UNLABELLED: One hundred fifty patients with sustained virologic response (SVR) after treatment of chronic hepatitis C were enrolled in a long-term clinical follow-up study; patients were followed for 5 years for liver-related outcomes and evidence of biochemical or virologic relapse. Patients with stage 2 or greater fibrosis on pretreatment biopsy were invited to undergo a long-term follow-up biopsy after their fourth year of follow-up. One hundred twenty-eight patients (85%) were followed through their fourth year, and long-term follow-up biopsies were obtained from 60 patients (40%). Forty-nine patients had paired pretreatment and long-term follow-up biopsies blindly rescored. Forty of these patients (82%) had a decrease in fibrosis score, and 45 (92%) had a decrease in combined inflammation score. Ten patients (20%) had normal or nearly normal livers on long-term follow-up biopsy. Two patients with pretreatment cirrhosis developed hepatocellular carcinoma (HCC), and one died. All the other patients with pretreatment cirrhosis or advanced fibrosis had improved fibrosis scores on long-term follow-up biopsy. No patient had conclusive evidence of virologic relapse. Three patients had persistently elevated alanine aminotransferase levels; two of these had new liver disease. CONCLUSION: In a cohort of 150 patients with SVR followed for 5 years, the majority of patients had good outcomes. Serum virologic relapse was not seen, but two patients with pretreatment cirrhosis developed HCC, and one died. In a blind rescoring of 49 paired pretreatment and long-term follow-up biopsies, 82% improved fibrosis scores and 92% improved at least one component of inflammation. A minority of patients had normal or nearly normal liver tissue on long-term follow-up biopsy. Patients with cirrhosis pretreatment are at a low but real risk of HCC after SVR.
UNLABELLED: One hundred fifty patients with sustained virologic response (SVR) after treatment of chronic hepatitis C were enrolled in a long-term clinical follow-up study; patients were followed for 5 years for liver-related outcomes and evidence of biochemical or virologic relapse. Patients with stage 2 or greater fibrosis on pretreatment biopsy were invited to undergo a long-term follow-up biopsy after their fourth year of follow-up. One hundred twenty-eight patients (85%) were followed through their fourth year, and long-term follow-up biopsies were obtained from 60 patients (40%). Forty-nine patients had paired pretreatment and long-term follow-up biopsies blindly rescored. Forty of these patients (82%) had a decrease in fibrosis score, and 45 (92%) had a decrease in combined inflammation score. Ten patients (20%) had normal or nearly normal livers on long-term follow-up biopsy. Two patients with pretreatment cirrhosis developed hepatocellular carcinoma (HCC), and one died. All the other patients with pretreatment cirrhosis or advanced fibrosis had improved fibrosis scores on long-term follow-up biopsy. No patient had conclusive evidence of virologic relapse. Three patients had persistently elevated alanine aminotransferase levels; two of these had new liver disease. CONCLUSION: In a cohort of 150 patients with SVR followed for 5 years, the majority of patients had good outcomes. Serum virologic relapse was not seen, but two patients with pretreatment cirrhosis developed HCC, and one died. In a blind rescoring of 49 paired pretreatment and long-term follow-up biopsies, 82% improved fibrosis scores and 92% improved at least one component of inflammation. A minority of patients had normal or nearly normal liver tissue on long-term follow-up biopsy. Patients with cirrhosis pretreatment are at a low but real risk of HCC after SVR.
Authors: G Saracco; F Rosina; M L Abate; L Chiandussi; V Gallo; E Cerutti; A Di Napoli; A Solinas; A Deplano; A Tocco Journal: Hepatology Date: 1993-12 Impact factor: 17.425
Authors: Bart J Veldt; E Jenny Heathcote; Heiner Wedemeyer; Juerg Reichen; W Peter Hofmann; Stefan Zeuzem; Michael P Manns; Bettina E Hansen; Solko W Schalm; Harry L A Janssen Journal: Ann Intern Med Date: 2007-11-20 Impact factor: 25.391
Authors: B J Veldt; G Saracco; N Boyer; C Cammà; A Bellobuono; U Hopf; I Castillo; O Weiland; F Nevens; B E Hansen; S W Schalm Journal: Gut Date: 2004-10 Impact factor: 23.059
Authors: Kei Fujiwara; Robert D Allison; Richard Y Wang; Patricia Bare; Kentaro Matsuura; Cathy Schechterly; Krishna Murthy; Francesco M Marincola; Harvey J Alter Journal: Hepatology Date: 2012-12-06 Impact factor: 17.425
Authors: Richard K Sterling; Jacob A Wegelin; Paula G Smith; R Todd Stravitz; Velimir A Luketic; Michael Fuchs; Puneet Puri; Mitchell L Shiffman; Melissa A Contos; A Scott Mills; Arun J Sanyal Journal: Clin Gastroenterol Hepatol Date: 2010-08-20 Impact factor: 11.382