Changes in histological lesions and serum fibrogenesis markers in chronic hepatitis C patients non-responders to interferon alpha

Background/Aims: The aim of this study was to evaluate the: changes in histological lesions and serum N-terminal peptide of type III procollagen (PIIINP) and hyaluronate (HA) levels in virologic non-responder patients treated by Interferon alpha (IFN alpha). Methods: We enrolled 183 patients treated by IFN alpha and 56 controls, all with paired biopsy specimens. Yearly liver fibrosis progression was estimated before and during a follow-up of 1 year. Results: By contrast to sustained responders, non-responders (n = 105) did not achieve improvement of histological scores after therapy. Their yearly fibrosis progression rate was similar before and during follow-up (0.18, 95% CI: 0.16-0.20, vs 0.26 (95% CI: 0.12-0.40) fibrosis units/year, NS), and was not different in controls (0.17, 95% CI: 0.06-0.27). The levels of PIIINP and hyaluronate (HA) remained unchanged during follow-up. Histological improvement was observed for the second biopsy in 25% of non-responders, but also in 23 % of controls. This improvement was not correlated with decrease of AET level, viral load, PIIINP, or HA. Conclusions: Our results suggest that IFN alpha therapy is unable to decrease PIIINP or HA levels and cannot improve the histological outcome in virologic non-responder patients. The histological improvement observed in a subset of patients may be linked to sample fluctuation or lack of reproducibility of histological scores. (C) 2001 European Association for the Study of the Liver. Published by Elsevier Science B.V. All rights reserved.