BMJ 1994;308:1235 (7 May)

Letters

Asymptomatic hepatitis C infection Be cautious with liver biopsy

EDITOR, - In her review of hepatitis C Carol A Seymour arrives at a confusing conclusion about the value of liver biopsy in infected asymptomatic blood donors.1 Liver biopsy "seems essential" once the condition has been diagnosed because patients respond to antiviral treatment. Seymour later admits that therapeutic trials are required in this group of patients but then advocates a nationwide policy to identify, follow up, and treat asymptomatic people infected with hepatitis C virus. The two important issues she fails to address are sampling bias in the estimation of the frequency of liver disease in asymptomatic donors and the lack of evidence that treatment affects the long term outlook in hepatitis C.

It is wrong to make statements about the prevalence of disease in selected populations. The careful documentation of the North London Blood Transfusion Centre shows how selected the group who undergo liver biopsy can become.2 In contrast, . . . [Full text of this article]


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Relevant Article

Asymptomatic infection with hepatitis C virus
C A Seymour
BMJ 1994 308: 670-671. [Extract] [Full Text]

This article has been cited by other articles:

  • Craske, J, Paver, W K, Neeleman, J, Unwin, C, Farrel, M, Foster, G R, Thomas, H C (1994). Hepatitis C virus infection. BMJ 308: 1710-1710 [Full text]  
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