Regression of Fibrosis in Chronic Hepatitis C After Therapy with Interferon and Ribavirin

Authors: Arif A.¹; Levine R.A.¹; Sanderson S.O.¹; Bank L.¹; Velu R.P.²; Shah A.³; Mahl T.C.⁴; Gregory D.H.⁵

Source: Digestive Diseases and Sciences, Volume 48, Number 7, July 2003 , pp. 1425-1430(6)

Publisher: Springer

Abstract:

Interferon and ribavirin decrease necroinflammation in chronic hepatitis C with or without virological clearance; however, reversibility of fibrosis remains to be established. We evaluated the effect of combination therapy on virological and liver histopathological outcomes in 52 naïve patients and 79 patients unresponsive to interferon monotherapy with predominantly genotype 1 chronic hepatitis C. One hundred four patients completed interferon and ribavirin treatment after 24–48 weeks. Fifty-six paired liver biopsies (mean biopsy interval 28 months) were assessed by the Ishak score. Sustained virological responses were 37% in naïve patients and 22% in re-treated patients. In virological responders and nonresponders, fibrosis and necroinflammation scores decreased by -0.91 (P =0.04) and -0.5 (P =0.02) and by -2.8 (P =0.001) and -0.66 (P =0.06), respectively. Interferon and ribavirin had greater benefit on fibrosis when associated with clearance of HCV RNA. Treatment strategies in virological nonresponders who show fibrosis regression should include consideration of maintenance therapy, if such treatment eventually proves to benefit histological outcomes.

Keywords: Ishak score; liver biopsy; ALT improvement; HCV RNA clearance

Language: English

Document Type: Research article

Affiliations: 1: Department of Medicine, Division of Gastroenterology, State University of New York, Upstate Medical University, Syracuse, New York, USA 2: School of Management, Syracuse University, Syracuse, New York, USA 3: Department of Medicine, University of Rochester School of Medicine, Strong Memorial Hospital, Rochester, New York, USA 4: Department of Medicine, University of Buffalo School of Medicine, Veterans Administration Medical Center, Buffalo, New York, USA 5: Department of Medicine, Mary Imogene Bassett Hospital, Cooperstown, New York, USA

Publication date: 2003-07-01

• In this: publication
• By this: publisher
• In this Subject: Gastroenterology
• By this author: Arif A. ;  Levine R.A. ;  Sanderson S.O. ;  Bank L. ;  Velu R.P. ;  Shah A. ;  Mahl T.C. ;  Gregory D.H.

Website © Publishing Technology. Article copyright remains with the publisher, society or author(s) as specified within the article.

• Terms and conditions
• Privacy policy
• Information for advertisers