Regression of hepatic fibrosis in hepatitis C with long-term interferon treatment

Cirrhosis occurs in 20-50% of patients with hepatitis C and is thought to be irreversible. We describe two patients with cirrhosis secondary to hepatitis C in whom the extensive fibrosis and cirrhosis appeared to regress in response to treatment with interferon-alpha (IFN-alpha). Both patients were...

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Bibliographic Details
Published in:Digestive diseases and sciences 1998-12, Vol.43 (12), p.2573-2576
Main Authors: DUFOUR, J.-F, DELELLIS, R, KAPLAN, M. M
Format: Article
Language:English
Subjects:
Adult
Alanine Transaminase - blood
Biological and medical sciences
Female
Hepacivirus - genetics
Hepatitis C, Chronic - complications
Hepatitis C, Chronic - drug therapy
Hepatitis C, Chronic - pathology
Hepatitis C, Chronic - physiopathology
Humans
Immunomodulators
Interferon-alpha - therapeutic use
Liver - pathology
Liver Cirrhosis - drug therapy
Liver Cirrhosis - pathology
Liver Cirrhosis - physiopathology
Medical sciences
Pharmacology. Drug treatments
RNA, Messenger - analysis
Treatment Outcome
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Summary:Cirrhosis occurs in 20-50% of patients with hepatitis C and is thought to be irreversible. We describe two patients with cirrhosis secondary to hepatitis C in whom the extensive fibrosis and cirrhosis appeared to regress in response to treatment with interferon-alpha (IFN-alpha). Both patients were in the early stages of cirrhosis, class A in the Child-Pugh classification, total score 5 for each patient. Both responded fully to IFN-alpha and had normalization of all liver function tests and disappearance of hepatitis C viral RNA. Liver biopsies, performed before and after treatment, were coded unpaired by patient, combined with 21 liver biopsies from eight other patients with chronic hepatitis, and read independently by two pathologists using the Knodell scoring system. Knodell scores decreased from 14 to 3.5 and from 13.5 to 4 in these two patients. Cirrhosis and extensive fibrosis, present at baseline, were not present on follow-up liver biopsies, which were of sufficient size to reduce the likelihood of sampling error. We conclude that hepatic fibrosis and clinically early cirrhosis may be reversible in some patients with hepatitis C who respond to treatment with IFN-alpha.
ISSN:0163-2116
1573-2568
DOI:10.1023/A:1026601904609