After diagnosis, it is important to check how much the liver tissue has
already been damaged. People with more advanced liver damage or cirrhosis of
the liver should be urgently considered for hepatitis C treatment to prevent
further liver damage.
Various procedures are used to investigate the condition of the liver
Blood tests: In addition to levels of the liver enzymes AST and ALT,
other blood values are determined, e.g. gamma-GT, thrombocytes, serum albumin,
platelet count and bilirubin. These values help in estimating the liver’s
ability to function but may not provide a precise guide to the stage of liver
Liver biopsy/liver puncture (an invasive technique): A liver biopsy
is considered to be a very useful method for establishing the extent of liver
inflammation and any possible scarring of liver tissue (degree of fibrosis).2
In a biopsy, tissue is removed directly from the liver under a local
anaesthetic and examined using a microscope. There’s more information on this
in the Liver
Elastography (a non-invasive technique): Elastography is a relatively
new procedure, which can be used to assess the degree of scarring in the liver,
also known as liver stiffness. Doctors can assess how much the liver is scarred
by measuring the speed at which sound waves pass through the liver.
Elastography can replace a biopsy in certain cases – in particular, in
combination with blood value results.1,3 Elastography devices are not available everywhere, however. For certain
investigations a tissue sample is still necessary.