title: Effectiveness of interferon alfa on incidence of hepatocellular carcinoma and decompensation in cirrhosis type C. European Concerted Action on Viral Hepatitis (EUROHEP).
abstract: OBJECTIVE
  The role of interferon alfa treatment in improving morbidity endpoints in patients with chronic hepatitis C infection is currently under debate. The aim of this study was to evaluate the effectiveness of interferon in preventing hepatocellular carcinoma and decompensation in cirrhosis type C.
  
  
  METHODS
  A retrospective cohort study was carried out on 329 consecutive Caucasian patients with cirrhosis followed for a mean period of 5 years at seven tertiary care university hospitals. Inclusion criteria were biopsy-proven cirrhosis, anti-HCV positivity, abnormal serum aminotransferase levels and absence of complications of cirrhosis.
  
  
  RESULTS
  The yearly incidence of hepatocellular carcinoma was 2.3% for 136 untreated patients and 1.0% for 193 patients treated with interferon alfa. The yearly incidence of hepatic decompensation was 5.7 for untreated and 1.5 for the treated patients. Fourteen (7%) of 193 treated patients showed sustained aminotransferase normalization and none of them developed complications of cirrhosis. At enrollment, untreated patients were older and had more severe liver disease than patients treated with interferon. After adjustment for clinical and serologic differences at entry between treated and untreated patients, the 5-year estimated probability of the occurrence of hepatocellular carcinoma was 2.1% and 2.7% and of decompensation was 7% and 11% for treated and untreated cases, respectively.
  
  
  CONCLUSIONS
  This analysis did not detect any significant benefit of interferon alfa on morbidity in patients with compensated cirrhosis type C, although it suggests a reduction in complications of cirrhosis for those with a sustained response to therapy, and it indicates the need for better therapies.
authors.affiliation: Istituto di Patologia Speciale Medica, Medicina Interna B, University of Verona, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Fattovich
authors.forename: G
authors.initials: G
authors.lastname: Giustina
authors.forename: F
authors.initials: F
authors.lastname: Degos
authors.forename: G
authors.initials: G
authors.lastname: Diodati
authors.forename: F
authors.initials: F
authors.lastname: Tremolada
authors.forename: F
authors.initials: F
authors.lastname: Nevens
authors.forename: P
authors.initials: P
authors.lastname: Almasio
authors.forename: A
authors.initials: A
authors.lastname: Solinas
authors.forename: J T
authors.initials: JT
authors.lastname: Brouwer
authors.forename: H
authors.initials: H
authors.lastname: Thomas
authors.forename: G
authors.initials: G
authors.lastname: Realdi
authors.forename: R
authors.initials: R
authors.lastname: Corrocher
authors.forename: S W
authors.initials: SW
authors.lastname: Schalm
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000517:prevention & control*; D006526:Hepatitis C / Q000150:complications / Q000628:therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000150:complications / Q000517:prevention & control*; D008113:Liver Neoplasms / Q000209:etiology / Q000517:prevention & control*; D008137:Longitudinal Studies; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha