Improved histology with treatment

[orleans]

I have always heard that treatment can improve ones liver but studies showing that are rare.  Here is a small one.    

J Infect. 2006 Dec 26; : 17194480 (P,S,E,B,D) Impact of peginterferon alpha-2b and ribavirin treatment on liver tissue in patients with HCV or HCV-HIV co-infection.

[My paper] Rui Sarmento-Castro, Ana Horta, Olga Vasconcelos, Helena Coelho, Josefina Mendez, Ana Paula Tavares, João Seabra, Manuela Duarte, Leonor Chaves, Olga Fortes, Cristina Recalde, Angela Ventura, Nuno Pires, Luciana Pinho, Nancy Dias, Fátima Carneiro
Infectious Diseases Department, Hospital de Joaquim Urbano, Rua Câmara Pestana 348, 4369-004 Porto, Portugal.
OBJECTIVE: To evaluate the effect of treatment with peginterferon alpha-2b and ribavirin on liver histology in patients with chronic hepatitis C (CHC) with or without HIV infection. METHODS: Patients received peginterferon alpha-2b (1.5mu/kg/week during the first 4weeks; 1.0mu/kg/week thereafter) plus ribavirin (800-1200mg/day, adjusted for weight) for 24 (genotypes 2/3) or 48weeks (genotypes 1/4). Paired liver biopsy specimens were obtained at baseline and at the end of follow-up. RESULTS: 108 paired biopsy specimens were available: 67 from HCV-monoinfected and 41 from co-infected patients. At the end of follow-up, necroinflammatory activity (NIA) was significantly reduced (P/=1 point (Ishak et al criteria) in 65.7% of HCV-monoinfected patients. In co-infected patients, NIA was significantly reduced (P/=1 point in 42.5% of cases. In both groups, results were better for patients who attained sustained virological response (SVR). HCV RNA was undetectable in the second biopsy specimens of all patients who attained SVR. CONCLUSION: Liver fibrosis is reduced significantly after a course of therapy in patients with chronic hepatitis C. Reduction of fibrosis is more significant in patients who are monoinfected with HCV and in those who attained SVR.

[virgocharm]

what is inflamation? is it part of liver pain?

[nygirl7]

Inflammation is not fibrosis.

[orleans]

Once UND is attained does not the inflamation subside? Thus the normal ast/alt often experienced during the rest of treatment.

[nygirl7]

Thanks Friole - you might be one of the only people who have had the pre and post biopsies to be able to speak from experience. I remember when I first was starting treatment I was 'going to' but then now 18 months post I'm like do I REALLY wanna find out and go through all that? Nope. Chicken. Bak bak bak bak bak.

I agree - the progression will stop if you SVR and stop the inflammation but to assume the liver would become drastically altered in that short a time just makes no sense to me - what took 20 years to develop won't go away over night.

[frijole]

I believe that the liver is one of the only organs that can regenerate.  However, I don't think the damage can be reversed unless the inflammation caused by the hepatitis virus has stopped, and unless one achieves SVR, the inflammation continues.

My biopsy pre treatment was grade 1, stage 1-2.  I treated 56 weeks and relapsed.  My biopsy done last december (about 16 months post treatment) was grade 1, stage 1-2.  I waws disappointed that there was no improvement but grateful that there was no progression.

frijole