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staging fibrosis with serum tests?
Mar 10, 2006

Do you use the any of the new serum based blood tests to stage liver disease/fibrosis in HIV/HCV co-infected, or still think biopsy more accurate in these patient groups?

Response from Dr. McGovern

There is a little more data in HIV/HCV coinfected patients now on use of serum based blood tests. These tests, in general, are better at predicting who has mild disease and who has advanced disease. They are not as good at predicting people in the middle.

The other problem about serum tests is that it doesn't tell you anything about inflammation and fatty infiltration, which I think is important in terms of understanding the risk of progression, even if the fibrosis score is low.

We will get more information about these tests as time goes on, but at present I still prefer a biopsy.

The clinical trial that I would really like to see happen is to get a baseline serum test at the same time as a liver biopsy and track both after two to three years to see if the serum markers track disease progression.



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