Interferon augments the anti-fibrotic activity of an angiotensin-converting enzyme inhibitor in patients with refractory chronic hepatitis C.
OBJECTIVE
To evaluate the effect of combination treatment with the interferon (IFN) and angiotensin-converting enzyme inhibitor (ACE-I) on several fibrotic indices in patients with refractory chronic hepatitis C (CHC).


METHODS
Perindopril (an ACE-I; 4 mg/d) and/or natural IFN (3 MU/L; 3 times a week) were administered for 12 mo to refractory CHC patients, and several indices of serum fibrosis markers were analyzed.


RESULTS
ACE-I decreased the serum fibrosis markers, whereas single treatment with IFN did not exert these inhibitory effects. However, IFN significantly augmented the effects of ACE-I, and the combination treatment exerted the most potent inhibitory effects. The serum levels of alanine transaminase and HCV-RNA were not significantly different between the groups, whereas the plasma level of transforming growth factor-beta was significantly attenuated almost in parallel with suppression of the serum fibrosis markers.


CONCLUSIONS
The combination therapy of an ACE-I and IFN may have a diverse effect on disease progression in patients with CHC refractory to IFN therapy through its anti-fibrotic effect.
Yoshiji
Hitoshi
H
Third Department of Internal Medicine, Nara Medical University, Shijo-cho 840, Kashihara, Nara 634-8522, Japan. yoshijih@naramed-u.ac.jp
Noguchi
Ryuichi
R
Kojima
Hideyuki
H
Ikenaka
Yasuhide
Y
Kitade
Mitsuteru
M
Kaji
Kosuke
K
Uemura
Masahito
M
Yamao
Junichi
J
Fujimoto
Masao
M
Yamazaki
Masaharu
M
Toyohara
Masahisa
M
Mitoro
Akira
A
Fukui
Hiroshi
H
D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D018450:Disease Progression; D004351:Drug Resistance; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D020913:Perindopril / Q000627:therapeutic use*; D016212:Transforming Growth Factor beta / Q000097:blood
D000806:Angiotensin-Converting Enzyme Inhibitors; D000998:Antiviral Agents; D016212:Transforming Growth Factor beta; D007372:Interferons; D020913:Perindopril