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Effect of Peginterferon Alfa-2a (Pegasys) on Liver Histology in Chronic HCV
by Revenire, Feb 27, 2004 12:00AM
This is very good news and adds evidence to the histolgic effects of interferon.
If anyone doesn't achieve the "12 week 2 log drop" magic number this is a good study to show to the doctors if they want you to stop treatment.
“In patients with chronic hepatitis C with or without cirrhosis, peginterferon alfa-2a (relative to IFN) significantly reduced fibrosis. The beneficial effects of peginterferon on liver histology are closely related to virologic response.”
Effect of Peginterferon Alfa-2a (Pegasys) on Liver Histology in Chronic Hepatitis C
If anyone doesn't achieve the "12 week 2 log drop" magic number this is a good study to show to the doctors if they want you to stop treatment.
“In patients with chronic hepatitis C with or without cirrhosis, peginterferon alfa-2a (relative to IFN) significantly reduced fibrosis. The beneficial effects of peginterferon on liver histology are closely related to virologic response.”
Effect of Peginterferon Alfa-2a (Pegasys) on Liver Histology in Chronic Hepatitis C
This is not great news for those who do not respond.
Unfortunately for those who do not, the rates of histological progression is back to where it was within one to two years and can be worse in some patients.
So, for those with mild histology to begin with, who are female or who have low risk for progression, and who are genotype 1, this might be something to consider before making the decision to treat. Women of childbearing age also have issues to consider with regard to Interferon therapy.
Here is an article on that.
I hope this helps,
thanbey
Rats! I thought I was getting this down...........
sorry about that
thanbey
After reading the articles I am now seriously considering to stop treatment.. I now feel that I have false hope and have been in denial.. Thank you for the reality check. EDGAR
While it is clear that people who achieve a SVR benefit the most from the antifibrotic effects of peginterferons don't a certain percentage of nonresponders also benefit?
It seems to me that the jury is still out on that question.
We won't know that until the HALT-C (studying Pegasys) and COPILOT (studying PEG-Intron) studies are completed, or later. These, to my knowlegde, are large studies -- both involving over 1000 patients.
"Both studies will attempt to determine whether long-term treatment with low-dose pegylated interferon can help delay the development of fibrosis and cirrhosis, slow the progression from compensated to decompensated cirrhosis, and reduce the chances of developing liver cancer (hepatocellular carcinoma)."
How long after completing treatment does it take for any benefit to show up in a biopsy? Two years? Five? One?
Best,
Scott
So, yes, it is possible that non-responders can be maintained and receive a certain amount of histological improvement as long as they are on low dose monotherapy.
When you break it down, it looks like this:
Less than 50% of genotype 1's realize an SVR and of that some, but not all, have some histological benefit.
Those who do not respond, may have to be on interferon for a long time or intermittently for a long time, perhaps life (like insulin for diabetics) if they can tolerate the medications.
That is why, since most people do not progress or die of hepatitis C once they are diagnosed, it is really important to assess whether the risks (sides, adverse events, and possible non-responde) outweight the benefits. There has been at least one study out of the Harvard School of Public Health that concluded that the risks do outweigh the benefits for those (particulalry women) who have mild disease.
So, it isn't a matter of whether treatment is good, bad or ugly. It is a matter of optimal timing and the real likelihood that there are better options coming along for those who can wait. It might just be that those who can, should. This is one of the reasons Roche has been very careful about the 12 week PCR result. There AMY be less risk of being interferon dependent if those who probably are not going to respond discontinue if the 12 week PCR is still positive or has not revealed a 2 log drop in viral load.
I hope this helps.
thanbey
Hepatitis C Outreach Project
If I hadn't tx'ed, I'ld be dead.
You asked how I was. Well, I'm good b/have to watch for fluid build up. I'm looking for a good mild herbal diuritic. Also, the encephalitis-ammonia thing. Its just a balance of diet, exercise and rest. I feel much better, so good in fact, that I have to pace myself, b/c my energy is not boundless anymore.
I feel as if my liver has really improved since the hep c is gone. And I've learned not to add further insult to the liver's injuries. The longer I stay away from drugs and alcohol, the more I realize I no longer need or want them. And my liver thanks me, too. It's kinda like a pet now.
I feel that at many times this forum has been very helpful, and many times it has been a depressant.
Maybe the time has come for me to put this forum down for a while.
Thank you ... Edgar