The presence of steatosis and elevation of alanine aminotransferase levels are associated with fibrosis progression in chronic hepatitis C with non-response to interferon therapy☆
Received 20 July 2007; received in revised form 8 October 2007; accepted 17 December 2007. published online 26 February 2008.
Background/Aims
Interferon (IFN) therapy leads to regression of hepatic fibrosis in chronic hepatitis C patients who achieve a sustained virologic response (SVR), while the beneficial effect is limited in those who fail to do so. The aim of the present study was to define factors associated with progression of fibrosis in patients who do not achieve a SVR.
Methods
Fibrosis staging scores were compared between paired liver biopsies before and after IFN in 97 chronic hepatitis C patients who failed therapy. The mean interval between biopsies was 5.9 years. Factors associated with progression of fibrosis were analyzed.
Results
Fibrosis progressed in 23%, remained unchanged in 47% and regressed in 29%. Steatosis and a high average alanine aminotransferase (ALT) between biopsies were independent factors for progression of fibrosis with risk ratios of 5.53 and 4.48, respectively. Incidence and yearly rate of progression of fibrosis was 64% and 0.22±0.29 fibrosis units per year in those with both risk factors compared to 8% and −0.04±0.17 fibrosis units per year in those negative for both factors.
Conclusions
Hepatic steatosis and elevated ALT levels are risk factors for progression of fibrosis in chronic hepatitis C patients who fail to achieve a SVR to IFN therapy and therefore may be therapeutic targets to halt the potentially progressive disease.
☆ The authors who have taken part in the research of this paper declared that they do not have a relationship with the manufactures of the drug involved either in the past or present and they did not receive funding from the manufactures to carry out their research. They did not receive funding from any source to carry out this study.
ABSTRACT