Chapter 35 – Impact of interferon alpha-2b and of combination with ribavirin on progression of liver fibrosis in patients with chronic hepatitis C

Publisher Summary This chapter discusses the hypothesis that treatment with a combination of interferon (IFN) alpha-2b and ribavirin (R) alters the rate of progression of liver fibrosis that was examined among 1,972 chronic hepatitis C patients. A sustained virological response was obtained in 44% with IFN-R vs 15% with IFN and in 0% of controls. Hepatitis C virus (HCV) can be lethal when it leads to cirrhosis, the last stage of liver fibrosis. The annual rate of fibrosis decreased by 189% as compared to controls, septal fibrosis disappeared in 56% responders, the rate of fibrosis decreased by 66%, and progression to septal fibrosis was observed in only 15% nonresponders. These results, not apparent in individual trials, demonstrated that IFN-R dramatically reduces the rate of fibrosis progression. IFN-R combination treatment slows the rate of progression of liver fibrosis and therefore has an impact on the natural history of chronic hepatitis C. IFN-R has the potential to reduce the morbidity and mortality of chronic hepatitis C in sustained virological responders, and allow for stabilization of nonresponders awaiting new generations of drugs.