Interferon-based Therapy for Hepatitis C Improves Fibrosis Even in Individuals w

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Interferon-based Therapy for Hepatitis C Improves Fibrosis Even in Individuals without Virological Response By Liz Highleyman

Successful treatment with interferon-based therapy can clear hepatitis C virus (HCV) and slow or halt liver disease progression, but studies have produced conflicting results with regard to improvement or reversal of existing liver fibrosis.

In a study described in the February 2009 Journal of Viral Hepatitis, J. Vergniol and colleagues used non-invasive blood biomarkers (FibroTest) and transient elastometry (FibroScan) to evaluate changes in fibrosis among 416 French patients with chronic hepatitis C enrolled between May 2003 and March 2006, 112 of whom started antiviral treatment.

Liver fibrosis was staged using FibroTest and FibroScan at study entry, then every year in untreated individuals and at the end of treatment and 6 months thereafter in treated patients. Non-invasive methods are not as accurate as the "gold standard" of liver biopsy, but patients may be more willing to undergo repeated serial non-invasive evaluations to assess changes over time.

Results

FibroTest and FibroScan values were significantly higher both at baseline and after 1 year in the treated group compared with the untreated group. However, there was no significant difference between the 2 groups in FibroTest or FibroScan scores at the end of follow-up, indicating improvement in the treated group. FibroTest and FibroScan values decreased in treated patients regardless of whether they achieved virological response. In a multivariate analysis, interferon-based treatment was the only factor independently associated with decreased FibroScan values.

In conclusion, the study authors wrote, "whatever the virological response, treatment for HCV infection is associated with an improvement of FibroScan and FibroTest values.""Further studies are needed to compare these non-invasive methods with liver biopsy," they added. "These non-invasive methods, and especially FibroScan, should be useful for assessing treatment efficacy in clinical trials of new drugs."Centre d'Investigation de la Fibrose hépatique, Hôpital Haut-Lévêque, CHU Bordeaux, Pessac, France; Service d'Hépato-Gastroentérologie, Hôpital Saint-André, CHU Bordeaux, Bordeaux, France; INSERM, U889, Université Victor Segalen Bordeaux 2, Bordeaux, France.4/21/09