Document Detail


Impact of pegylated interferon alfa-2b and ribavirin on liver fibrosis in patients with chronic hepatitis C.
MedLine Citation:
PMID:  11984517     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Liver fibrosis is an important prognostic factor in patients with hepatitis C. The effect of pegylated (PEG) interferon alone or its combination with ribavirin on fibrosis has not been established. METHODS: We pooled individual data from 3010 naive patients with pretreatment and posttreatment biopsies from 4 randomized trials. Ten different regimens combining standard interferon, PEG interferon, and ribavirin were compared. The impact of each regimen was estimated by the percentage of patients with at least 1 grade improvement in the necrosis and inflammation (METAVIR score), the percentage of patients with at least 1 stage worsening in fibrosis METAVIR score, and by the fibrosis progression rate per year. RESULTS: Necrosis and inflammation improvement ranged from 39% (interferon 24 weeks) to 73% (optimized PEG 1.5 and ribavirin; P < 0.001). Fibrosis worsening ranges from 23% (interferon 24 weeks) to 8% (optimized PEG 1.5 and ribavirin; P < 0.001). All regimens significantly reduced the fibrosis progression rates in comparison to rates before treatment. The reversal of cirrhosis was observed in 75 patients (49%) of 153 patients with baseline cirrhosis. Six factors were independently associated with the absence of significant fibrosis after treatment: baseline fibrosis stage (odds ratio [OR] = 0.12; P < 0.0001), sustained viral response (OR = 0.36; P < 0.0001), age < 40 years (OR = 0.51; P < 0.001), body mass index < 27 kg/m(2) (OR = 0.65; P < 0.001), no or minimal baseline activity (OR = 0.70; P = 0.02), and viral load < 3.5 millions copies per milliliter (OR = 0.79; P = 0.03). CONCLUSIONS: PEG-interferon and ribavirin combination significantly reduces the rate of fibrosis progression in patients with hepatitis C.
Authors:
Thierry Poynard; John McHutchison; Michael Manns; Christian Trepo; Karen Lindsay; Zachary Goodman; Mei-Hsiu Ling; Janice Albrecht
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Gastroenterology     Volume:  122     ISSN:  0016-5085     ISO Abbreviation:  Gastroenterology     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-01     Completed Date:  2002-05-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1303-13     Citation Subset:  AIM; IM    
Affiliation:
Service d'Hépato-Gastroentérologie, Groupe Hospitalier Pitié-Salpêtrière, Université Paris VI, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antiviral Agents / administration & dosage*
Drug Therapy, Combination
Hepatitis C, Chronic / drug therapy*
Humans
Interferon Alfa-2b / administration & dosage*
Liver Cirrhosis / drug therapy*
Polyethylene Glycols / administration & dosage*
Ribavirin / administration & dosage*
Chemical
Reg. No./Substance:
0/Antiviral Agents; 0/Polyethylene Glycols; 36791-04-5/Ribavirin; 99210-65-8/Interferon Alfa-2b
Comments/Corrections
Comment In:
Gastroenterology. 2002 May;122(5):1525-8   [PMID:  11984538 ]
Z Gastroenterol. 2003 Mar;41(3):271-4   [PMID:  16308928 ]
Gastroenterology. 2003 Apr;124(4):1166-7   [PMID:  12671922 ]
Gastroenterology. 2003 May;124(5):1561   [PMID:  12760398 ]
Gastroenterology. 2003 Jun;124(7):2003-4; author reply 2004-5   [PMID:  12812198 ]
Gastroenterology. 2003 Aug;125(2):629-30; author reply 630-31   [PMID:  12891578 ]
Gastroenterology. 2003 Feb;124(2):584; author reply 584-5   [PMID:  12557174 ]

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