Long-term follow-up of chronic hepatitis C patients with sustained virological response to alpha-interferon

Background/Aims: This study aimed to determine the long-term outcome of hepatitis C virus (HCV)-in-fected patients who respond to interferon treatment with clearance of serum HCV RNA. Methods: We performed a long-term biochemical, virological, and histological follow-up of all sustained virological responders, defined as those who became HCV RNA negative at follow-up 6 months after the end of treatment, from 3 controlled interferon trials performed in Sweden between 1988 and 1994. Results: At biochemical and virological long-term follow-up performed in 26 sustained virological responders 3.5–8.8 years (mean±SD, 5.4±1.6 years) after the end of IFN therapy, 22 patients (85%) had normal serum ALT levels, and 24 patients (92%) were HCV RNA negative in serum. Liver biopsies performed in 23 patients 2.1–8.7 years (mean±SD, 5.0±1.8 years) after end of treatment showed no or minimal inflammation, whereas mild and probably irreversible fibrosis was seen in a few patients. Conclusion: In this well-defined material of sustained responders to IFN therapy, the long-term prognosis was excellent. Nearly all had a durable response, not only biochemically and virologically, but more importantly also histologically with normalisation or near normalisation of previous histological lesions.