alpha-interferon improves liver fibrosis in chronic hepatitis C - Clinicalsignificance of the serum N-terminal propeptide of procollagen type III

Our objective was to estimate the effect of interferon (IFN) on the evoluti on of fibrosis in chronic hepatitis C and the significance of the N-termina l propeptide of procollagen type III (PIIIP) as a marker of fibrogenesis. O ne hundred seventeen patients, 72 male (61%) and 45 female (39%), with a me an age of 40.7 +/- 11.9 years were treated with alpha 2b-IFN, 3 to 5 MU, fo r 12 months: sustained responders (SR = 44), relapsers (RR = 35), and nonre sponders (NR = 38). Liver biopsies were performed before treatment and 1 ye ar after cessation of IFN for evaluation of the histological activity index (HAI). Serum PIIIP was obtained at the time of liver biopsy, at the beginn ing, during, and end of therapy and during the follow-up. The normal value in 29 healthy individuals was 0.37 +/- 0.18 U/L. Staging was reduced in 58% of SR, 12.5% of RR, and 11.5% of NR. There was a correlation between PIIIP and the HAI before (n = 71, r(s) = 0.41, P < 0.0004) and after IFN (n = 71 , r(s) = 0.58, P < 0.0001). The SR had a better improvement in grading (90. 3%; P < 0.05) and staging (58%; P < 0.001). The correlation of the HAI para meters with the variation of PIIIP showed significance only for fibrosis (r (s) = 0.36, P < 0.002) and portal inflammation (r(s) = 0.35, P < 0.01). PII IP normalized only in patients whose fibrosis improved (P < 0.01). At the e nd of therapy, PIIIP had a predictive value in the distinction of SR from R R (PPV, 64; PNV, 55.6). During the follow-up, PIIIP remained lower in SR co mpared with RR and NR (P < 0.002). The response to alpha -IFN improved live r inflammation and fibrosis. Serum PIIIP is a useful noninvasive method to evaluate serially fibrogenesis in chronic hepatitis C treated with IFN.