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Aspartate aminotransferase to the platelet ratio index after treatment for hepatitis C

The latest issue of the European Journal of Gastroenterology & Hepatology investigates the durability of a sustained virological response and long-term changes in aspartate aminotransferase to the platelet ratio index after successful treatment with peginterferon/ribavirin for chronic hepatitis C

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Previous studies, mostly retrospective using conventional interferon, have suggested a favorable prognosis for patients with chronic hepatitis C and a sustained virological response.

However, long-term outcome, including changes in the degree of hepatic fibrosis, of sustained virological response patients in the era of pegylated interferon remains underdefined.

Dr Vasilios Papastergiou and colleagues reported that they prospectively evaluated the long-term virological, clinical, and biochemical outcomes, including aspartate aminotransferase-to-platelet ratio index, in chronic hepatitis C patients with a sustained virological response.

The team included 145 consecutive, treatment-naive chronic hepatitis C patients who achieved an sustained virological response after combination therapy with pegylated interferon-α/ribavirin.

The mean follow-up time was 69 months.

The researchers noted that the overall incidence of hepatocellular carcinoma and liver-related death was 1.4% and 0.7%, respectively.

Among 9 patients with pretreatment cirrhosis, 2 developed hepatocellular carcinoma, and 1 of them died.

The risk of progression to hepatocellular carcinoma was as high as 22%
European Journal of Gastroenterology & Hepatology

No patient had conclusive evidence of late virological relapse.

The team of doctors examined that all patients retained normal liver biochemistry, except for 5 of 145, who had persistently elevated transaminase levels, all of whom were diagnosed with new liver disease.

The research team found that aminotransferase-to-platelet ratio index values improved significantly with treatment and continued to improve after a mean of 61 months from an sustained virological response in patients with significant pretreatment fibrosis.

Dr Vasilios's team concluded, "The long-term outcome, including aminotransferase-to-platelet ratio index, of chronic hepatitis C patients treated successfully with pegylated interferon/ribavirin and followed for a mean of about 6 years is favorable."

"However, a high risk of progression to hepatocellular carcinoma and liver-related death remains for patients with pretreatment cirrhosis, in our setting, as high as 22%, and 11%, respectively."

Euro J of Gastroenterol & Hepatol 2013: 25(7): 798-805
20 June 2013

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