Report from EASL; The European Association for the Study of the Liver Conference, Rotterdam, April 28-May 3, 2000 - Report 8

In this small study of 8 patients with decompensated cirrhosis (DC) secondary to HCV, no virologic response was achieved at the end-of-treatment but an ETR biochemical response was achieved.

G Ersoz, US Akarca, F Gunsar, R Vardar, Z karasu, Y Batur,
EU Medical School, Dept of Gastroenterology, Izmir, Turkey

We conducted a study to determine the effects of Interferon (IFN)+ribavirin (R) therapy on patients with decompensated cirrhosis. Eight patients (3 ascites, 5 variceal bleeding, aged 35-66) with HCV-related DC, whose ALT values are two-times higher than upper limit of normal, were included into the study. Patients have been treated with IFN-a2b, 3 million units TIW (3X/week) + ribavirin 1000-1200 mg/day for 6 months; clinical response, ALT, HCV-RNA, and side effects were investigated.

Results:

Two patients dropped out because of leukopenia and neurologic side effects in 1^st and 2^nd months. Six patients completed 6 months of treatment, but all of them missed some IFN (4, 12, 8, 6, 3, 1 doses, respectively), because of leukopenia and/or thrombocytopenia. All patients experienced a significant decrease in hemoglobin level (13.0± 1.1 vs. 12± 1.3); 3 of them needed a dose reduction of ribavirin. Following the 6 month treatment ALT values decreased significantly (122± 30 vs. 62± 25). None of the cases became HCV-RNA negative. One patient with ascites became ascites-free. None experienced a worsening of clinical signs. There were no differences in Child-P scores before and after treatment (6.0± 1.2 vs. 5.5± 0.8).

The authors concluded:

IFN+Ribavirin treatment is able to induce end-of-treatment biochemical response, but fails to achieve virologic response in patients with HCV related decompensated cirrhosis. Although that treatment has potentially serious side effects, with close follow-up it may help some decompensated cirrhotics improve to compensated state.