Abstract | OBJECTIVES: Previous studies, mostly retrospective using conventional interferon, have suggested a favorable prognosis for patients with chronic hepatitis C and a sustained virological response (SVR). However, long-term outcome, including changes in the degree of hepatic fibrosis, of SVR patients in the era of pegylated interferon (PegIFN) remains underdefined. We prospectively evaluated the long-term virological, clinical, and biochemical outcomes, including aspartate aminotransferase-to-platelet ratio index (APRI), in chronic hepatitis C patients with an SVR. PATIENTS AND METHODS: We included 145 consecutive, treatment-naive chronic hepatitis C patients (mean age 47.3±9.1 years; 87 men; 42.1% genotype 1; 36.6% genotype 2/3) who achieved an SVR after combination therapy with PegIFN-α/ ribavirin. RESULTS: The mean follow-up time was 68.8±35 months. The overall incidence of hepatocellular carcinoma (HCC) and liver-related death was 1.4 and 0.7%, respectively. Among nine (7.6%) patients with pretreatment cirrhosis, two (22.2%) developed HCC and one of them (11.1%) died. No patient had conclusive evidence of late virological relapse. All patients retained normal liver biochemistry, except for five of 145 (3.5%), who had persistently elevated transaminase levels, all of whom were diagnosed with new liver disease. APRI values improved significantly with treatment (0.95±1.09 vs. 0.66±0.64, P<0.001) and continued to improve after a mean of 61.4±45.5 months from an SVR in patients (n=54; 37.2%) with significant (Metavir ≥F2) pretreatment fibrosis (1.13±0.66 vs. 0.67±0.45, P<0.001). CONCLUSION: The long-term outcome, including APRI, of chronic hepatitis C patients treated successfully with PegIFN/ ribavirin and followed for a mean of 5.7 years is favorable. However, a high risk of progression to HCC and liver-related death remains for patients with pretreatment cirrhosis, in our setting, as high as 22.2 and 11.1%, respectively.
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Authors | Vasilios Papastergiou, Maria Stampori, Phillipos Lisgos, Crisostomos Pselas, Kleopatra Prodromidou, Stylianos Karatapanis |
Journal | European journal of gastroenterology & hepatology
(Eur J Gastroenterol Hepatol)
Vol. 25
Issue 7
Pg. 798-805
(Jul 2013)
ISSN: 1473-5687 [Electronic] England |
PMID | 23395996
(Publication Type: Journal Article)
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Chemical References |
- Antiviral Agents
- Biomarkers
- Interferon alpha-2
- Interferon-alpha
- RNA, Viral
- Recombinant Proteins
- Polyethylene Glycols
- Ribavirin
- Aspartate Aminotransferases
- peginterferon alfa-2b
- peginterferon alfa-2a
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Topics |
- Adult
- Antiviral Agents
(therapeutic use)
- Aspartate Aminotransferases
(blood)
- Biomarkers
(blood)
- Carcinoma, Hepatocellular
(blood, diagnosis, virology)
- Chi-Square Distribution
- Disease Progression
- Drug Therapy, Combination
- Female
- Greece
- Hepacivirus
(drug effects, genetics)
- Hepatitis C, Chronic
(blood, complications, diagnosis, drug therapy, mortality)
- Humans
- Interferon alpha-2
- Interferon-alpha
(therapeutic use)
- Liver Cirrhosis
(blood, diagnosis, virology)
- Liver Neoplasms
(blood, diagnosis, virology)
- Male
- Middle Aged
- Platelet Count
- Polyethylene Glycols
(therapeutic use)
- Predictive Value of Tests
- Prospective Studies
- RNA, Viral
(blood)
- Recombinant Proteins
(therapeutic use)
- Ribavirin
(therapeutic use)
- Risk Factors
- Time Factors
- Treatment Outcome
- Viral Load
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