Published online Nov 27, 2023. doi: 10.4254/wjh.v15.i11.1170
Peer-review started: October 24, 2023
First decision: November 7, 2023
Revised: November 7, 2023
Accepted: November 13, 2023
Article in press: November 13, 2023
Published online: November 27, 2023
Processing time: 30 Days and 15.8 Hours
In the management of the growing population of hepatitis C virus-infected patients, a significant clinical challenge exists in determining the most effective methods for assessing liver impairment. The prognosis and treatment of chronic hepatitis C depend, in part, on the evaluation of histological activity, specifically cell necrosis and inflammation, and the extent of liver fibrosis. These parameters are traditionally obtained through a liver biopsy. However, liver biopsy presents both invasiveness and potential sampling errors, primarily due to inadequate biopsy size. To circumvent these issues, several non-invasive markers have been proposed as alternatives for diagnosing liver damage. Different imaging techniques and blood parameters as single markers or combined with clinical information are included. This Editorial discusses the identification of a set of six distinctive lipid metabolites in every fibrosis grade that appear to show a pronounced propensity to create clusters among patients who share the same fibrosis grade, thereby demonstrating enhanced efficacy in distinguishing between the different grades.
Core Tip: Accurate diagnosis of liver damage in chronic hepatitis C is pivotal for decision-making. Liver biopsy, the traditional "gold standard" for assessing tissue damage, offers valuable insights but is invasive, with potential complications and sampling errors. Non-invasive methods have made progress in the last decade, but challenges remain. Various non-invasive techniques are in development, including serum biomarker assays and advanced imaging. They often struggle to distinguish intermediate fibrosis stages and are affected by hepatic and extrahepatic factors. This Editorial discusses which identified potential biomarkers in plasma samples linked to each fibrosis grade and hepatitis C virus-induced pathogenesis.