Liver biopsy in chronic hepatitis C Histopathology, molecular diagnostic analysis, and implications for therapeutic management

Histological evaluation of liver biopsies is the gold standard for assessing the severity of liver disease in chronic hepatitis C. In conjunction with anamnestic and serological data, it provides critical information regarding prognosis and therapeutic consequences. Grading of the necroinflammatory activity and staging of the manifested fibrosis according to well-established scoring systems are the essential parameters of the histopathological report. The frequency of chronic hepatitis C necessitates awareness of coinciding liver damage by nutritional or drug toxicity, bile duct diseases, and hereditary hemochromatosis. Detection of hepatitis C virus (HCV) RNA directly from the formalin fixed, paraffin-embedded biopsy specimen is highly sensitive and offers help in cases of equivocal results of serological testing for HCV.