Digestive Diseases and Sciences

, Volume 41, Supplement 12, pp 109S–114S

Short-term versus sustained response to interferon therapy

Effect on histology
  • Olle Reichard
Article

Abstract

In order to evaluate the histological treatment response in patients with chronic hepatitis C virus (HCV) infection, different histological scoring systems have been developed. The scoring systems provide means of statistically comparing histopathological parameters in serial liver biopsies and have thus become important requirements of therapeutic trials. Patients with biochemical and virological responses to interferon (IFN) also improve histologically during treatment. However, after treatment cessation, many patients will have a biochemical/virological relapse. These short-term responders also relapse histologically, thus limiting the long-term benefit of a single treatment course, although, repeated courses of IFN in short-term responders may retard histological deterioration. In contrast, sustained biochemical/virological responders seem to have a durable histological response with a continuous and gradual improvement of all necroinflammatory parameters and fibrosis posttreatment.

Key words

hepatitis C chronic infection interferon-α treatment outcome liver histology 

References

  1. 1.
    Tremolada F, Casarin C, Alberti A, Drago C, Tagger A, Ribero ML, Realdi G: Long-term follow-up of non-A, non-B (type C) post-transfusion hepatitis. J Hepatol 16:273–281, 1992Google Scholar
  2. 2.
    Takahashi M, Yamada G, Miyamoto R, Doi T, Endo H, Tsuji T: Natural course of chronic hepatitis C. Am J Gastroenterol 88:240–243, 1993Google Scholar
  3. 3.
    Tong MJ, El-Farra NS, Reikes AR, Co RL: Clinical outcomes after transfusion-associated hepatitis C. N Engl J Med 332:1463–1466, 1995Google Scholar
  4. 4.
    Tine F, Magrin S, Craxi A, Pagliaro L: Interferon for non-A, non-B chronic hepatitis. A meta-analysis of randomised clinical trials. J Hepatol 13:192–199, 1991Google Scholar
  5. 5.
    Reichard O, Foberg U, Frydén A, Mattsson L, Norkrans G, Sönnerborg A, Wejsål R, Yun ZB, Weiland O: High sustained response rate and clearance of viremia in chronic hepatitis C following treatment with interferon α2b for 60 weeks. Hepatology 19:280–285, 1994Google Scholar
  6. 6.
    Davis GL, Balart LA, Schiff ER, Lindsay K, Bodenheimer HC Jr, Perrillo RP, Carey W, Jacobson IM, Payne J, Dienstag JL, Van Thiel DH, Tamburro C, Lefkowitch J, Albrecht J, Meschievitz C, Ortego TJ, Gibas A, and the Hepatitis Interventional Therapy Group: Treatment of chronic hepatitis C with recombinant interferon alpha. A multicenter randomized, controlled trial. N Engl J Med 321:1501–1506, 1989Google Scholar
  7. 7.
    Shindo M, Di Bisceglie AM, Cheung L, Shih WK, Cristiano K, Feinstone SM, Hoofnagle JH: Decrease in serum hepatitis C viral RNA during alpha-interferon therapy for chronic hepatitis C. Ann Intern Med 115:700–704, 1991Google Scholar
  8. 8.
    Camps J, Castilla A, Ruiz J, Civeira MP, Prieto J: Randomised trial of lymphoblastoid α-interferon in chronic hepatitis C. Effects on inflammation, fibrogenesis and viremia. J Hepatol 17:390–396, 1993Google Scholar
  9. 9.
    Schlichting P, Hølund B, Poulsen H: Liver biopsy in chronic aggressive hepatitis. Diagnostic reproducibility in relation to size of specimen. Scand J Gastroenterol 18:27–32, 1983Google Scholar
  10. 10.
    Scheuer PJ, Ashrafzadeh P, Sherlock S, Brown D, Dusheiko G: The pathology of hepatitis C. Hepatology 15:567–571, 1992Google Scholar
  11. 11.
    Bach N, Thung SN, Schaffner F: The histological features of chronic hepatitis C and autoimmune chronic hepatitis: A comparative analysis. Hepatology 15:572–577, 1992Google Scholar
  12. 12.
    Desmet VJ, Gerber M, Hoofnagle JH, Manns M, Scheuer PJ: Classification of chronic hepatitis: Diagnosis, grading and staging. Hepatology 19:1513–1520, 1994Google Scholar
  13. 13.
    Knodell RG, Ishak KG, Black WC, Chen TS, Craig R, Kaplowitz N, Kiernan TW, Wollman J: Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis. Hepatology 1:431–435, 1981Google Scholar
  14. 14.
    Reichard O, Glaumann H, Norkrans G, Wejstål R, Frydén A, Schvarcz R, Weiland O: Histological outcome in patients with chronic hepatitis C given a 60-week interferon alfa-2b treatment course. Liver 14:169–174, 1994Google Scholar
  15. 15.
    The French METAVIR Cooperative Study Group: Intraobserver and interobserver variations in liver biopsy interpretation in patients with chronic hepatitis C. Hepatology 20:15–20, 1994Google Scholar
  16. 16.
    Shindo M, Arai K, Sokawa Y, Okuno T: Hepatic hepatitis C virus RNA as a predictor of a long-term response to interferon-α-therapy. Ann Intern Med 122:586–591, 1995Google Scholar
  17. 17.
    Yabu K, Kiyosawa K, Mori H, Matsumoto A, Yoshizawa K, Tanaka E, Furuta S: Serum collagen type IV for the assessment of fibrosis and resistance to interferon therapy in chronic hepatitis C. Scand J Gastroenterol 29:474–479, 1994Google Scholar
  18. 18.
    Kasahara A, Hayashi N, Hiramatsu N, Oshita M, Hagiwara H, Katayama K, Kato M, Masuzawa M, Yoshihara H, Kishida Y, Shimizu Y, Inoue A, Fusamoto H, Kamada T: Ability of prolonged interferon treatment to suppress relapse after cessation of therapy in patients with chronic hepatitis C: A multicenter randomized controlled trial. Hepatology 21:291–297, 1995Google Scholar
  19. 19.
    Suou T, Hosho K, Kishimoto Y, Horie Y, Kawasaki H: Long-term decrease in serum N-terminal propeptide of type III procollagen in patients with chronic hepatitis C treated with interferon alfa. Hepatology 22:426–431, 1995Google Scholar
  20. 20.
    Weiland O, Zhang Y-Y, Widell A: Serum HCV RNA levels in patients with chronic hepatitis C given a second course of interferon alpha-2b treatment after relapse following initial treatment. Scand J Infect Dis 25:25–30, 1993Google Scholar
  21. 21.
    Reichard O, Glaumann H, Weiland O: Long-term histological outcome in patients with chronic hepatitis C treated repeatedly with interferon alpha-2b without sustained response. Scand J Infect Dis 26:383–389, 1994Google Scholar
  22. 22.
    Reichard O, Glaumann H, Frydén A, Norkrans G, Schvarcz R, Sönnerborg A, Yun Z-B, Weiland O: Two-year biochemical, virological, and histological follow-up in patients with chronic hepatitis C responding in a sustained fashion to interferon alfa-2b treatment. Hepatology 21:918–922, 1995Google Scholar

Copyright information

© Plenum Publishing Corporation 1996

Authors and Affiliations

  • Olle Reichard
    • 1
  1. 1.Department of Infectious Diseases, Karolinska InstituteDanderyd HospitalStockholmSweden
  2. 2.Department of Infectious Diseases, Karolinska InstituteDanderyd HospitalDanderydSweden

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