Currently, liver biopsies are not considered mandatory for HCV patients. However, it provides some good information such as determining the level of fibrosis/histological changes to predict prognosis and to guide choice of treatments. It is useful in patients whose diagnosis is uncertain, are immunocompromised, or when other co-infections are suspected. The decision of whether or not to have a biopsy is a balance between the usefulness of the information you get vs the risks of the procedure.
It is important to find a doctor who does a lot of biopsies and have done a lot of biopsies. Finding a more experienced doctor can reduce the risks of the procedure.
There are other tests that may be used to approximate the information provided by a biopsy such as ultrasound techniques, and a new test called Fibrosure by LabCorp which is used to estimate the level of liver fibrosis. This test is much less invasive than biopsies.
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