[Do the interferons have an antifibrotic action? The hepatologist's point of view]

Major progress in the treatment of hepatitis C has been achieved in the last ten years with an obvious histologic impact. The last approved regimen combines ribavirin (10.6 mg per kg) with pegylated interferon (1.5 microgram per kg) which permits to obtain improvement of necrosis and inflammation in 73% of patients with only 8% of fibrosis worsening. CURRENT KNOWLEDGE AND KEYS POINTS: Reversibility of post hepatitis C cirrhosis is now well documented. However, this reversibility has been observed mainly in young cirrhotic patients, particularly in those with sustained virologic response. For older patients with decompensated cirrhosis the reversibility has not been established. Interferon alpha directly or indirectly is indeed an effective anti-fibrotic agent in chronic hepatitis C. The indirect anti-fibrotic effect through the antiviral effect has been considerably improved by the pegylation and the association with ribavirin.