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Management of Hep C in the future
Dec 8, 2013

Hello Doctor, Many greetings from London where your helpful forum is read with a great deal of interest. I know that up to now a liver biopsy is usually carried out before initiating therapy with interferon and ribavirin for hep c. With the advent of the era of interferon free treatment looming (which is truly wonderful news), do you think this practice will continue? Will it still be necessary to have a liver biopsy before starting treatment on the new drugs? Thank you for the support and advice you offer to so many on this forum. Regards, David

Response from Dr. Taylor

Dear David, Thank you for your kind words. In places where we can access hepatitis C treatment -- no, we do not need liver biopsy. There is benefit to being cured with medications. Cure of hepatitis C reduces the chance that we will develop scarring in the liver, liver failure, or liver cancer. Cure also reduces the chance of us spreading hepatitis C to others.

Liver biopsy can be helpful when we are trying to decide about whether to be treated now with existing medications, else wait for medications that may be easier, better tolerated, with higher likelihood of cure, given without interferon shots, and given for a shorter period of time. Whether we should take interferon shots now depends on a numer of factors -- including our genotype, and what medications we have access to. For example, in the U.S. sofosbuvir was approved yesterday! for use without interferon injections for persons with certain hep C characteristics.

In general, test and treat without liver biopsy may be the best stategy to address the hep C epidemic -- but depends on access to medications. Warm Regards to you.

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