Long-term follow up of chronic hepatitis C patients after α-interferon treatment:: A functional study

Aim: To evaluate the long-term functional outcome of chronic hepatitis C (CHC) patients treated with interferon (IFN) therapy. Methods: Thirty-six patients with CHC were followed up for a mean of 36 months (+/-19, SD) after a course of IFN therapy. Biochemical, virological (qualitative hepatitis C virus (HCV)-RNA and HCV genotype), and functional (monoethylglycinexylidide (MEGX) test) evaluations were carried out at the time of liver biopsy. Patients were divided into long-term responders (LTR), relapsers (RR), or non-responders (NR) according to IFN therapy outcome. At the end of follow up, patients were noninvasively re-evaluated by means of biochemistry, qualitative HCV-RNA, MEGX test, and liver ultrasonography. Results: A significant decrease in MEGX values was observed in all patients. However, when patients were examined according to treatment outcome, only NR and RR showed a significant decrease in liver function as compared to pretreatment levels (MEGX(30), 80.5 +/- 26.8-62.9 +/- 24.2 ng/mL, P < 0.01; MEGX(60), 72.9 +/- 18.1-60.5 +/- 19.7 ng/mL, P < 0.05; MEGX(AUC), 3816 +/- 1243-3095 +/- 1205 ng/mL per h, P < 0.05). On the contrary, LTR patients showed no significant modifications in MEGX values at each sampling time (MEGX(15), 72.9 +/- 31.4-70.3 +/- 29.7 ng/mL; MEGX(30), 84.0 +/- 27.6- 71.5 +/- 21.8 ng/ mL; MEGX(60), 69.5 +/- 26.8-63.2 +/- 14.4 ng/ mL; MEGX(AUC) 4028 +/- 1378-3620 +/- 1041 ng/ mL per h). At the end of follow up, LTR patients showed normal liver biochemistry and negativity of serum HCV-RNA, while NR and RR patients showed a significant decrease in platelets. Conclusions: In CHC patients long-term response to IFN therapy, besides favoring positive clinical and virologic long-term outcome, results in maintaining preserved liver function. Furthermore, IFN therapy seems to determine a decrease in the rate of functional disease progression, even in NR and RR. The MEGX test may be considered as a useful tool for performing serial follow up of CHC patients. (C) 2001 Blackwell Science Asia Pty Ltd.