Role of liver fibrosis assessment in decision-making and efficacy surveillance for antiviral therapy in patients with chronic hepatitis B

Liver fibrosis / cirrhosis is the outcome of the progression of chronic hepatitis B and is associated with liver events and long- term prognosis. Effective antiviral therapy can delay or even reverse disease progression. Therefore,assessment of liver fibrosis degree before and during treatment is of great importance in initiating antiviral therapy,developing therapeutic regimens,and monitoring antiviral effects and complications. The semi- quantitative histological scoring system is widely acknowledged in the assessment of liver fibrosis degree and is an important basis for the initiation of antiviral therapy for hepatitis B,as well as a method commonly used for efficacy surveillance. Morphological and structural quantitative methods provide objective histological assessment of liver fibrosis and may cover the shortage of conventional semi- quantitative scoring system. Non- invasive methods for the assessment of liver fibrosis may reduce but not completely substitute liver histological examinations; a consensus has not been reached on their cut- off values to make decisions to initiate antiviral therapy,but such non- invasive methods can provide rich information on therapeutic effect and long- term prognosis.