Willingness to undergo a repeat liver biopsy among HIV/hepatitis C virus-coinfected and hepatitis C virus-monoinfected patients

J Clin Gastroenterol. 2013 May-Jun;47(5):457-60. doi: 10.1097/MCG.0b013e318266fe70.

Abstract

Background: Guidelines for chronic hepatitis C virus (HCV) management have recommended that a liver biopsy be repeated at 3-year intervals for HIV/HCV-coinfected patients and 5-year intervals for those with HCV monoinfection to assess fibrosis progression. However, it is unclear if patients are willing to repeat this procedure.

Objective: To determine the prevalence and factors, particularly HIV coinfection, associated with willingness to repeat a liver biopsy.

Methods: A questionnaire was administered to 235 HCV-infected patients (113 with HIV coinfection) between January 2008 and June 2011 who previously underwent liver biopsy. The main outcome was self-reported willingness to repeat the biopsy. The questionnaire collected data on other hypothesized determinants of willingness to repeat the biopsy. These were evaluated by logistic regression.

Results: Among 235 subjects who completed the questionnaire, 32 (14%) reported unwillingness to repeat the biopsy, most commonly because of a perception that it was unimportant for care [13(41%)], concerns regarding pain [12(38%)], and a poor experience with the prior biopsy [7(21%)]. Considering biopsy to be safe [odds ratio (OR), 4.45; 95% CI, 1.50-13.27], important (OR, 4.87; 95% CI, 1.83-12.95), and knowing a person who underwent liver biopsy (OR, 3.45; 95% CI, 1.16-10.23) were associated with willingness to repeat the biopsy. HIV was not associated with willingness to repeat the biopsy (OR, 1.42; 95% CI, 0.67-3.03).

Conclusions: Eighty-six percent of chronic HCV-infected patients were willing to repeat a liver biopsy. HIV was not associated with unwillingness. In patients in whom a repeat liver biopsy is indicated, education on the utility and safety of the biopsy is important to its acceptance.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Attitude to Health*
  • Biopsy / statistics & numerical data*
  • Coinfection / pathology*
  • Disease Progression
  • Female
  • HIV
  • HIV Infections / complications*
  • HIV Infections / pathology
  • Hepacivirus
  • Hepatitis C, Chronic / complications*
  • Hepatitis C, Chronic / pathology
  • Humans
  • Liver / pathology*
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / etiology
  • Liver Cirrhosis / pathology
  • Male
  • Middle Aged
  • Surveys and Questionnaires