CHANGES IN LIVER FIBROSIS AT THE END OF ALPHA-INTERFERON THERAPY AND 6 TO 18 MONTHS LATER IN PATIENTS WITH CHRONIC HEPATITIS-C - QUANTITATIVE ASSESSMENT BY A MORPHOMETRIC METHOD

Background/Aims: The aims of the study were to determine, in patients with chronic hepatitis C treated with alpha interferon: (i) changes in the morphometric evaluation of liver fibrosis at the end of treatment and 6, 12 and 18 months after treatment; (ii) the predictive value of histologic lesions for the response to treatment, in particular the p redictive value of morphometric evaluation of liver fibrosis. Methods: Seventy patients with chronic hepatitis C who participated in two tri als of recombinant interferon alpha 2b treatment mere studied. Liver s pecimens mere obtained before and at the end of treatment and 6, 12 or 18 months later. Histologic lesions mere assessed according to the Kn odell system. Quantitative study of total fibrosis and of Disse space collagen was done by the computerized automated morphometric method. R esults: A significant decrease in morphometric Disse space collagen wa s observed at the end of treatment and 6 months later. This decrease w as also observed, although it mas not significant, 12 and 18 months af ter treatment. There was no relationship between this decrease and the biochemical and virological responses or the dose of interferon. The pretreatment Knodell activity score, but not the morphometric evaluati on of fibrosis, was a significant predictor of sustained response. Con clusion: A decrease in Disse space collagen, as assessed by the sensit ive morphometric method, was observed at the end of and 6 months after treatment. This observation is consistent with an anti-fibrogenetic e ffect of alpha interferon. Mild or moderate histologic activity was as sociated with a sustained response to therapy.