Development of small hepatocellular carcinoma 80 months after clearance of hepatitis C virus with interferon therapy.
We describe a patient who had a complete and sustained response to interferon (IFN) therapy for chronic hepatitis C but developed small hepatocellular carcinoma (HCC) 80 months later. A 55-year-old Japanese man with hepatitis C virus (HCV) infection and histological features of chronic active hepatitis was treated with recombinant IFN alpha-2a, 9,000,000 U daily for 2 weeks followed by three times a week for 22 weeks. He successfully responded to IFN therapy with a normalization of serum alanine aminotransferase and continuous disappearance of serum HCV-RNA. However, 80 months after the cessation of IFN therapy, the patient's alpha-fetoprotein (AFP) level became elevated for the first time and HCC, 12 mm in diameter, was detected by routine ultrasonographic screening. Laparotomy revealed a small HCC with no metastasis, and the nontumorous liver demonstrated chronic inactive hepatitis. This case indicates the need for careful follow-up using ultrasonography and AFP testing for at least 7 years after completing IFN therapy in all patients with chronic hepatitis C, even if the patients have a complete response to the therapy.
Yamada
M
M
Department of Internal Medicine, Anjo Kosei Hospital, Anjo, Aichi, Japan.
Ichikawa
M
M
Matsubara
A
A
Ishiguro
Y
Y
Yamada
M
M
Yokoi
S
S
D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000209:etiology*; D006526:Hepatitis C / Q000150:complications* / Q000628:therapy; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D000509:alpha-Fetoproteins / Q000378:metabolism
D016898:Interferon-alpha; D000509:alpha-Fetoproteins