Clinical

Prognosis "excellent" in hepatitis C patients with sustained response to interferon

Last Updated: 2004-09-24 11:50:43 -0400 (Reuters Health)

By Megan Rauscher

NEW YORK (Reuters Health) - Patients with chronic hepatitis C who mount a sustained virological response to interferon monotherapy have an excellent long-term prognosis, results of a large European study indicate.

"The key end point for treatment efficacy in chronic hepatitis C is absence of detectable virus at six months after treatment," investigators note in the October issue of the journal Gut.

"However, the incidence of clinical events during long-term follow up of patients with sustained virological response is still poorly documented and may differ between the Eastern and Western world," they point out.

To investigate, they analyzed individual patient data from a group of patients treated in eight European follow up studies of interferon therapy for chronic hepatitis C. The sample included 286 sustained virological responders and 50 biochemical responders (detectable virus but normal alanine aminotransferase levels) who were followed for 59 months.

Among sustained virological responders, the rates of late virological relapse and decompensation were low after five years of follow up, 4.7% and 1.0%, respectively, and there were no cases of hepatocellular carcinoma (HCC). Five-year survival was comparable to the general European population matched for age and sex.

Among biochemical responders, rates of decompensation and HCC were 9.1% and 7.1%, respectively.

Dr. Solko W. Schalm of Erasmus Medical Center in Rotterdam, the Netherlands, told Reuters Health: "The take home message is that in patients with chronic hepatitis C, a blood test taken 6 months after stopping antiviral therapy can predict long term outcome."

"If the sensitive PCR test detects no virus, the patient can be considered cured from the infection and long term liver complications are rare," he added.

Gut 2004;53:1504-1508.