The presence of steatosis and elevation of alanine aminotransferase levels are associated with fibro

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Journal of Hepatology

Volume 48, Issue 5, May 2008, Pages 736-742

The presence of steatosis and elevation of alanine aminotransferase levels are

associated with fibrosis progression in chronic hepatitis C with non-response to

interferon therapy

Masayuki Kurosaki1, Kotaro Matsunaga1, Itsuko Hirayama1, Tomohiro Tanaka1,

Mitsuaki Sato1, Nobutoshi Komatsu1, Naoki Umeda1, Takanori Hosokawa1, Ken Ueda1,

Kaoru Tsuchiya1, Hiroyuki Nakanishi1, Jun Itakura1, Yasuhiro Asahina1, Shozo

Miyake1, Nobuyuki Enomoto2 and Namiki Izumi1, ,

1Division of Gastroenterology and Hepatology, Musashino Red Cross Hospital,

1-26-1 Kyonan-cho, Musashino-shi, Tokyo 180-8610, Japan

2First Department of Internal Medicine, University of Yamanashi, Yamanashi,

Japan

Received 20 July 2007; revised 8 October 2007; accepted 17 December 2007.

Associate Editor: J.G. McHutchison. Available online 26 February 2008.

References and further reading may be available for this article. To view

references and further reading you must purchase this article.

Background/Aims

Interferon (IFN) therapy leads to regression of hepatic fibrosis in chronic

hepatitis C patients who achieve a sustained virologic response (SVR), while the

beneficial effect is limited in those who fail to do so. The aim of the present

study was to define factors associated with progression of fibrosis in patients

who do not achieve a SVR.

Methods

Fibrosis staging scores were compared between paired liver biopsies before and

after IFN in 97 chronic hepatitis C patients who failed therapy. The mean

interval between biopsies was 5.9 years. Factors associated with progression of

fibrosis were analyzed.

Results

Fibrosis progressed in 23%, remained unchanged in 47% and regressed in 29%.

Steatosis and a high average alanine aminotransferase (ALT) between biopsies

were independent factors for progression of fibrosis with risk ratios of 5.53

and 4.48, respectively. Incidence and yearly rate of progression of fibrosis was

64% and 0.22 ± 0.29 fibrosis units per year in those with both risk factors

compared to 8% and −0.04 ± 0.17 fibrosis units per year in those negative for

both factors.

Conclusions

Hepatic steatosis and elevated ALT levels are risk factors for progression of

fibrosis in chronic hepatitis C patients who fail to achieve a SVR to IFN

therapy and therefore may be therapeutic targets to halt the potentially

progressive disease.

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df6bef316eef4331d1134247bfffd

Journal of Hepatology

Volume 48, Issue 5, May 2008, Pages 736-742

The presence of steatosis and elevation of alanine aminotransferase levels are

associated with fibrosis progression in chronic hepatitis C with non-response to

interferon therapy

Masayuki Kurosaki1, Kotaro Matsunaga1, Itsuko Hirayama1, Tomohiro Tanaka1,

Mitsuaki Sato1, Nobutoshi Komatsu1, Naoki Umeda1, Takanori Hosokawa1, Ken Ueda1,

Kaoru Tsuchiya1, Hiroyuki Nakanishi1, Jun Itakura1, Yasuhiro Asahina1, Shozo

Miyake1, Nobuyuki Enomoto2 and Namiki Izumi1, ,

1Division of Gastroenterology and Hepatology, Musashino Red Cross Hospital,

1-26-1 Kyonan-cho, Musashino-shi, Tokyo 180-8610, Japan

2First Department of Internal Medicine, University of Yamanashi, Yamanashi,

Japan

Received 20 July 2007; revised 8 October 2007; accepted 17 December 2007.

Associate Editor: J.G. McHutchison. Available online 26 February 2008.

References and further reading may be available for this article. To view

references and further reading you must purchase this article.

Background/Aims

Interferon (IFN) therapy leads to regression of hepatic fibrosis in chronic

hepatitis C patients who achieve a sustained virologic response (SVR), while the

beneficial effect is limited in those who fail to do so. The aim of the present

study was to define factors associated with progression of fibrosis in patients

who do not achieve a SVR.

Methods

Fibrosis staging scores were compared between paired liver biopsies before and

after IFN in 97 chronic hepatitis C patients who failed therapy. The mean

interval between biopsies was 5.9 years. Factors associated with progression of

fibrosis were analyzed.

Results

Fibrosis progressed in 23%, remained unchanged in 47% and regressed in 29%.

Steatosis and a high average alanine aminotransferase (ALT) between biopsies

were independent factors for progression of fibrosis with risk ratios of 5.53

and 4.48, respectively. Incidence and yearly rate of progression of fibrosis was

64% and 0.22 ± 0.29 fibrosis units per year in those with both risk factors

compared to 8% and −0.04 ± 0.17 fibrosis units per year in those negative for

both factors.

Conclusions

Hepatic steatosis and elevated ALT levels are risk factors for progression of

fibrosis in chronic hepatitis C patients who fail to achieve a SVR to IFN

therapy and therefore may be therapeutic targets to halt the potentially

progressive disease.

_________________________________________________________________

Make Windows Vista more reliable and secure with Windows Vista Service Pack 1.

http://www.windowsvista.com/SP1?WT.mc_id=hotmailvistasp1banner