In the present study, published in the
May 2008 Journal of Hepatology, Japanese investigators conducted a study
to define factors associated with fibrosis progression in patients who did not
achieve sustained virological response (SVR; continued undetectable HCV RNA six
months after completion of treatment).
Fibrosis staging scores were compared
for 97 non-responder chronic hepatitis C patients who had paired liver
biopsies performed before and after unsuccessful interferon-based therapy.
The average interval between biopsies was 5.9 years.
Results
•
Fibrosis progressed in 23% of the patients, remained unchanged in 47%, and regressed
in 29%.
•
Independent risk factors for progression of fibrosis were:
•
Steatosis (fat accumulation in the liver): risk ratio 5.53;
•
High mean alanine aminotransferase (ALT) level between biopsies: risk ratio 4.48.
•
The annual incidence rate of fibrosis progression was 64% for patients with both
risk factors, compared to 8% for those with neither.
•
The yearly fibrosis progression rate was 0.22 +/- 0.29 fibrosis units per year
for patients with both risk factors versus -0.04 +/-0.17 for those with neither.
Conclusion
Based
on these findings, the study authors concluded, "Hepatic steatosis and elevated
ALT levels are risk factors for progression of fibrosis in chronic hepatitis C
patients who fail to achieve a SVR to interferon therapy and therefore may be
therapeutic targets to halt the potentially progressive disease."
4/08/08
Reference M
Kurosaki, K Matsunaga, I Hirayama, and others. The presence of steatosis and elevation
of alanine aminotransferase levels are associated with fibrosis progression in
chronic hepatitis C with non-response to interferon therapy. Journal of
Hepatology 48(5): 736-742. May 2008.
FDA-approved
Treatments
Results
