Abstract
Methods: We studied 157 patients in accordance with the inclusion criteria, who underwent paired liver biopsies from 1994 to 2012. Ninety-three patients had treatment failure (TF) and 64 patients were treatment-naive (TN). Annual fibrosis progression rate (FPR) was calculated and significant fibrosis progression (SFP) was defined as ≥2 stage increase in fibrosis during follow-up. Because of the differences in baseline biochemical and histological features, multiple regression analyses with backward elimination were performed to find out independent predictors of SFP and FPR. Results: Demographic characteristics and duration between paired liver biopsies were similar in TF and TN-groups. Baseline ALT and GGT levels (82±48 vs. 45±20 and 60±45 vs. 36±27, respectively), baseline mean fibrosis stage (2.9±1.1 vs. 1.9±0.8) and histologic activity index (6.7±1.9 vs. 4.3±1.6) were higher in TF-group compared to TN-group (p < 0.001). According to regression analyses strongest independent predictor of fibrosis progression was GGT level (OR: 1.03, 95%CI 1.01–1.5, p < 0.001). Treatment experience (OR: 4.55, 95%CI 1.27–16.2, p = 0.02) and follow-up ALT levels (OR: 4.20, 95%CI 1.41–12.5, p = 0.01) also appeared independent predictors of FPR and SFP. Conclusion: Failed interferon-based treatment against CHC may lead to accelerated FPR in long-term compared to natural course.
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