Liver fibrosis and hepatic stellate cells improvement of chronic hepatitis C patients by interferon-beta-1a with or without sustained viral response.
Author(s): Rao HY, Wei L, Li J, Zhang LF, Chen HY, Zhu LM, Liu F, Sun Y, Wang H
Affiliation(s): Peking University People's Hospital, Peking University Hepatology Institute, Beijing, China.
Publication date & source: 2009-03, Hepatogastroenterology., 56(90):328-34.
Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't
BACKGROUND/AIMS: We aimed to assess liver fibrosis in biopsies from patients with chronic hepatitis C and relationship to different responses to interferon-beta-la. METHODOLOGY: 21 patients with chronic hepatitis C were divided into two groups randomly and treated with recombinant human interferon-beta-la (IFN-B-1a) or IFN-beta-1a plus ribavirin (RBV) for 24 weeks, then followed up for another 24 weeks. 42 liver biopsies of 21 patients before and after treatment respectively were evaluated on conventional histological assessment. Then we studied 21 patients liver biopsies by immunohistochemical analysis of alpha-smooth muscle actin (alpha-SMA) and collagen type III. RESULTS: A significant improvement in HAI fibrosis staging was detected after therapy in all sustained viral responders (SVR) and non-responders (NR) patients. The percentages of cases with HAI scores and fibrosis staging decreased obviously were 100.0% and 71.4% in SVR patients and 50.0% and 42.9% in NR patients. The patients with combination therapy or normal ALT on 48w would more often receive the HAI and fibrosis staging decrease. The significantly lower alpha-SMA-positive HSCs and mean expression level of collagen type III were detected in the post-treatment biopsies. The HAI, alpha-SMA, collagen type III values were significantly correlated with the values of the semiquantitative indexes of fibrosis. CONCLUSIONS: IFN-beta-1a therapy is effective for patients with chronic hepatitis C on liver histology regardless of viral response. The alpha-SMA-positive HSCs and collagen type III expression are responsible for liver fibrosis.