Liver Function under Interferon/Ribavirin Therapy of Chronic Hepatitis C

Background: Quantitative testing of liver function (QTLF) is one way to show the efficacy of antiviral treatment of Hepatitis C. Data on liver function in patients with chronic Hepatitis C during antiviral 'therapy are lacking. We therefore investigated if and to what extent antiviral therapy influenced quantitative testing of liver function (QTLF). Methodology: One hundrend seven patients with chronic Hepatitis C (genotype 1) were treated with pegylated-interferon 2 alpha/ribavirin for 48 weeks. Quantitative testing of liver function, including aminopyrine breath test (ABT), galactose elimination capacity (GEC), sorbitol clearance (SCl) and indocyanine green clearance (ICG) was performed before and 12 weeks after initiation of antiviral therapy. QTLF was repeated at the end of the therapy (week 48) and 6 months after therapy. Results: After 3 months of treatment, 97 patients showed normal transaminases and were negative for HCV-RNA. ABT and GEC as parameters of microsomal and cytosolic liver function were reduced in all patients before therapy initiation and returned to normal values in the therapy responders after 3 months. Parameters of liver perfusion (SCl and ICG) require one year of treatment before returning to normal levels. In non-responders, QTLF did not change during therapy, in relapsers, QTLF results deteriorated after ending the therapy. Conclusion: All liver tests return to normal within one year after eradication of the Hepatitis C virus. Parameters measuring the liver plasma flow (SCl and ICG) require more time to become normal, most likely due to tissue remodelling processes.