One aim of our study was to define the impact of Peg-IFN maintenance therapy on www.selleckchem.com/products/a-769662.html hepatic function

in patients with advanced, but compensated, chronic HCV. In three large clinical trials, maintenance therapy failed to slow disease progression or reduce clinical outcomes.22-24 In the HALT-C Trial, serum HCV RNA and ALT and hepatic inflammation were reduced by maintenance therapy.22 The latter effects could potentially reflect a reduction in hepatic injury, which might improve hepatic function or blood flow. However, in the current study, Peg-INF maintenance therapy failed to improve any of the serially performed QLFTs—a group of tests that evaluated a broad range of hepatic functions and blood flow. The lack of improvement in QLFTs in the current study provides additional evidence that maintenance therapy with low-dose Peg-IFN is AP24534 datasheet ineffective. Another major aim of our study was to evaluate the independent ability of QLFTs to predict future clinical outcomes. Our patient cohort was ideal for addressing this aim because all had advanced fibrosis, all were at risk for future clinical outcome, and none had experienced previous decompensation. In follow-up, 24% of our cohort experienced a clinical outcome similar to the rate of clinical outcome observed in the HALT-C

Trial as a whole.22 Our results are likely representative of the whole HALT-C cohort, and the general population of, compensated patients with advanced chronic HCV. Because QLFTs monitor changes in hepatic metabolism and blood flow, changes common to all liver diseases, they could potentially be useful in monitoring patients with any liver disease. Despite a 48.5% prevalence of hepatic steatosis in our cohort, the relationships of CA Cls, shunt, and PHM to stages of hepatic fibrosis and cirrhosis are preserved and not altered by body mass index (BMI), hepatic steatosis, homeostasis model assessment (HOMA) score, hepatic inflammation, alcohol use, and smoking.19 In addition, SPECT liver-spleen scan has correlated with the severity of a variety of liver diseases.25-28 Progression of chronic

all HCV is characterized pathologically by accumulation of fibrosis and physiologically by impairment of hepatic function and blood flow. In our study, we measured physiologic impairment using a battery of QLFTs. We previously demonstrated that these QLFTs predicted cirrhosis, stage of fibrosis, varices, and variceal size.19 Also, they identified the subgroup of patients with the most severe disease who failed to respond to antiviral therapy and tracked improvement in hepatic function after SVR.20 In the current study, QLFTs identified patients with the greatest hepatic impairment who developed clinical outcomes. We defined cutoffs for QLFTs that predicted risk for future clinical decompensation over a median duration of follow-up of 5.5 years.