Letters To The Editor
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Aug 7, 2007; 13(29): 4025-4026
Published online Aug 7, 2007. doi: 10.3748/wjg.v13.i29.4025
Is liver biopsy mandatory in children with chronic hepatitis C?
Raffaele Iorio, Antonio Verrico, Antonietta Giannattasio
Raffaele Iorio, Antonio Verrico, Antonietta Giannattasio, Department of Pediatrics, University “Federico II”, Naples, Italy
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Raffaele Iorio, MD, Department of Pediatrics, University “Federico II”, Via Sergio Pansini n. 5, Naples 80131, Italy. riorio@unina.it
Telephone: +39-8-17464337
Received: May 24, 2007
Revised: June 3, 2007
Accepted: June 18, 2007
Published online: August 7, 2007
Abstract

Liver biopsy is considered the most accurate means to estimate the necroinflammatory activity and the extent of fibrosis. However, histology evaluation is an invasive procedure associated with risk to the patient, risk of sampling error and diagnostic inconsistencies due to inter- and intra-observer error. On the basis of histological studies performed so far, chronic hepatitis C in children appears morphologically benign in the majority of cases. At the Pediatric Liver Unit of our university, a total of 67 children with chronic hepatitis C underwent liver biopsy. Liver biopsy was repeated 5.5 years after the initial histological evaluation in 21 children. On a total number of 88 liver biopsies, micronodular cirrhosis was detected only in one genotype 1b-infected obese child. Since liver histology investigation of a child with chronic hepatitis C has few chances to highlight severe lesions, we question how liver biopsy helps in the management of children with chronic hepatitis C.

Keywords: Liver fibrosis; Cirrhosis; Natural history; Liver biopsy; Children