The literature about the role of liver biopsy in the management of patients with hepatitis B (HBV) infection is much less extensive. This may be related to several aspects of the disease itself and of the available treatment options. Firstly, HBV is not cytotoxic; rather, it is the host’s immune response to the virus that injures the liver. Therefore, the mere presence of an infection does not warrant a liver biopsy, which is most likely to be normal. Secondly, compared with HCV, the treatment for HBV is much more easily tolerated and widely applicable across the spectrum of infection, especially if nucleoside analogues like lamivudine or adefovir are used. Therefore, liver biopsy is not required to predict treatment outcome.
In the 2002 Consensus Conference of the European Association for the Study of Liver Disease , it was suggested that histological assessment of the extent of necroinflamma-tion and the stage of fibrosis by an expert pathologist is an integral part of the management of patients with HBV infection. Liver biopsy could also identify other liver diseases. Serial biopsies have demonstrated significant histological improvement in 56% of patients who receive long-term lamivudine. Spend less money now – for your efficient drug to cost less.