The Impact of Tobacco Smoking on Disease Progression and Response to Treatment in Chronic Hepatitis C
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- Category: Vol. 77, December 2009
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The Impact of Tobacco Smoking on Disease Progression and Response to Treatment in Chronic Hepatitis C,KAMAL EL-DEEN EL-ATREBI, HALA T. EL-BASSYOUNI and EHSSAN H. HASSAN
Abstract
Smoking plays a deleterious role in progression of chronic HCV disease. The aim of the work is to assess the effect of cigarette smoking on disease progression and response to the treatment in chronic hepatitis C. 100 compensated male Chronic HCV patients were subjected to full history taking including full detailed history of tobacco smoking. Patients were divided into two groups: Chronic heavy smokers (who smoke more than 20cig/day and for more than 20 packs/year) and non-smokers groups. Full general and abdominal exami-nation (excluding symptoms and signs of chronic liver disease), full laboratory investigations, and liver biopsy were done as a pre-enrollment for combination therapy (Peg-IFN-alpha and RBV).
The smokers were 38 (38%) while non-smokers were 62 (62%). The histological activity grades were as followed: mild 64 (64.0%), moderate 22 (22.0%) and severe 14 (14.0%). There were no fibrosis in 8 (8%), early fibrosis in 58 (58%) and advanced fibrosis was in 34 (34%). 12 (12%) out of the one hundred patients were non-responder to Peg-IFN and ribavirin combined therapy and 88 (88%) were responders.
Smokers showed highly significant increase in moderate and severe necro-inflammation versus non smokers. There was no statistically significant difference between the two groups in the early stage of liver fibrosis in spite of increase in advanced fibrosis in the smoker group. All the smokers had degree of fibrosis, while 6.5% of the non-smoker showed no fibrosis. Concerning the response rate of chronic HCV to the combined therapy of Peg-IFN and Ribavirin we did not find a significant difference between the two groups.
In Conclusion: Smoking plays a deleterious role in pro-gression of chronic HCV disease because of enhancing the necro-inflammatory activity. Although additional work is necessary to confirm, these findings may raise the possibility that smoking could play a role in aggravating liver fibrosis. Therefore, it is highly recommended to quit smoking especially in chronic HCV patients.