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Histological and virological long‐term outcome in patients treated with interferon‐α2b and ribavirin for chronic hepatitis C
Author(s) -
Schvarcz R.,
Glaumann H.,
Reichard O.,
Weiland O.
Publication year - 1999
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1046/j.1365-2893.1999.00156.x
Subject(s) - ribavirin , medicine , gastroenterology , fibrosis , interferon , stage (stratigraphy) , inflammation , hepatitis c virus , chronic hepatitis , hepatitis c , immunology , virus , biology , paleontology
Long‐term virological and histological outcome following interferon‐α2b (IFN‐α2b) and ribavirin treatment for 24 weeks was studied in 20 patients with chronic hepatitis C who were without a lasting response to IFN as monotherapy. Following combination therapy, sustained virological response (SR) was achieved in 12 patients (i.e. hepatitis C virus (HCV) RNA negative in serum 6months post‐treatment). Eleven of these patients remained HCV RNA negative in serum 2 years post‐treatment. A virological long‐term response (LTR) was more frequent in patients with a previous end‐of‐treatment response to IFN monotherapy than in non‐responders. Liver histology at follow‐up, ≥24months post‐treatment, showed substantial improvement in patients with a virological LTR to the combination treatment. In all nine patients biopsied at the 2‐year follow‐up, liver inflammation had disappeared totally (grade=0), and the stage (fibrosis) had improved. In contrast, no significant changes in grade or stage were noted in patients with a virological non‐LTR to combination treatment. A significant improvement in inflammation was noted, in patients with a virological LTR, from 3.6 to 0.2 ( P <0.01) and in fibrosis from 2.0 to 1.4 ( P <0.05) whereas the corresponding scores for patients with a virological non‐LTR did not change significantly, from 3.1 to 1.5 for inflammation and for fibrosis from 1.3 to 1.3. We conclude that patients with chronic hepatitis C who achieve a virological sustained response 6months post‐treatment with IFN‐α2b and ribavirin will remain virological responders for a follow‐up period of least 24months, concomitant with a disappearance of inflammatory activity and a marked improvement of fibrosis in the liver.