Complete eradication of hepatitis C virus after interferon treatment for chronic hepatitis C

M. S. De Mitri, G. Morsica, C. H. Chen, L. Mêle, P. Baccarini, R. Chianese, A. Piccinini, A. Lazzarin, E. Pisi

Research output: Contribution to journalArticle

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Abstract

Background. Alpha-interferon therapy can lead to a persistent biochemical response, but discordant opinions have been expressed on the definition of sustained response and on the real possibility of complete eradication of hepatitis C virus (HCV). Aims. To define the clinical, virological and histologic profiles of the patients with sustained response. Patients. Twenty-eight patients with three different biochemical and virological patterns of response to interferon therapy (16 sustained responders, 6 responders with relapse and 6 non responders) were studied for a follow-up period of 36 months. Methods. HCV-RNA sequences were investigated in serum, peripheral blood mononuclear cells and in liver tissue by means of reverse transcriptase-polymerase chain reaction, targeted to the 5' non coding region. Viral load in serum was quantified by branched-DNA signal amplification. HCV genotypes were evaluated using a line probe assay. Results. All sustained responders showed persistent normal ALT values and loss of serum HCV-RNA during the treatment and in the entire follow-up period. The HCV clearance was also demonstrated in peripheral blood mononuclear cells and in liver tissue. Pre-treatment HCV-RNA quantitation showed that sustained responders had a significantly lower viral load compared to relapsers and non responders (p = 0.005). HCV genotyping showed that patients infected by genotypes 2a, 3a were more likely to achieve a sustained response. Interestingly, a prolonged response was also observed in the only three patients with pre-treatment detectable viral load infected by genotype 3a and in patients with genotype 1b and low viraemia levels. To assess the histologic outcome following HCV eradication, all sustained responders underwent a second liver biopsy in the follow-up period (6-18 months). Periportal necrosis and portal inflammation were significantly improved. Conclusions. Our results suggest that persistent loss of HCV-RNA in serum, peripheral blood mononuclear cells and liver as well as histologic improvement are consistent with the complete HCV eradication even from intracellular compartments and from potential extra-hepatic sites of viral persistence. Moreover, pre-treatment viral load, HCV infecting genotypes and histologic features may influence the clinical outcome of hepatitis C and the response to interferon therapy.

Original languageEnglish
Pages (from-to)255-261
Number of pages7
JournalItalian Journal of Gastroenterology and Hepatology
Volume29
Issue number3
Publication statusPublished - 1997

Fingerprint

Chronic Hepatitis C
Hepacivirus
Interferons
Viral Load
Genotype
Therapeutics
Liver
Blood Cells
RNA
Serum
Viremia
Hepatitis C
Reverse Transcriptase Polymerase Chain Reaction
Interferon-alpha
Reference Values
Necrosis
Inflammation
Biopsy
Recurrence

Keywords

  • Chronic hepatitis C
  • HCV genotype
  • HCV RNA eradication
  • Interferon
  • Liver histology
  • Viral load

ASJC Scopus subject areas

  • Gastroenterology

Cite this

De Mitri, M. S., Morsica, G., Chen, C. H., Mêle, L., Baccarini, P., Chianese, R., ... Pisi, E. (1997). Complete eradication of hepatitis C virus after interferon treatment for chronic hepatitis C. Italian Journal of Gastroenterology and Hepatology, 29(3), 255-261.

Complete eradication of hepatitis C virus after interferon treatment for chronic hepatitis C. / De Mitri, M. S.; Morsica, G.; Chen, C. H.; Mêle, L.; Baccarini, P.; Chianese, R.; Piccinini, A.; Lazzarin, A.; Pisi, E.

In: Italian Journal of Gastroenterology and Hepatology, Vol. 29, No. 3, 1997, p. 255-261.

Research output: Contribution to journalArticle

De Mitri, MS, Morsica, G, Chen, CH, Mêle, L, Baccarini, P, Chianese, R, Piccinini, A, Lazzarin, A & Pisi, E 1997, 'Complete eradication of hepatitis C virus after interferon treatment for chronic hepatitis C', Italian Journal of Gastroenterology and Hepatology, vol. 29, no. 3, pp. 255-261.
De Mitri, M. S. ; Morsica, G. ; Chen, C. H. ; Mêle, L. ; Baccarini, P. ; Chianese, R. ; Piccinini, A. ; Lazzarin, A. ; Pisi, E. / Complete eradication of hepatitis C virus after interferon treatment for chronic hepatitis C. In: Italian Journal of Gastroenterology and Hepatology. 1997 ; Vol. 29, No. 3. pp. 255-261.
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abstract = "Background. Alpha-interferon therapy can lead to a persistent biochemical response, but discordant opinions have been expressed on the definition of sustained response and on the real possibility of complete eradication of hepatitis C virus (HCV). Aims. To define the clinical, virological and histologic profiles of the patients with sustained response. Patients. Twenty-eight patients with three different biochemical and virological patterns of response to interferon therapy (16 sustained responders, 6 responders with relapse and 6 non responders) were studied for a follow-up period of 36 months. Methods. HCV-RNA sequences were investigated in serum, peripheral blood mononuclear cells and in liver tissue by means of reverse transcriptase-polymerase chain reaction, targeted to the 5' non coding region. Viral load in serum was quantified by branched-DNA signal amplification. HCV genotypes were evaluated using a line probe assay. Results. All sustained responders showed persistent normal ALT values and loss of serum HCV-RNA during the treatment and in the entire follow-up period. The HCV clearance was also demonstrated in peripheral blood mononuclear cells and in liver tissue. Pre-treatment HCV-RNA quantitation showed that sustained responders had a significantly lower viral load compared to relapsers and non responders (p = 0.005). HCV genotyping showed that patients infected by genotypes 2a, 3a were more likely to achieve a sustained response. Interestingly, a prolonged response was also observed in the only three patients with pre-treatment detectable viral load infected by genotype 3a and in patients with genotype 1b and low viraemia levels. To assess the histologic outcome following HCV eradication, all sustained responders underwent a second liver biopsy in the follow-up period (6-18 months). Periportal necrosis and portal inflammation were significantly improved. Conclusions. Our results suggest that persistent loss of HCV-RNA in serum, peripheral blood mononuclear cells and liver as well as histologic improvement are consistent with the complete HCV eradication even from intracellular compartments and from potential extra-hepatic sites of viral persistence. Moreover, pre-treatment viral load, HCV infecting genotypes and histologic features may influence the clinical outcome of hepatitis C and the response to interferon therapy.",
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AU - Morsica, G.

AU - Chen, C. H.

AU - Mêle, L.

AU - Baccarini, P.

AU - Chianese, R.

AU - Piccinini, A.

AU - Lazzarin, A.

AU - Pisi, E.

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N2 - Background. Alpha-interferon therapy can lead to a persistent biochemical response, but discordant opinions have been expressed on the definition of sustained response and on the real possibility of complete eradication of hepatitis C virus (HCV). Aims. To define the clinical, virological and histologic profiles of the patients with sustained response. Patients. Twenty-eight patients with three different biochemical and virological patterns of response to interferon therapy (16 sustained responders, 6 responders with relapse and 6 non responders) were studied for a follow-up period of 36 months. Methods. HCV-RNA sequences were investigated in serum, peripheral blood mononuclear cells and in liver tissue by means of reverse transcriptase-polymerase chain reaction, targeted to the 5' non coding region. Viral load in serum was quantified by branched-DNA signal amplification. HCV genotypes were evaluated using a line probe assay. Results. All sustained responders showed persistent normal ALT values and loss of serum HCV-RNA during the treatment and in the entire follow-up period. The HCV clearance was also demonstrated in peripheral blood mononuclear cells and in liver tissue. Pre-treatment HCV-RNA quantitation showed that sustained responders had a significantly lower viral load compared to relapsers and non responders (p = 0.005). HCV genotyping showed that patients infected by genotypes 2a, 3a were more likely to achieve a sustained response. Interestingly, a prolonged response was also observed in the only three patients with pre-treatment detectable viral load infected by genotype 3a and in patients with genotype 1b and low viraemia levels. To assess the histologic outcome following HCV eradication, all sustained responders underwent a second liver biopsy in the follow-up period (6-18 months). Periportal necrosis and portal inflammation were significantly improved. Conclusions. Our results suggest that persistent loss of HCV-RNA in serum, peripheral blood mononuclear cells and liver as well as histologic improvement are consistent with the complete HCV eradication even from intracellular compartments and from potential extra-hepatic sites of viral persistence. Moreover, pre-treatment viral load, HCV infecting genotypes and histologic features may influence the clinical outcome of hepatitis C and the response to interferon therapy.

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