BACKGROUND/AIMS: To evaluate whether sustained response to a-interferon improves clinical outcome in patients with chronic hepatitis C. METHODS: A cohort of 410 consecutive patients (65% with chronic hepatitis, 35% with cirrhosis) were treated with a-interferon in two trials (mean follow-up 62.1 months, range 7-109 months). All were serum HCV RNA positive before therapy and received first 10 then 5 million units of a-2b or a-nl interferon three times weekly for 6 to 12 months. Sustained response was defined as normal aminotransferases 12 months after stopping interferon. RESULTS:Sixty-two patients (15.1%: 54 with chronic hepatitis, eight with cirrhosis) were sustained responders. At the end of follow-up, 56 out of 62 sustained responders (90.3%) were serum HCV RNA negative. No biochemical relapse after 12 months was seen in sustained responders, regardless of initial histology, HCV genotype or persistence of HCV RNA. Although three died of non-hepatic causes, no liver-related events were observed among sustained responders. Complications of liver disease occurred in 34 relapsers/non-responders: nine hepatocellular carcinomas, 21 ascites and four portal hypertensive bleedings. Eleven relapsers/nonresponders died: eight of hepatic and three of non-hepatic causes. Event-free survival was significantly longer in sustained responders than in all the remaining patients. In a regression analysis, sustained response to interferon, low age and absence of cirrhosis were independent predictors of event-free survival. CONCLUSIONS: Hepatitis C virus is probably eradicated and progression of liver disease is prevented in most patients who remain HCV RNA negative with normal transaminases for more than 1 year after stopping treatment.
RCT Entities:
BACKGROUND/AIMS: To evaluate whether sustained response to a-interferon improves clinical outcome in patients with chronic hepatitis C. METHODS: A cohort of 410 consecutive patients (65% with chronic hepatitis, 35% with cirrhosis) were treated with a-interferon in two trials (mean follow-up 62.1 months, range 7-109 months). All were serum HCV RNA positive before therapy and received first 10 then 5 million units of a-2b or a-nl interferon three times weekly for 6 to 12 months. Sustained response was defined as normal aminotransferases 12 months after stopping interferon. RESULTS: Sixty-two patients (15.1%: 54 with chronic hepatitis, eight with cirrhosis) were sustained responders. At the end of follow-up, 56 out of 62 sustained responders (90.3%) were serum HCV RNA negative. No biochemical relapse after 12 months was seen in sustained responders, regardless of initial histology, HCV genotype or persistence of HCV RNA. Although three died of non-hepatic causes, no liver-related events were observed among sustained responders. Complications of liver disease occurred in 34 relapsers/non-responders: nine hepatocellular carcinomas, 21 ascites and four portal hypertensive bleedings. Eleven relapsers/nonresponders died: eight of hepatic and three of non-hepatic causes. Event-free survival was significantly longer in sustained responders than in all the remaining patients. In a regression analysis, sustained response to interferon, low age and absence of cirrhosis were independent predictors of event-free survival. CONCLUSIONS:Hepatitis C virus is probably eradicated and progression of liver disease is prevented in most patients who remain HCV RNA negative with normal transaminases for more than 1 year after stopping treatment.
Authors: A Gramenzi; P Andreone; S Fiorino; C Cammà; M Giunta; D Magalotti; C Cursaro; C Calabrese; V Arienti; C Rossi; G Di Febo; M Zoli; A Craxì; G Gasbarrini; M Bernardi Journal: Gut Date: 2001-06 Impact factor: 23.059
Authors: C Cammà; S Bruno; F Schepis; O Lo Iacono; P Andreone; A G Gramenzi; A Mangia; A Andriulli; M Puoti; A Spadaro; M Freni; V Di Marco; L Cino; G Saracco; A Chiesa; A Crosignani; N Caporaso; F Morisco; M G Rumi; A Craxì Journal: Gut Date: 2002-12 Impact factor: 23.059
Authors: Sarah L George; Bruce R Bacon; Elizabeth M Brunt; Kusal L Mihindukulasuriya; Joyce Hoffmann; Adrian M Di Bisceglie Journal: Hepatology Date: 2009-03 Impact factor: 17.425
Authors: Filomena Morisco; Rocco Granata; Tommaso Stroffolini; Maria Guarino; Laura Donnarumma; Laura Gaeta; Ilaria Loperto; Ivan Gentile; Francesco Auriemma; Nicola Caporaso Journal: World J Gastroenterol Date: 2013-05-14 Impact factor: 5.742
Authors: Roland El Braks; Nathalie Ganne-Carrie; Helene Fontaine; Jacques Paries; Veronique Grando-Lemaire; Michel Beaugrand; Stanislas Pol; Jean-Claude Trinchet Journal: World J Gastroenterol Date: 2007-11-14 Impact factor: 5.742
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