Is interferon a useful treatment for virus C cirrhosis?
The authors have reviewed the recent literature on the usage of interferon alpha and beta with patients affected by liver cirrhosis caused by HCV. Broad wide surveys, consisting of ten trials, met the criteria for inclusion in the study. The following points were considered: the degree of complete response (transaminase normalization); complete follow-up response; viremia clearance. Interferon alpha was used in 9 cases out of 10, while interferon beta was used in one case only, with variable dosage and different time of administration, according to the different studies. A total of 539 patients affected by chronic hepatitis or cirrhosis were examined. 245 of them were affected by chronic cirrhosis: the response was complete in 65 patients out of 245 examined (26%), while 17 of 245 (7%) had a limited response. The clearance of viremia, in those studies where this value was reported, was noted in no more than 75% of the responders. The best results were achieved in those cases where it had been possible to use higher dosages of IFN (up to 6 MU x 3) and for a period of more than 12 months, without causing noteworthy side effects. The low percentage of patients with a limited response (7%) should not dissuade from using IFN. In accordance with significant recent reports, in several cases this therapy would lead to a slowing down of the histological progression of the disease and even to a decrease in the percentage of hepato-carcinoma developments, consequently resulting in a longer life for the patient and in less need of hospitalization. These results could justify the use of interferon even though it is a very expensive treatment.
Ambulatory of Hepatology III Medical Division, Santo Spirito in Sassia Hospital, ASL RM E, Rome.
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Massini