Morphological study of liver in patients of chronic hepatitis C treated with interferon

The effect of interferon therapy on liver morphology was assessed in ten patients with serologically proven chronic hepatitis C. All these patients received 3 million units of alpha interferon three times a week. Six patients received therapy for 6 months, two patients for 12 months, one patient each for 3 and 9 months. All patients underwent a second liver biopsy 1 to 6 months after cessation of therapy. Alanine aminotransferase levels were determined before, during and after therapy. Each biopsy was assessed histologically by revised classification of chronic hepatitis proposed by Desmet et al and Kondell histological activity index was determined. Four patients showed significant reduction in the necroinflammatory activity with decrease in the HAI and normalisation of ALT level. Three patients showed partial reduction in the necroinflammatory activity with partial reduction of ALT levels. Two patients did not show any change in the grade of disease while one patient showed worsening of necroinflammatory activity with rising ALT levels. One patient showed a significant reduction in fibrosis with conversion of early developing cirrhosis into bridging fibrosis. A second liver biopsy is extremely useful for assessing the response of interferon treatment, however, it must be done at a suitable time after cessation of therapy.