Clinical outcome of chronic hepatitis C in patients treated with interferon: comparison between responders and non-responders

Aim, To evaluate the prognosis of chronic hepatitis C in relation to interf eron therapy response and the persistence of therapeutic benefits. Patients/Methods. We studied the clinical outcome of 191 patients with chro nic infection (152 chronic hepatitis C and 39 cirrhosis) treated with recom binant alpha-interferon (3 - 6 MU on alternate days for 1 year) during a me an period of 47 months (range 22.5-73.8). Control tests were done at 6-mont h intervals, HCV RNA was determined pre- and posttreatment in all participa nts, but continued yearly in longterm responders. The appearance of cirrhos is was estimated using a non-invasive method that utilizes a model based on clinical, instrumental and biochemical variables. Ascites, encephalopathy, haemorrhage, hepatocellular carcinoma, and death were considered liver-dis ease-related events. Results, A total of 39 patients were long-term responders, 36 relapsers, an d 116 non-responders; 92% of long-term responders cleared HCV RNA and remai ned negative throughout the study period. The 3 HCV-RNA-positive long-term responders continued being so. No biochemical relapse was observed in long- term responders regardless of virological status. New cirrhosis was observe d in 3/30 relapsers, in 9/85 non-responders, and in no long-term responders . Overall, 9 episodes of severe events occurred in 20% of cirrhotics and in 0.6% of chronic hepatitis, all non-responders. Conclusions, Long-term response interrupts the progression to cirrhosis and reduces the incidence of severe complications, Multivariate analysis revea led that "baseline diagnosis of cirrhosis" was the only independent factor predictive of an unfavourable outcome of chronic HCV-related liver disease.