TIME-COURSE OF HISTOLOGICAL-CHANGES IN PATIENTS WITH A SUSTAINED BIOCHEMICAL AND VIROLOGICAL RESPONSE TO INTERFERON-ALPHA THERAPY FOR CHRONIC HEPATITIS-C VIRUS-INFECTION
A. Tsubota et al., TIME-COURSE OF HISTOLOGICAL-CHANGES IN PATIENTS WITH A SUSTAINED BIOCHEMICAL AND VIROLOGICAL RESPONSE TO INTERFERON-ALPHA THERAPY FOR CHRONIC HEPATITIS-C VIRUS-INFECTION, Journal of hepatology, 27(1), 1997, pp. 49-55
Background/Aims: Although biochemical and virological responses to int
erferon-alpha therapy for chronic hepatitis virus infection have been
extensively studied, long-term changes in liver histology have not bee
n well documented. Methods: We retrospectively analyzed 105 paired liv
er biopsy specimens taken before and after treatment from 93 patients
who persistently showed biochemical remission and an absence of viremi
a for up to 68 months. Results: The grading scores for necroinflammato
ry and fibrotic activity in the liver biopsy specimens decreased signi
ficantly after interferon-alpha therapy. Histological scores graded ac
cording to Knodell's components improved significantly in every catego
ry after interferon-alpha therapy, However, inflammatory cell infiltra
tes remained within the portal tracts for long periods; necroinflammat
ion in the periportal and lobular regions were absent in most of the p
ost-therapy specimens. The cumulative disappearance rate, calculated u
sing the Kaplan-Meier method, was significantly lower for portal infla
mmation than for periportal or lobular necroinflammation but was equiv
alent to that for histological disease activity. On univariate analysi
s, age and fibrosis at the onset of treatment were significant factors
influencing the response of histological disease activity to interfer
on-alpha therapy (p=0.025 and 0.049, respectively). Using Cox's propor
tional hazard analysis, age was the only significant independent predi
ctor of histological response to treatment (p=0.035). Conclusions: Cli
nical remission of chronic hepatitis C virus infection is associated w
ith histological resolution of necroinflammatory in the periportal and
lobular regions. Host-related factors are likely to influence whether
early remission of inflammation after interferon-alpha therapy occurs
.