The evaluation of early viral response (RVT) and the assessment of haematological adverse effects

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Article Title:	The evaluation of early viral response (RVT) and the assessment of haematological adverse effects
Authors:	Veronica Grec, Eftimie Miuțescu
Affiliation:	Faculty of Medicine, Pharmacy and Dental Medicine, ″Vasile Goldis″ Western University of Arad, Romania
Abstract:	The clinical consequence of chronic hepatitis C, the most important one is progressive liver fibrosis leading to cirrhosis, the last one may complicate in its turn with portal hypertension, liver failure and / or hepatocellular carcinoma. Recognition of fibrosis as an "engine" of cirrhogenous evolution of liver disease brought the need to assess this element in daily practice. Traditionally, liver biopsy followed by anatomopathological examination of the product is used for the assessment of liver fibrosis. In recent years, this invasive method associated with lower mortality, but constant (no series of liver biopsies punctures in the world published without associated mortality), which has limitations related to inter – and intra- observer, underestimation of hepatic cirrhosis and cost is replaced by noninvasive methods of usual assessment. Decreased blood cell response to therapy always occurs and can be grounds for a reduction of dosage or discontinuation. At 3 months of therapy, 76 % of patients had anemia, leucopenia 77 % and 41 % thrombocytopenia. Advanced Fibrosis is a major predictor of morbidity and mortality in chronic liver disease. Despite its limitations, liver biopsy remains the main method for staging liver fibrosis. Non-invasive tests are superior in detecting fibrosis as a dynamic phenomenon and in monitoring antifibrotic therapy. Using noninvasive methods (FibroMax) as first-line diagnostic protocol of liver fibrosis can avoid puncture in most patients. Noninvasive test results will be interpreted in clinical context. When results are unexplained liver puncture is indicated. Algorithm that associates biopsy and serological tests may become the best way of staging and monitoring of liver fibrosis.
Keywords:	early viral response; viral C hepatitis; fibrosis
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*Correspondence:	Grec Veronica, Faculty of Medicine, Pharmacy and Dental Medicine, Arad Romania, email:medicina@uvvg.ro