TITLE: Interferon therapy lowers the rate of
progression to hepatocellular carcinoma in chronic hepatitis C but
not significantly in an advanced stage: a retrospective study in
1148 patients. Viral Hepatitis Therapy Study Group.
BACKGROUND/AIM: Hepatocellular carcinoma frequently develops
during the advanced stages of chronic hepatitis C. We examined
whether interferon prevents the development of hepatocellular
carcinoma in chronic hepatitis C patients.
METHODS: Japanese patients with chronic hepatitis C (n = 1.148;
117 with portal fibrous expansion (F1), 636 with bridging fibrosis
(F2), 355 with bridging fibrosis and architectural distortion (F3))
and 40 cirrhotic (F4) patients were treated with interferon. These
patients were followed from 1 to 7 years after interferon therapy.
Blood tests and image analysis were serially performed to assess
response to interferon and to detect hepatocellular carcinoma.
Fifty-five cirrhotic type C patients (control F4) not receiving
interferon were enrolled in this study.
RESULTS: Sustained (SR: 27.5%) and transient (TR: 23.0%)
responders totaled 50.5%, while 49.5% did not respond to
interferon. SR showed an improvement in disease stage reflected by
increased platelet counts. Fifty-two patients (9 F2, 36 F3, and 7
F4) developed hepatocellular carcinoma in the follow-up period; 3
SR, 8 TR, and 41 non-responders (NR). The cumulative incidence of
hepatocellular carcinoma in F2 was significantly lower (p = 0.019)
in SR compared with NR, but not in SR in F3 and F4 patients.
However, the cumulative incidence of hepatocellular carcinoma was
significantly decreased in all SR (p = 0.0001) and TR (p = 0.0397)
compared with all NR. CONCLUSION: These results indicate that
interferon therapy in chronic hepatitis C patients lowered the rate
of progression of hepatocellular carcinoma in sensitive cases but
not in patients in an advanced stage.
AUTHOR: Okanoue T, Itoh Y, Minami M, Sakamoto S, Yasui K,
Sakamoto M, Nishioji K, Murakami Y, Kashima K Third Department of
Internal Medicine, Kyoto Prefectural University of Medicine, Japan.
SOURCE: J Hepatol 1999 Apr;30(4):653-9
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