Long-term beneficial effects in sustained responders to interferon-alfa therapy for chronic hepatitis C

J Hepatol. 2001 May;34(5):748-55. doi: 10.1016/s0168-8278(01)00062-9.


Background/aims: Assessment of chronic hepatitis C outcome in sustained responders to interferon requires prolonged observation and close monitoring. We prospectively studied the impact of sustained response on histology and clinically relevant outcomes.

Methods: The 47 sustained responders (ten with cirrhosis) from two interferon trials involving 235 chronic hepatitis C patients (81 with cirrhosis) were included. Hepatitis C virus (HCV) RNA was assessed every 6 months, liver histological changes from baseline, 6-12 and 48-72 months after treatment discontinuation.

Results: The mean follow-up was 102 +/- 19 months. HCV RNA became undetectable in 36/47 responders. Four responders, who had remained viremic, later relapsed. The histology progressively improved in non-viremic and viremic patients, with a more marked improvement in the former (P = 0.0089), normalizing in 53 vs. 0% (P = 0.0220). No patient progressed to cirrhosis. One non-viremic cirrhotic patient developed a hepatocellular carcinoma. Non-responders from the two original trials had worse histological outcomes and those with cirrhosis had a higher rate of clinically relevant events compared with cirrhotics showing a sustained biochemical response (4.5 vs. 1.2 cases/100 person-years; CI for the difference, 0.3-6.3).

Conclusions: Most sustained, virological responders without cirrhosis normalize liver histology in the long-term and are cured of the disease. Sustained responders remaining viremic still show histological improvement, albeit to a lesser extent.

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use*
  • Carcinoma, Hepatocellular / virology
  • Esophageal and Gastric Varices / etiology
  • Female
  • Follow-Up Studies
  • Hepacivirus / genetics
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / pathology
  • Humans
  • Interferon-alpha / therapeutic use*
  • Liver / pathology
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / virology
  • Liver Neoplasms / virology
  • Male
  • Middle Aged
  • RNA, Viral / analysis
  • Randomized Controlled Trials as Topic
  • Treatment Outcome
  • Viremia / virology


  • Antiviral Agents
  • Interferon-alpha
  • RNA, Viral