Changes in histological lesions and serum fibrogenesis markers in chronic hepatitis C patients non-responders to interferon alpha

Background/Aims: The aim of this study was to evaluate the: changes in hist ological lesions and serum N-terminal peptide of type III procollagen (PIII NP) and hyaluronate (HA) levels in virologic non-responder patients treated by Interferon alpha (IFN alpha). Methods: We enrolled 183 patients treated by IFN alpha and 56 controls, all with paired biopsy specimens. Yearly liver fibrosis progression was estima ted before and during a follow-up of 1 year. Results: By contrast to sustained responders, non-responders (n = 105) did not achieve improvement of histological scores after therapy. Their yearly fibrosis progression rate was similar before and during follow-up (0.18, 95 % CI: 0.16-0.20, vs 0.26 (95% CI: 0.12-0.40) fibrosis units/year, NS), and was not different in controls (0.17, 95% CI: 0.06-0.27). The levels of PIII NP and hyaluronate (HA) remained unchanged during follow-up. Histological i mprovement was observed for the second biopsy in 25% of non-responders, but also in 23 % of controls. This improvement was not correlated with decreas e of AET level, viral load, PIIINP, or HA. Conclusions: Our results suggest that IFN alpha therapy is unable to decrea se PIIINP or HA levels and cannot improve the histological outcome in virol ogic non-responder patients. The histological improvement observed in a sub set of patients may be linked to sample fluctuation or lack of reproducibil ity of histological scores. (C) 2001 European Association for the Study of the Liver. Published by Elsevier Science B.V. All rights reserved.