Is liver biopsy still needed in children with chronic viral hepatitis?

Table 2 Liver biopsy findings in children with chronic hepatitis B and C n (%)

Type of infection	Patients (n)	Age,yr (mean ± SD or range)	Grading of necroinflammatory activity			Staging of fibrosis				Ref.
			mean HAI ± SD	Minimal/mild	Moderate/severe	mean ± SD	No/low grade	Severe/cirrhosis	Cirrhosis
HBV	30	12.9 ± 2.5	5.4 ± 3.4	25 (84)	5 (16)	1.7 ± 0.9	24 (80)	6 (20)	1 (3)	Pokorska-Śpiewak et al[52]
HBV	35	10.2 (2.0-20.2)	-	33 (94)	2 (6)	-	28 (80)	7 (20)	2 (7)	Boxall et al[77]
HBV	190	7.5 ± 4.1	6.07 ± 3.22	135 (71)	55 (29)	1.71 ± 0.78	183 (96)	7 (4)	1 (0.5)	Mozer-Lisewska et al[30]
HBV	47	9 (1-17)	-	34 (72)	13 (28)	-	41 (87)	6 (13)	0	Dzierzanowska-Fangrat et al[78]
HCV	30	11.5 ± 3.6	4.2 ± 2.5	29 (97)	1 (3)	1.2 ± 0.9	28 (93)	2 (7)	0	Pokorska-Śpiewak et al[52]
HCV	44	8.6 ± 4.1	-	32 (73)	12 (27)	-	39 (89)	5 (11)	-	Mohan et al[43]
HCV	44	14.5 ± 4.0	-	33 (75)	11 (25)	-	35 (80)	9 (20)	-	Mohan et al[43]
HCV	112	8.6 (1-19)	-	-	-	-	107 (96)	5 (4)	1 (1)	Guido et al[79]
HCV	80	9.1 ± 4.8	-	62 (78)	17 (21)	-	66 (83)	13 (16)	1 (1)	Guido et al[80]
HCV	121	9.8 ± 3.7	5.1	72 (60)	49 (40)	-	114 (94)	7 (6)	2 (2)	Goodman et al[46]
HCV	42	13.4 ± 4.1	-	30 (71)	12 (29)	-	37 (88)	5 (12)	-	Mohan et al[42]
HCV	109	8.8 ± 4.2	3.3 ± 1.5	-	-	1.36 ± 0.5	105 (97)	4 (3)	-	Kage et al[81]
HBV/HCV	10	12.6 ± 2.7	6.2 ± 3.0	7 (70)	3 (30)	1.7 ± 0.8	9 (90)	1 (10)	0	Pokorska-Śpiewak et al[52]

HAI: Histological activity index; HBV: Hepatitis B virus; HCV: Hepatitis C virus.