Impact of peginterferon alpha-2b and ribavirin treatment on liver tissue in patients with HCV or HCV–HIV co-infection

Summary 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 (1.5 μ/kg/week during the first 4 weeks; 1.0 μ/kg/week thereafter) plus ribavirin (800–1200 mg/day, adjusted for weight) for 24 (genotypes 2/3) or 48 weeks (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 < 0.001), and fibrosis scores improved by ≥1 point (Ishak et al criteria) in 65.7% of HCV-monoinfected patients. In co-infected patients, NIA was significantly reduced ( P < 0.001), and fibrosis scores improved by ≥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.