Long-term follow up of Egyptian patients with chronic hepatitis c: impact of interferon therapy on their outcome - with special reference to HCC

ABSTRACT

To our knowledge no previous data worldwide investigated the effects of interferon therapy in the treatment of hepatitis C virus [HCV] for longer than two years. So, this study was conducted to address the longer-term [3.5 years] Group II 59 patients, chronic HCV with no cirrhosis, [interferon group-I] received interferon 3MIU every other day for 6 months. 57 patients completed the interferon therapy as 2 patients excluded during interferon therapy.outcomes of clinical, virological, biochemical and clinical responses to interferon therapy and the change in incidence of hepatocellular carcinoma [HCC] and other HCV-related complications in-patients with chronic hepatitis C with and without liver cirrhosis. 139 patients in our study were classified into 4 groups Group I 20 patients, chronic HCV with no cirrhosis, [control group-1] received silymarin 70 mg thrice daily for 3.5 years. Group III 20 patients, chronic HCV with cirrhosis, [control group-2] received silymarin 70mg thrice daily for 3.5 years. Group IV 40 patients, chronic HCV with cirrhosis, [interferon group-2] received interferon 3MIU every other day. for 6 months. Evaluation of our patients during the study period was based on the followings 1] Response at the end of interferon therapy and 3 years after interferon withdrawal. 2] Incidence of liver decompensation. 3] Incidence of portal hypertension 4] Incidence of gastrointestinal bleeding. 5] Incidence of hepatocellular carcinoma. 1- Interferon alpha is effective in chronic hepatitis C and 49% of patients obtain a sustained benefit [long-term responders]. 2-The sustained response to interferon therapy in patients with chronic hepatitis C with cirrhosis is 0% after 3 years of stop interferon. 3-Interferon therapy significantly reduces the risk of developing portal hypertension, ascites and hepato-cellular carcinoma in patients with HCV cirrhosis irrespective of the virological response to interferon. - Early treatment of patients with chronic hepatitis C before reaching the stage of cirrhosis.- Proper selection of patient who is candidate for interferon therapy to increase the response rate. Cirrhosis should not be considered a reason for excluding patients with HCV- related liver disease from interferon therapy