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CHU 2007, February 9   Painless monitoring of hepatitis     The Hepato-Gastro-Enterology Department of the Poitiers university hospital (CHU) recently came into possession of a fibroscan employing ultrasound elastography. A landmark achievement of French technology, this apparatus avoids biopsies 90% of the time. Here are the details as recounted by Pr. Christine Silvain. The “hepatitis” days organized in mid-January at the Poitiers CHU were interesting in two ways. While sensitizing the public to these pathologies – and consequently to risk factors (*) -, they also informed patients as well as health professionals on recent advances in screening and treatment. Even though fibroses, cirrhoses and other forms of liver cancer do not appear to be regressing (0.85% of the Poitou-Charentes population suffers from hepatitis B, and 0.65% from hepatitis C), progress nonetheless remains palpable. It is at this point that we get back to the .. fibroscan! Since November 2006, the Poitiers CHU Hepato-Gastro-Enterology Department has been employing this non-invasive French technology in detection of liver pathologies. The apparatus allows practitioners to “perform diagnoses of the severity of hepatitic disease”. Pr. Christine Silvain goes into detail: “The fibroscan allows for assessment of the fibrosis, that is to say the scarring process that will occur as the hepatitis evolves. It is in accordance with this fibrosis that treatment will or will not be decided upon.” Patient comfort Above and beyond the initial diagnosis, the fibroscan enables one to “see whether the fibrosis is evolving in one or in the other direction” and to “evaluate the degree of gravity of the cirrhosis”. To sum matters up, the technology provides a patient with genuine comfort, insofar as he or she no longer needs to undergo liver biopsy. “Before, we had to put a needle in the patient’s liver, and it hurt”, recognizes the person in charge of the hepato-gastro-enterology department. Today, measurement of the liver’s elasticity, which is the very principle of the fibroscan, takes place in the framework of a routine visit. “A hard and elastic tissue is known to be fibrous; it consequently suffices to emit a pulse on the skin. This wave is echoed in the liver and measurement of the speed at which the wave progresses is performed. The more quickly the wave penetrates, the greater the degree of elasticity”. For instance, elasticity at 20kPa corresponds to a cirrhosis. French technology may fairly be said to be changing the lives not only of practitioners on the whole, but also and especially of the individual patient. (*) Hepatitis C is transmitted by the blood, whereas Hepatitis B is propagated through blood or sexual transmission. 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