Correlation Between Peritoneoscopic Findings and Response to Interferon in Patients with Chronic Hepatitis C

Abstract

Abstract:This study was designed to investigate the correlation between peritoneoscopic liver surface findings and the alanine aminotransferase (ALT) response to interferon, and to identify peritoneoscopic findings potentially useful as predictors of interferon responsiveness, in chronic hepatitis C. In all, 119 patients with hepatitis C viremia and histological evidence of chronic hepatitis received interferon alpha, in total doses of 258 to 660 million units (MU). A sustained response was seen in 29 cases (24%), a transient response with ALT relapse after therapy completion in 41 (35%) and no response in 49 (41%). Among 64 type 1 b cases, 8 (13%) showed sustained, 27 (42%) transient and 29 (45%) no response. The sustained response rate was higher with Shimada's code 200 than with code 300 or 400, even for type 1b. Interferon therapy was ineffective in more than 50% with code 300 or 400, especially in type 1b, suggesting that interferon efficacy decreases with disease progression. The sustained response rate was significantly higher, and that of no response significantly lower, in patients without reddish liver surface markings than in those with such markings (p<0.05), even in type lb. About 50% of those with reddish markings showed no response, indicating that absence of reddish markings may be a useful predictor of sustained response. The liver fibrosis score was significantly higher in the no response than in the transient and sustained response groups (p<0.02).In summary, patients with reddish liver surface markings and/or advanced fibrosis do not show a good response to interferon.