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a, C Rossie, G Di Febod, M Zolia, A Craxìc, G Gasbarrini
a, M Bernardia
a Dipartimento di
Medicina Interna, Cardioangiologia ed Epatologia, Università di
Bologna, Bologna, Italy, b Istituto Metodologie Diagnostiche Avanzate,
Consiglio Nazionale delle Ricerche, Palermo, Italy, c Cattedra di Gastroenterologia, Clinica Medica,
Università di Palermo, Palermo, Italy, d Dipartimento
di Medicina Interna e Gastroenterologia, Università di Bologna,
Bologna, Italy, e Dipartimento Clinico di Scienze Radiologiche ed
Istopatologiche, Università di Bologna, Bologna, Italy, f Present addresses: Divisione di
Medicina Interna, Ospedale Maggiore, Bologna, Italy. Clinica Medica,
Università Cattolica del Sacro Cuore, Roma,
Italy
Correspondence to: Dr P Andreone, Semeiotica Medica, Policlinico S Orsola, Via Massarenti, 9-40138 Bologna, Italy. andreone{at}med.unibo.it
Accepted for publication 19
December 2000
BACKGROUND
The role of
interferon treatment on the natural history of hepatitis C virus
related cirrhosis is under debate.
AIMTo evaluate the
effect of interferon on the clinical course of compensated hepatitis C
virus related cirrhosis.
PATIENTS AND
METHODSSeventy two cirrhotic patients treated
with interferon and 72 untreated controls matched treated patients with
for quinquennia of age, sex, and Child-Pugh's score were enrolled in a
prospective non-randomised controlled trial. Treated patients received
leucocytic interferon alfa, with an escalating schedule for 12 months.
The incidence and risk (Cox regression analysis) of clinical
complications (hepatocellular carcinoma, ascites, jaundice, variceal
bleeding, and encephalopathy) and death were calculated.
RESULTSOver
median follow up periods of 55 months for treated and 58 for untreated
subjects, seven and nine patients, respectively, died, and 20 and 32, respectively, developed at least one clinical complication (ns).
Hepatocellular carcinoma developed in six treated and 19 untreated
patients (p=0.018). Seven treated patients showed sustained
aminotranferase normalisation and none died or developed complications. Clinical complications were significantly associated with low albumin, bilirubin, and prothrombin activity while
hepatocellular carcinoma was significantly related to no treatment with
interferon, oesophageal varices, and high 
fetoprotein levels. By
stratified analysis, the beneficial effect of interferon was
statistically evident only in patients with baseline fetoprotein
levels 
20 ng/ml.
CONCLUSIONSInterferon
does not seem to affect overall or event free survival of patients with
hepatitis C virus related cirrhosis while it seems to prevent the
development of hepatocellular carcinoma. Patients who achieved
sustained aminotransferase normalisation survived and did not develop
any complications during follow up.
This article has been cited by other articles:
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  B J Veldt, G Saracco, N Boyer, C Camma, A Bellobuono, U Hopf, I Castillo, O Weiland, F Nevens, B E Hansen, et al. Long term clinical outcome of chronic hepatitis C patients with sustained virological response to interferon monotherapy Gut, October 1, 2004; 53(10): 1504 - 1508. [Abstract] [Full Text] [PDF]
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