Treatment of hepatitis C virus–related cirrhosis: A randomized, controlled trial of interferon alfa-2b versus no treatment

✍ Scribed by Dominique-Charles Valla; Michele Chevallier; Patrick Marcellin; Jean-Louis Payen; Christian Trepo; Marianne Fonck; Marc Bourliere; Evelyne Boucher; Jean-Philippe Miguet; David Parlier; Catherine Lemonnier; Pierre Opolon

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 97 KB
• Volume: 29
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.510290616

✦ Synopsis

To examine the effects of interferon (IFN) therapy on clinical, biochemical, and histological features in patients with compensated hepatitis C virus (HCV)-related cirrhosis, we have conducted a randomized, controlled trial of IFN therapy versus observation. Eight centers included a total of 99 patients with biopsy-proven cirrhosis. IFN-␣2b, 3 million units three times per week, or no antiviral therapy was given for 48 weeks. Twenty-three patients dropped out. End-of-treatment biochemical response was not observed in any of the 39 controls but was observed in 6 of the 47 treated patients (P F .02); sustained biochemical response was obtained in only 2 treated patients. Controls and treated patients did not significantly differ with regard to the changes in serum level of albumin, bilirubin, ␣-fetoprotein, in plasma prothrombin, in histological activity, or liver collagen content. During trial or follow-up (160 ؎ 57 weeks), hepatocellular carcinoma developed in 9 controls and 5 treated patients (NS); decompensation of cirrhosis occurred in 5 controls and 7 treated patients. Seven controls and 10 treated patients died. In conclusion, in patients with compensated HCV-related cirrhosis, a 48-week course of IFN therapy is safe and is able to induce end-of-treatment biochemical response in a significant proportion of patients. However, a 48-week course of IFN therapy usually fails to achieve sustained response and, within the limit of this study, did not significantly improve the 3-year outcome. Therefore, a longer course of IFN therapy or combination therapy with ribavirin should be evaluated in patients with HCV-related cirrhosis. (HEPATOLOGY 1999;29:1870-1875.) Abbreviations: HCV, hepatitis C virus; IFN, interferon. From Services d'he ´patogastroente ´rologie, 1 Groupe hospitalier Pitie ´-Salpe ˆtrie `re and