Reuters Health Information (2004-11-12): Hepatitis C clearance maintained years after successful interferon therapy
Hepatitis C clearance maintained years after successful interferon therapy
Last Updated: 2004-11-12 12:15:09 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Sustained virological
responses to interferon therapy for hepatitis C virus (HCV) infection
persist for as long as 12 years, according to a report in the November
Journal of Medical Virology.
Previous studies have shown persistent virological and biochemical
remission for up to 5 years after successful treatment with interferon,
the authors explain, but HCV eradication from the liver has not been
well validated in longer follow-up.
Dr. Natsuko Tsuda from Osaka National Hospital, Osaka, Japan and
colleagues monitored 38 sustained virological responders and 37
biochemical responders for 4.4 years to 12 years interferon therapy for
All sustained virological responders remained persistently negative
for serum HCV RNA, with normal ALT levels, during the entire follow-up
period, the authors report, whereas all biochemical responders had
persistent HCV viremia and nearly half (46%) experienced biochemical
Four sustained virological responders (but no biochemical
responders) developed hepatocellular carcinoma (from 6 months to 5.5
years after treatment), the report indicates. All four patients had
cirrhosis or bridging fibrosis before treatment.
HCV RNA strands were not found in biopsies from 15 sustained
virological responders performed 5.9 to 12.5 years after pre-treatment
biopsies, the researchers note, but all but one of 15 biochemical
responders who had repeat biopsies had both positive and negative HCV
RNA strands in the liver.
Hepatitis B virus DNA was not found in liver biopsies, irrespective of HCV clearance, the results indicate.
All histological measures improved significantly in the sustained
virological responders, whereas only piecemeal necrosis and focal
necrosis improved in the biochemical responders. In both groups,
evidence of at least mild inflammation remained in the post-treatment
"Collectively, these findings suggest that HCV seroclearance at 6
months after interferon therapy withdrawal would usually imply
virological cure," the authors conclude. "Although further studies with
a larger number of patients are necessary, control of biochemical
disease activity to near-normal levels may also confer favorable
long-term histological outcomes."
J Med Virol 2004;74:406-413.