VCU finds long-term use of interferon can prevent progression of hepatitis C

By Erin Lucero
Office of Development, School of Medicine

A Virginia Commonwealth University study has demonstrated for the first time that long-term use of interferon therapy for patients with chronic hepatitis C can prevent the disease’s progression. The study findings were published in the November issue of the journal Gastroenterology.

"If this study’s findings are confirmed, they strongly suggest that long-term interferon therapy can reduce the risk for liver cancer and ultimately could reduce the need for liver transplants," said Mitchell L. Shiffman, M.D., lead author of the study and chief of gastroenterology and hepatology at VCU’s Medical College of Virginia Hospitals. "This is critically important because hepatitis C infections and deaths have been forecasted for dramatic increases over the next two decades."

At least half the patients with chronic hepatitis C who undergo interferon therapy still have detectable levels of the hepatitis C virus in their blood after treatment. However, in some of these patients, interferon therapy has the alternative benefit of slowing or reversing liver damage caused by the virus. The VCU study shows that, even when HCV is still detectable, the long-term use of interferon therapy can provide long-term benefit by suppressing liver inflammation, which in turn could slow down or prevent the development of fibrosis and cirrhosis that lead to liver failure.

The study enrolled 53 chronic HCV patients for whom six months of interferon therapy had slowed or reversed HCV-induced liver damage even while HCV was still detectable in the blood. Study participants were randomly assigned to either discontinue treatment or continue treatment for an additional two years at a lower dose of interferon.

Eighty percent of the participants who continued interferon therapy suffered no additional liver inflammation and saw continued improvement in their liver despite the presence of HCV. In contrast, 30 percent of the participants who stopped treatment saw HCV levels rapidly return to pre-treatment status; their liver damage returned to pre-treatment levels within a year.

Building on the VCU research, the National Institutes of Health will sponsor a nine-center, nationwide trial that will enroll participants with chronic HCV for whom treatment has not eliminated the virus. The participants will be treated with a new long-acting and better tolerated form of interferon for up to four years. The study will determine whether the therapy can prevent HCV’s progression to cirrhosis, liver cancer and the need for liver transplantation. VCU will be one of the participating centers.

Affecting an estimated 4 million Americans, HCV is the most common blood-borne infection in the country and the leading cause of liver transplantation. According to the Centers for Disease Control and Prevention, treatment is effective in 10 percent to 40 percent of patients, with 8,000 to 10,000 deaths each year. The CDC estimates that about 70 percent of those infected with HCV may develop chronic liver disease, 15 percent may develop cirrhosis and five percent may die from consequences of long-term infection, such as liver cancer or cirrhosis.