for Veterans and the Public
Frequently Asked Questions
Q: Is there a reason to have a liver biopsy done more than once?
Doctors perform liver biopsies to evaluate how much the hepatitis C virus has affected the liver: very little, moderately, or severely. Liver damage from hepatitis C usually takes many years to develop, and it is not felt by the patient. Long-term damage to the liver can lead to scarring, and when the scarring becomes severe, this is called cirrhosis. Many patients have a liver biopsy to better understand the status of their liver and to help them decide whether to get treatment.
A biopsy generally determines the degree of liver inflammation (called the "grade") and the degree of liver scarring (the "stage"). Both the grade and the stage are given a score from 0 to 4. However, the stage is the most important factor--someone with a "stage 4 biopsy" is said to have cirrhosis.
On average, there is an increase of 1 point in the stage score about every 5-10 years. How often someone should get a liver biopsy depends on the particular patient.
You may want a repeat liver biopsy if:
- It has been 5 years or more since your last liver biopsy.
- Your earlier biopsy or biopsies found your stage to be 0 to 3 (not 4) and you want to know whether your liver disease has progressed.
- You are thinking of starting treatment (or re-treatment) because your most recent liver biopsy showed an increase in liver damage compared with a previous biopsy.
You should not need a repeat liver biopsy if:
- You already know you have cirrhosis.
- You have a high risk of complications with liver biopsy, such as a very low platelet count or a history of the blood-clotting disorder hemophilia.
- You already have been treated for hepatitis C and achieved a sustained response. This means no virus was present in your blood 6 months after you stopped taking the medications. Usually, no further liver damage will occur.