Non invasive diagnosis of fibrosis in HCV infection: Role in the treatment indication, follow-up, and the assessment of the prognosis

Chronic hepatitis C virus (HCV) infection associated with necroinflammation predisposes to liver fibrosis and cirrhosis, and leads severe end-stage complications. The staging of fibrosis is of basic importance for the indication of antiviral treatment, monitoring the response and predicting the prognosis in patients with HCV-related liver disease. Since liver biopsy, the „gold standard” for the diagnosis of fibrosis is invasive, and has some other limitations, non-invasive methods have been developed and now widely used in the clinical practice. Serum biomarkers, and the physical approaches measuring liver stiffness by elastography as well as combination algorithms, have gradually been integrated into guidelines, and reduce the need for biopsy. We review these non-invasive fibrosis markers and discuss their role in the indication of treatment, follow-up, and the assessment of prognosis for patients with chronic HCV infection.