INTERFERON TREATMENT OF CIRRHOTIC-PATIENTS WITH CHRONIC HEPATITIS-C

Hepatitis C virus (HCV) infection is one of the more important infecti ous diseases yet to be conquered. An estimated 3.5 million people in t he USA have chronic HCV. Each year, 8000 to 10000 of these chronically infected patients die of a liver-related complication of their infect ion. The introduction of effective blood screening assays has resulted in a remarkable decrease in the incidence of post-transfusion HCV inf ection. Nonetheless it is essential to have a treatment programme for chronic HCV disease that prevents the development and the progression of compensated cirrhosis to either decompensated cirrhosis or hepatoce llular carcinoma, as many individuals present to the health care syste m with chronic active hepatitis or cirrhosis, A completely safe and ef fective treatment strategy for chronic HCV, with or without cirrhosis, remains to be developed. Of the various treatment alternatives curren tly available, only interferon (IFN) has been evaluated extensively. I FN therapy has been shown to induce remissions of the hepatic inflamma tory process and also to eliminate the viral infection in some treated cases. As a result, the selection of patients for treatment and the d ose and the duration of therapy with IFN are still controversial issue s. It is widely held that cirrhotic individuals do not respond to IFN therapy and that treatment of decompensated cirrhotic individuals with HCV infection is dangerous. Here we review data regarding the availab le experience with IFN treatment of HCV-positive individuals with cirr hosis and compare the response rates of cirrhotics to those reported f or individuals with chronic active HCV.