Does protracted antiviral therapy impact on HCV-related liver cirrhosis progression?
OBJECTIVE
To study the outcomes of patients with compensated hepatitis C virus-related cirrhosis.


METHODS
Twenty-four grade A5 and 11 grade A6 of Child-Pugh classification cirrhotic patients with active virus replication, treated for a mean period of 31.3 +/- 5.1 mo with moderate doses of interferon-alpha and ribavirin, were compared to a cohort of 36 patients with similar characteristics, without antiviral treatment. Salivary caffeine concentration, a liver test of microsomal function, was determined at the starting and thrice in course of therapy after a mean period of 11 +/- 1.6 mo, meanwhile the resistive index of splenic artery at ultra sound Doppler, an indirect index of portal hypertension, was only measured at the beginning and the end of study.


RESULTS
Eight out of the 24 A5- (33.3%) and 5 out of the 11 A6- (45.45%) treated-cirrhotic patients showed a significant improvement in the total overnight salivary caffeine assessment. A reduction up to 20% of the resistive index of splenic artery was obtained in 3 out of the 8 A5- (37.5%) and in 2 out of the 5 A6- (40%) cirrhotic patients with an improved liver function, which showed a clear tendency to decrease at the end of therapy. The hepatitis C virus clearance was achieved in 3 out of the 24 (12.5%) A5- and 1 out of the 11 (0.091%) A6-patients after a median period of 8.5 mo combined therapy. In the cohort of non-treated cirrhotic patients, not only the considered parameters remained unchanged, but 3 patients (8.3%) had a worsening of the Child-Pugh score (P = 0.001).


CONCLUSIONS
A prolonged antiviral therapy with moderate dosages of interferon-alpha and ribavirin shows a trend to stable liver function or to ameliorate the residual liver function, the entity of portal hypertension and the compensation status at acceptable costs.
Tarantino
Giovanni
G
Department of Clinical and Expermtal Medicine, Federico II University Medical School of Naples,Via S. Pansini, 5, Naples 80131, Italy. tarantin@unina.it
Gentile
Antonio
A
Capone
Domenico
D
Basile
Vincenzo
V
Tarantino
Marianna
M
Di Minno
Matteo-Nicola-Dario
MN
Cuocolo
Alberto
A
Conca
Paolo
P
D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000517:prevention & control*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012254:Ribavirin / Q000627:therapeutic use*