffiliations: Tufts-New England Medical Center; Boston, MA 02111 (Wong)University of Massachusetts; Worcester, MA 01655 (Koff) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoWatchful Waiting with Periodic Liver Biopsy versus Immediate Empirical Therapy for Histologically Mild Chronic Hepatitis C: A Cost-Effectiveness Analysis John B. Wong and Raymond S. Koff Periodic Liver Biopsy for Mild Hepatitis C Barry Kisloff Metrics 4 September 2001Volume 135, Issue 5Page: 381-382KeywordsAminotransferasesBiopsyChronic hepatitis CCirrhosisDeath ratesHepatitis ALiverLiver diseasesPatientsQuality of life ePublished: 4 September 2001 Issue Published: 4 September 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...