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Theeffect of achieving a sustained virological response (SVR) followinginterferon-alpha (IFNalpha) treatment on the clinical outcomes of patients withHCV-related cirrhosis is unknown. In an attempt to assess the risk ofliver-related complications, HCC and liver-related mortality in patients withcirrhosis according to the response to IFNalpha treatment, a retrospectivedatabase was developed including all consecutive patients with HCV-related,histologically proven cirrhosis treated with IFNalpha monotherapy betweenJanuary 1992 and December 1997. SVR was an undetectable serum HCV-RNA by PCR 24weeks after IFNalpha discontinuation. HCC was assessed by ultrasound every 6months. Independent predictors of all outcomes were assessed by Cox regressionanalysis. Of 920 patients, 124 (13.5%) were classified as achieving a SVR.During a mean follow-up of 96.1 months (range: 6-167) the incidence rates per100 person-years of liver-related complications, HCC and liver-related deathwere 0, 0.66, and 0.19 among SVR and 1.88, 2.10, and 1.44 among non-SVR(P<0.001 by log-rank test). Multivariate analyses found that non-SVR wasassociated with a higher risk of liver-related complications (hazard ratio, HR,not applicable), HCC (HR 2.59; 95% CI 1.13-5.97) and liver-related mortality(HR 6.97; 95% CI 1.71-28.42) as compared to SVR. CONCLUSION: Thus, in patientswith HCV-related, histologically proven cirrhosis, achievement of a SVR afterIFNalpha therapy was associated with a reduction of liver-related mortalitylowering both the risk of complications and HCC development. Irrespective ofSVR achievement, all patients should continue surveillance because the risk ofoccurrence of HCC was not entirely avoided. Leggil'articolo