Abstract
The majority of patients exposed to the hepatitis C virus develop chronic infection. The morbidity and mortality associated with chronic hepatitis C (CHC) is a consequence of progressive liver fibrosis, leading to cirrhosis, decompensated liver disease and hepatocellular carcinoma. As fibrosis is the key determinant of prognosis and influences treatment decisions and enrolment in surveillance programs, accurate assessment of fibrosis is crucial in the management of CHC. Currently liver biopsy is the “gold standard” for fibrosis assessment, but has a number of limitations including morbidity and mortality, sampling error and inter/intra-observer variability. The identification of non-invasive biomarkers of fibrosis has expanded rapidly over the last 10 years, providing an attractive alternative to liver biopsy. This article will review non-invasive biomarkers (serum biochemistry, imaging-based and genetic) for the assessment of fibrosis and fibrosis progression in CHC.
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