BACKGROUND & AIMS: Impact of hepatitis C treatment has never taken into account the dynamics of fibrosis progression. This study assessed the impact of interferon on liver fibrosis progression in patients with chronic hepatitis C according to 3-month aminotransferase activity response. METHODS: We recruited 287 patients, 185 treated and 102 control, with paired biopsy specimens. Before follow-up, the fibrosis progression rate per year was estimated as the ratio between fibrosis stage in METAVIR units (1 U, 1 stage; 4 U, cirrhosis) and the duration of infection. During follow-up, fibrosis progression was assessed by the observed difference between stages divided by duration between biopsies. RESULTS: The median fibrosis progression rate in treated patients decreased compared with the rate before treatment from 0.103 F METAVIR U/yr (95% confidence interval [CI], 0.087-0.120) to 0.000 (95% CI, 0.000-0.000; P </= 0.0001). Among 91 treated responders, fibrosis stage worsened in 19 (22%), compared with 21 (22%) of 94 treated nonresponders and 57 of 102 controls (56%; P </= 0.0001 compared with treated patients), and improved in 26 (29%), 17 (18%), and 8 (8%; P = 0.0002 compared with 29% and P = 0.03 compared with 18%), respectively. These observed differences persisted after genotype, viremia, sex, age at infection, duration of infection, and alcohol consumption were taken into account. CONCLUSIONS: Interferon treatment changes the natural fibrosis progression rate in patients with chronic hepatitis C independently of genotype and early response.
BACKGROUND & AIMS: Impact of hepatitis C treatment has never taken into account the dynamics of fibrosis progression. This study assessed the impact of interferon on liver fibrosis progression in patients with chronic hepatitis C according to 3-month aminotransferase activity response. METHODS: We recruited 287 patients, 185 treated and 102 control, with paired biopsy specimens. Before follow-up, the fibrosis progression rate per year was estimated as the ratio between fibrosis stage in METAVIR units (1 U, 1 stage; 4 U, cirrhosis) and the duration of infection. During follow-up, fibrosis progression was assessed by the observed difference between stages divided by duration between biopsies. RESULTS: The median fibrosis progression rate in treated patients decreased compared with the rate before treatment from 0.103 F METAVIR U/yr (95% confidence interval [CI], 0.087-0.120) to 0.000 (95% CI, 0.000-0.000; P </= 0.0001). Among 91 treated responders, fibrosis stage worsened in 19 (22%), compared with 21 (22%) of 94 treated nonresponders and 57 of 102 controls (56%; P </= 0.0001 compared with treated patients), and improved in 26 (29%), 17 (18%), and 8 (8%; P = 0.0002 compared with 29% and P = 0.03 compared with 18%), respectively. These observed differences persisted after genotype, viremia, sex, age at infection, duration of infection, and alcohol consumption were taken into account. CONCLUSIONS: Interferon treatment changes the natural fibrosis progression rate in patients with chronic hepatitis C independently of genotype and early response.
Authors: Etienne Patin; Zoltán Kutalik; Julien Guergnon; Stéphanie Bibert; Bertrand Nalpas; Emmanuelle Jouanguy; Mona Munteanu; Laurence Bousquet; Laurent Argiro; Philippe Halfon; Anne Boland; Beat Müllhaupt; David Semela; Jean-François Dufour; Markus H Heim; Darius Moradpour; Andreas Cerny; Raffaele Malinverni; Hans Hirsch; Gladys Martinetti; Vijayaprakash Suppiah; Graeme Stewart; David R Booth; Jacob George; Jean-Laurent Casanova; Christian Bréchot; Charles M Rice; Andrew H Talal; Ira M Jacobson; Marc Bourlière; Ioannis Theodorou; Thierry Poynard; Francesco Negro; Stanislas Pol; Pierre-Yves Bochud; Laurent Abel Journal: Gastroenterology Date: 2012-07-27 Impact factor: 22.682