TY - JOUR
T1 - Long-term beneficial effects in sustained responders to interferon-alfa therapy for chronic hepatitis C
AU - Bruno, Savino
AU - Battezzati, Pier Maria
AU - Bellati, Giorgio
AU - Manzin, Aldo
AU - Maggioni, Marco
AU - Crosignani, Andrea
AU - Borzio, Mauro
AU - Solforosi, Laura
AU - Morabito, Alberto
AU - Ideo, Gaetano
AU - Podda, Mauro
PY - 2001/5
Y1 - 2001/5
N2 - Background/Aims: Assessment of chronic hepatitis C outcome in sustained responders to interferon requires prolonged observation and close monitoring. We prospectively studied the impact of sustained response on histology and clinically relevant outcomes. Methods: The 47 sustained responders (ten with cirrhosis) from two interferon trials involving 235 chronic hepatitis C patients (81 with cirrhosis) were included. Hepatitis C virus (HCV) RNA was assessed every 6 months, liver histological changes from baseline, 6-12 and 48-72 months after treatment discontinuation. Results: The mean follow-up was 102 ± 19 months. HCV RNA became undetectable in 36/47 responders. Four responders, who had remained viremic, later relapsed. The histology progressively improved in non-viremic and viremic patients, with a more marked improvement in the former (P = 0.0089), normalizing in 53 vs. 0% (P = 0.0220). No patient progressed to cirrhosis. One non-viremic cirrhotic patient developed a hepatocellular carcinoma. Non-responders from the two original trials had worse histological outcomes and those with cirrhosis had a higher rate of clinically relevant events compared with cirrhotics showing a sustained biochemical response (4.5 vs. 1.2 cases/100 person-years; CI for the difference, 0.3-6.3). Conclusions: Most sustained, virological responders without cirrhosis normalize liver histology in the long-term and are cured of the disease. Sustained responders remaining viremic still show histological improvement, albeit to a lesser extent.
AB - Background/Aims: Assessment of chronic hepatitis C outcome in sustained responders to interferon requires prolonged observation and close monitoring. We prospectively studied the impact of sustained response on histology and clinically relevant outcomes. Methods: The 47 sustained responders (ten with cirrhosis) from two interferon trials involving 235 chronic hepatitis C patients (81 with cirrhosis) were included. Hepatitis C virus (HCV) RNA was assessed every 6 months, liver histological changes from baseline, 6-12 and 48-72 months after treatment discontinuation. Results: The mean follow-up was 102 ± 19 months. HCV RNA became undetectable in 36/47 responders. Four responders, who had remained viremic, later relapsed. The histology progressively improved in non-viremic and viremic patients, with a more marked improvement in the former (P = 0.0089), normalizing in 53 vs. 0% (P = 0.0220). No patient progressed to cirrhosis. One non-viremic cirrhotic patient developed a hepatocellular carcinoma. Non-responders from the two original trials had worse histological outcomes and those with cirrhosis had a higher rate of clinically relevant events compared with cirrhotics showing a sustained biochemical response (4.5 vs. 1.2 cases/100 person-years; CI for the difference, 0.3-6.3). Conclusions: Most sustained, virological responders without cirrhosis normalize liver histology in the long-term and are cured of the disease. Sustained responders remaining viremic still show histological improvement, albeit to a lesser extent.
KW - Chronic hepatitis C
KW - Clinically relevant outcomes
KW - Interferon
KW - Liver histology
KW - Long-term study
KW - Sustained response
UR - http://www.scopus.com/inward/record.url?scp=0034998785&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0034998785&partnerID=8YFLogxK
U2 - 10.1016/S0168-8278(01)00062-9
DO - 10.1016/S0168-8278(01)00062-9
M3 - Article
C2 - 11434622
AN - SCOPUS:0034998785
VL - 34
SP - 748
EP - 755
JO - Journal of Hepatology
JF - Journal of Hepatology
SN - 0168-8278
IS - 5
ER -