Sustained virological response to interferon-α is associated with improved outcome in HCV-related cirrhosis: A retrospective study


  • This study has been presented in part at the 56th Annual Meeting of the American Association for the Study of the Liver Diseases, San Francisco, CA, November 11-15, 2005.

  • Potential conflict of interest: Nothing to report.

  • Additional centers and principal investigators: A. Aghemo, Gastroenterology Unit, Fondazione IRCCS Maggiore Hospital, Mangiagalli & Regina Elena, University of Milan; A. Amato, Viral Hepatitis Unit, Seconda University of Naples; S. Boccia, Gastroenterology Unit, A. O. “S. Anna”, Ferrara; G. Colloredo, Department of Internal Medicine, Policlinico San Pietro, Bergamo; C. Cursaro, Department of Internal Medicine, Cardioangiology and Hepatology, University of Bologna; D. De Tullio, Infectious Diseases Unit, Policlinico “SS Annunziata”, Chieti; V. Di Marco, Gastroenterology and Hepatology Unit, University of Palermo; M. De Luca, Liver Unit, Department of Gastroenterology. AO “Cardarelli”, Naples; M. Fasano, Infectious Diseases Unit, University of Bari; E. Giannini, Gastroenterology Unit, University of Genova; M. Gios, Department of Clinical and Experimental Medicine, University of Padova; I. Grattagliano, Department of Internal Medicine, University of Bari; F. Morisco, Science of Foods Department, University of Naples “Federico II”; A. Picciotto, Department of Internal Medicine, University of Genova; P. Del Poggio, Liver Unit, AO di Treviglio; S. Rossi, Liver Unit, Department of Medicine, AO Fatebenefratelli e Oftalmico, Milan; M. Stanzione, Infectious Diseases Unit, University of Naples; R. Santoro, Department of Gastroenterology, Casa Sollievo della Sofferenza, San Giovanni Rotondo; G. Saracco, Department of Gastroenterology, Hospital “Molinette”, Torino; C. Mazzaro, Internal Medicine Unit, General Hospital of Pordenone.


The effect of achieving a sustained virological response (SVR) following interferon-α (IFNα) treatment on the clinical outcomes of patients with HCV-related cirrhosis is unknown. In an attempt to assess the risk of liver-related complications, HCC and liver-related mortality in patients with cirrhosis according to the response to IFNα treatment, a retrospective database was developed including all consecutive patients with HCV-related, histologically proven cirrhosis treated with IFNα monotherapy between January 1992 and December 1997. SVR was an undetectable serum HCV-RNA by PCR 24 weeks after IFNα discontinuation. HCC was assessed by ultrasound every 6 months. Independent predictors of all outcomes were assessed by Cox regression analysis. Of 920 patients, 124 (13.5%) were classified as achieving a SVR. During a mean follow-up of 96.1 months (range: 6-167) the incidence rates per 100 person-years of liver-related complications, HCC and liver-related death were 0, 0.66, and 0.19 among SVR and 1.88, 2.10, and 1.44 among non-SVR (P < 0.001 by log-rank test). Multivariate analyses found that non-SVR was associated with a higher risk of liver-related complications (hazard ratio, HR, not applicable), HCC (HR 2.59; 95% CI 1.13-5.97) and liver-related mortality (HR 6.97; 95% CI 1.71-28.42) as compared to SVR. Conclusion: Thus, in patients with HCV-related, histologically proven cirrhosis, achievement of a SVR after IFNα therapy was associated with a reduction of liver-related mortality lowering both the risk of complications and HCC development. Irrespective of SVR achievement, all patients should continue surveillance because the risk of occurrence of HCC was not entirely avoided. (HEPATOLOGY 2007;45:579–587.)