Información del artículo
Resumen
La biopsia hepática ha sido desde hace tiempo el patrón de referencia para evaluar el estado de la enfermedad hepática en pacientes con hepatitis C crónica. Aunque se sigue recomendando, este método se está cambiando por 2 motivos fundamentales: a) el tratamiento es más efectivo, y b) las pruebas bioquímicas y los test serológicos aportan mucha información sobre el estado de la enfermedad. Los patólogos pueden aumentar la relevancia y la utilidad de la biopsia hepática en la hepatitis C crónica, informando no sólo del estadio de la fibrosis y la actividad necroinflamatoria, sino también del grado de esteatosis y la acumulación de hierro, que están implicados en la progresión de la enfermedad. Además, pueden identificar otras enfermedades, como la esteatohepatitis y la hemocromatosis hereditaria. No obstante, con la utilización de los test serológicos se reducirán las indicaciones de la biopsia hepática.
For several years, liver biopsy has been the established gold standard for evaluating the status of liver disease in patients with chronic hepatitis C. Although this procedure continues to be recommended, current practice is changing for 2 main reasons: firstly, treatment is more effective and, secondly, biochemical and serological tests provide a great deal of information on disease progression. Pathologists can increase the importance and utility of liver biopsy in chronic hepatitis C, providing information not only on the stage of fibrosis and necroinflammatory activity but also on the grade of steatosis and iron accumulation, which are implicated in disease progression. Moreover, these specialists can identify other diseases, such as steatohepatitis and hereditary hemochromatosis. Nevertheless, the use of serological tests will reduce the indications for liver biopsy.
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