INF Therapy Can Regress
Hepatic Fibrosis Regresses in Interferon-Responsive Hepatitis C Patients
WESTPORT, Apr 05 (Reuters Health) - Hepatitis C-related hepatic fibrosis regresses in patients who experience a sustained virologic response to interferon therapy, according to a report in the April 4th issue of Annals of Internal Medicine.
Dr. Yasushi Shiratori, of the University of Tokyo in Japan, and colleagues examined liver biopsy specimens obtained 1 to 10 years apart from 593 patients with hepatitis C-related hepatic fibrosis, 487 of whom had received interferon treatment.
Among interferon-treated patients, 183 had a sustained virologic response. defined as a loss of serum hepatitis C viral RNA, and 304 had a nonsustained response, the authors report.
The biopsy activity grade, measured on a four-point scale from none to severe, improved in 89% of the patients with a sustained response, compared with 50% to 60% of patients with a nonsustained response and untreated patients, the results indicated.
Furthermore, the degree of fibrosis, measured on a five-point scale from none to cirrhosis, regressed in 59% of patients with a sustained virologic response and progressed in only 3%. In contrast, fibrosis progressed in 38% of untreated patients (and regressed in 5%) and progressed in 24% of patients with nonsustained response (and regressed in 19%), the investigators note.
The rate of fibrosis regression was 0.28 activity grade per year in patients with a sustained response, the researchers observe. On the other hand, fibrosis progressed at the rate of 0.10 grade per year in untreated patients and 0.02 grade per year in patients with a nonsustained virologic response.
"Comparison of fibrosis rates between treated and untreated patients carries built-in bias because the untreated patients had a milder stage of fibrosis and inflammatory activity," the investigators acknowledge.
Nevertheless, they conclude, "interferon therapy seemed to reduce the progression of hepatic fibrosis and cause regression of fibrosis in patients with virologic response to treatment, and it reduced progression of hepatic fibrosis in patients with nonsustained virologic response."
Ann Intern Med 2000;132:517-524