Histological benefits of virological response to peginterferon alfa-2a monotherapy in patients with hepatitis C and advanced fibrosis or compensated cirrhosis

Authors


Dr G. T. Everson, Section of Hepatology, University of Colorado School of Medicine, University of Colorado Health Sciences Center, UCH AOP, Hepatology Section, 1635 N Ursula, B-154, PO Box 6510, Aurora, CO 80045, USA.
E-mail: greg.everson@uchsc.edu

Summary

Background  Patients with chronic hepatitis C virus and advanced fibrosis or cirrhosis are at risk for disease progression and hepatic decompensation.

Aim  To determine the effects on hepatic histology of treatment with peginterferon alfa-2a (90 or 180 μg/week) or interferon alfa-2a (3 million units three times weekly) for 48 weeks in patients with paired biopsies.

Methods  Liver biopsies were obtained at baseline and 6 months after end of treatment. Histological and virological responses were compared.

Results  Patients attaining sustained virological response (n = 40) demonstrated the greatest improvements in fibrosis (−1.0, P < 0.0001) and inflammation (−0.65, P < 0.0001). Patients who cleared hepatitis C virus during treatment, but later relapsed (n = 59), experienced less improvement in fibrosis (−0.04, P < 0.0001) and inflammation (−0.14, P = 0.0768). Nonresponders (n = 85) showed no significant improvement in inflammation or fibrosis. Multiple regression analysis showed that the only factors contributing to improvement in fibrosis were sustained virological response (vs. nonresponder, P = 0.0005; vs. relapse, P = 0.7525) and body mass index ≤30 kg/m2 (P = 0.0995).

Conclusions  These findings indicate that virological response to peginterferon alfa-2a improves inflammation and fibrosis in hepatitis C virus patients with advanced fibrosis or cirrhosis. Improving virological response and maintaining ideal body weight are critical for achieving optimal histological outcomes in hepatitis C virus patients.

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