Loading ...
Sorry, an error occurred while loading the content.
 

IFN Slows Fibrosis Progression in Severe HCV

Expand Messages
  • claudine intexas
    NATAP - www.natap.org ... AASLD Dallas, Nov 9-13 Reported by Jules Levin see NATAP website for more AASLD coverage Abstract 625. EFFECT OF INTERFERON AND
    Message 1 of 1 , Dec 1, 2001
      NATAP - www.natap.org
      ----------------------

      AASLD
      Dallas, Nov 9-13
      Reported by Jules Levin
      see NATAP website for more AASLD coverage

      Abstract 625. EFFECT OF INTERFERON AND RIBAVIRIN ON
      PROGRESSION OF LIVER FIBROSIS IN PATIENTS WITH SEVERE
      CHRONIC HEPATITIS C.

      Armand Abergel, Corinne Bonny, HTMtel Dieu, Clermont
      Ferrand France; Sylvie Ughetto, Claude Darcha, Htmtel
      Dieu Blvd Leon Malfrey, Clermont Ferrand France;
      Michelle Chevalier, Inst Merieux, Lyon France; Cecile
      Henquell, CHU Place Henri Dunant, Clermont Ferrand
      France; Nathalie Martineau, Karine Randl, HTMtel Dieu
      Blvd Leon Malfrey, Clermont Ferrand France; Helene
      Lafeuille, Bruno Aublet-Cuvelier, CHU Place Henri
      Dunant, Clermont Ferrand France; Gilles Bommelaer,
      HTMtel Dieu Blvd Leon Malfrey, Clermont Ferrand France


      These study investigators report finding improved
      fibrosis progression following HCV therapy in patients
      with advanced liver disease (stage 3/4). For
      nonresponders, fibrosis progression reversed, and for
      nonresponders progression slowed.

      Several studies have shown that treatment with
      interferon plus ribavirin can lead to sustained
      virological response in patients with chronic
      hepatitis C. Poynard et al (Hepatology 2000;32:1131-7)
      assessed the effect of this combination regimen on
      hepatic fibrosis but included few cirrhotic
      patients.

      The aim of our study was to determine the impact of
      interferon and ribavirin (IR) combination on the
      progression of liver fibrosis in patients with severe
      chronic hepatitis C (Knodell fibrosis score = 3 or 4).


      Patients : Two hundred patients with severe chronic
      hepatitis C were enrolled in 2 trials between 1996 and
      1998. 75 patients received interferon (I) during 12
      months and ribavirine (R) during 6 months (Group A);
      75 were treated by I alone during 12 months (Group B)
      and 50 by a combination of IR during 12 months (Group
      C). There were no statistically significant difference
      between the groups A and C for age, ALT, viremia,
      genotypes, liver histology according to Knodell.
      Gender was significantly different between groups A
      and C (56% men in the group A and 75% in the group C;
      p=0.053).All the samples of liver were read by 2
      pathologists (CD, MC). Fibrosis stage were expressed
      in Knodell and Metavir units. Fibrosis progression
      rate was assessed using Metavir units (fibrosis
      score/number of years from the contamination or
      fibrosis score/time between 2 biopsies). In this study
      we compared histologic improvment between IR
      combination Group (A+C) and I alone (Group B) in
      patients with a known source of infection. Assessment
      was done in 76 patients and based on biopsy realised
      before and after treatment.

      Results : The means of the scores of fibrosis
      progression before treatment were respectively of 0.26
      (mediane 0.184) and 0.212 (mediane 0.186) in the
      combination group and in the interferon group. The
      means of the scores of fibrosis progression after
      treatment were respectively of -0.141 (mediane 0) and
      - 0.127 (mediane 0) in the combination group and in
      the interferon group. The fibrosis progression before
      and after treatment (progression before - progression
      after treatment) were not statistically different
      between the IR and I groups. The means of fibrosis
      progression in the patients treated by the combination
      regimen were of -0.333 (mediane 0) in patients with
      sustained response and of 0.017 (mediane 0) in non
      responders (Wilcoxon test: p< 0.002). The means of
      fibrosis progression in the group of patients treated
      by I alone were of -0.4 (mediane 0) in patients with
      sustained response and of -0.042 (mediane 0) in non
      responders (p < 0.02).

      Conclusions: 1) Interferon alone and the
      interferon-ribavirine combination decreased fibrosis
      progression in patients with severe chronic hepatitis
      C. 2) Response to treatment is the best predictive
      factor of the inhibition of fibrosis progression. 3)
      In non responders to the combination, it is not
      necessary to continue the ribavirin.



      __________________________________________________
      Do You Yahoo!?
      Buy the perfect holiday gifts at Yahoo! Shopping.
      http://shopping.yahoo.com
    Your message has been successfully submitted and would be delivered to recipients shortly.