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Impact of pegylated interferon alfa-2b and ribavirin on liver fibrosis in patients with chronic hepatitis C

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  • claudine intexas
    NATAP - www.natap.org NATAP HEPATITIS C REPORT Impact of pegylated interferon alfa-2b and ribavirin on liver fibrosis in patients with chronic hepatitis C For
    Message 1 of 1 , Sep 30, 2003
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      NATAP - www.natap.org

      NATAP HEPATITIS C REPORT
      Impact of pegylated interferon alfa-2b and ribavirin on liver
      fibrosis in patients with chronic hepatitis C

      For full article with tables:
      http://www.natap.org/2003/sept/093003_10.htm

      ABSTRACT

      Background & Aims: Liver fibrosis is an important prognostic factor
      in patients with hepatitis C. The effect of pegylated (PEG)
      interferon alone or its combination with ribavirin on fibrosis has
      not been established.

      Methods: We pooled individual data from 3010 naive patients with
      pretreatment and posttreatment biopsies from 4 randomized trials. Ten
      different regimens combining standard interferon, PEG interferon, and
      ribavirin were compared. The impact of each regimen was estimated by
      the percentage of patients with at least 1 grade improvement in the
      necrosis and inflammation (METAVIR score), the percentage of patients
      with at least 1 stage worsening in fibrosis METAVIR score, and by the
      fibrosis progression rate per year.

      Results: Necrosis and inflammation improvement ranged from 39%
      (interferon 24 weeks) to 73% (optimized PEG 1.5 and ribavirin; P <
      0.001). Fibrosis worsening ranges from 23% (interferon 24 weeks) to
      8% (optimized PEG 1.5 and ribavirin; P < 0.001). All regimens
      significantly reduced the fibrosis progression rates in comparison to
      rates before treatment. The reversal of cirrhosis was observed in 75
      patients (49%) of 153 patients with baseline cirrhosis. Six factors
      were independently associated with the absence of significant
      fibrosis after treatment: baseline fibrosis stage (odds ratio [OR] =
      0.12; P < 0.0001), sustained viral response (OR = 0.36; P < 0.0001),
      age < 40 years (OR = 0.51; P < 0.001), body mass index < 27 kg/m2 (OR
      = 0.65; P < 0.001), no or minimal baseline activity (OR = 0.70; P =
      0.02), and viral load < 3.5 millions copies per milliliter (OR =
      0.79; P = 0.03).

      Conclusions: PEG-interferon and ribavirin combination significantly
      reduces the rate of fibrosis progression in patients with hepatitis
      C.

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