Impact of peginterferon alpha-2b and ribavirin treatment on liver tissue in patients with HCV or HCV-HIV co-infection.
OBJECTIVE
To evaluate the effect of treatment with peginterferon alpha-2b and ribavirin on liver histology in patients with chronic hepatitis C (CHC) with or without HIV infection.


METHODS
Patients received peginterferon alpha-2b (1.5 micro/kg/week during the first 4 weeks; 1.0 micro/kg/week thereafter) plus ribavirin (800-1200 mg/day, adjusted for weight) for 24 (genotypes 2/3) or 48 weeks (genotypes 1/4). Paired liver biopsy specimens were obtained at baseline and at the end of follow-up.


RESULTS
108 paired biopsy specimens were available: 67 from HCV-monoinfected and 41 from co-infected patients. At the end of follow-up, necroinflammatory activity (NIA) was significantly reduced (P<0.001), and fibrosis scores improved by > or = 1 point (Ishak et al criteria) in 65.7% of HCV-monoinfected patients. In co-infected patients, NIA was significantly reduced (P<0.001), and fibrosis scores improved by > or = 1 point in 42.5% of cases. In both groups, results were better for patients who attained sustained virological response (SVR). HCV RNA was undetectable in the second biopsy specimens of all patients who attained SVR.


CONCLUSIONS
Liver fibrosis is reduced significantly after a course of therapy in patients with chronic hepatitis C. Reduction of fibrosis is more significant in patients who are monoinfected with HCV and in those who attained SVR.
Sarmento-Castro
Rui
R
Infectious Diseases Department, Hospital de Joaquim Urbano, Rua Câmara Pestana 348, 4369-004 Porto, Portugal. rsarmento@tvtel.pt <rsarmento@tvtel.pt>
Horta
Ana
A
Vasconcelos
Olga
O
Coelho
Helena
H
Mendez
Josefina
J
Tavares
Ana Paula
AP
Seabra
João
J
Duarte
Manuela
M
Chaves
Leonor
L
Fortes
Olga
O
Recalde
Cristina
C
Ventura
Angela
A
Pires
Nuno
N
Pinho
Luciana
L
Dias
Nancy
N
Carneiro
Fátima
F
D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D008099:Liver / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b