Long-term follow up of chronic hepatitis C patients after α-interferon treatment: A functional study

Authors


Correspondence: Prof. R Testa, Gastroenterology Unit, Department of Internal Medicine, University of Genova, Viale Benedetto XV, no 6, 16132 Genova, Italy. Email: rtesta@unige.it

Abstract

Aim: To evaluate the long-term functional outcome of chronic hepatitis C (CHC) patients treated with interferon (IFN) therapy.

Methods: Thirty-six patients with CHC were followed up for a mean of 36 months (± 19, SD) after a course of IFN therapy. Biochemical, virological (qualitative hepatitis C virus (HCV)-RNA and HCV genotype), and functional (monoethylglycinexylidide (MEGX) test) evaluations were carried out at the time of liver biopsy. Patients were divided into long-term responders (LTR), relapsers (RR), or non-responders (NR) according to IFN therapy outcome. At the end of follow up, patients were non-invasively re-evaluated by means of biochemistry, qualitative HCV-RNA, MEGX test, and liver ultrasonography.

Results: A significant decrease in MEGX values was observed in all patients. However, when patients were examined according to treatment outcome, only NR and RR showed a significant decrease in liver function as compared to pretreatment levels (MEGX30, 80.5 ± 26.8–62.9 ± 24.2 ng/mL, P < 0.01; MEGX60, 72.9 ± 18.1–60.5 ± 19.7 ng/mL, P < 0.05; MEGXAUC, 3816 ± 1243–3095 ± 1205 ng/mL per h, P < 0.05). On the contrary, LTR patients showed no significant modifications in MEGX values at each sampling time (MEGX15, 72.9 ± 31.4–70.3 ± 29.7 ng/mL; MEGX30, 84.0 ± 27.6–71.5 ± 21.8 ng/ mL; MEGX60, 69.5 ± 26.8–63.2 ± 14.4 ng/mL; MEGXAUC 4028 ± 1378–3620 ± 1041 ng/mL per h). At the end of follow up, LTR patients showed normal liver biochemistry and negativity of serum HCV-RNA, while NR and RR patients showed a significant decrease in platelets.

Conclusions: In CHC patients long-term response to IFN therapy, besides favoring positive clinical and virologic long-term outcome, results in maintaining preserved liver function. Furthermore, IFN therapy seems to determine a decrease in the rate of functional disease progression, even in NR and RR. The MEGX test may be considered as a useful tool for performing serial follow up of CHC patients.

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