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 journalArticlepeer-review

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

Keywords

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

ASJC Scopus subject areas

  • Gastroenterology

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