title: Interferon therapy does not prevent hepatocellular carcinoma in HCV compensated cirrhosis.
abstract: OBJECTIVE
  Recent experiences suggest that interferon may significantly decrease the incidence of hepatocellular carcinoma. We conducted a randomized study with interferon versus no therapy in hepatitis C virus Child A cirrhosis with abnormal alanine aminotransferase and HCV-RNA positive serum with the aim to investigate the incidence of hepatocellular carcinoma, worsening of cirrhosis's stage and death or orthotopic liver transplantation.
  
  
  METHODS
  A cohort of 122 patients prospectively followed was analyzed retrospectively to assess the effect of interferon therapy (mean follow-up: 96 +/- 18.3 months). We only chose patients with hepatitis C virus infection who had undergone blood transfusion before 1980. Hepatitis C virus serotype was determined by hepatitis C virus serotyping 1-6 assay (Murex Biothec Limited Temple Hill, Dartford, Kent, UK). HCV-RNA level was determined by bDNA, Chiron Corporation Emeryville, CA. Diagnosis of hepatocellular carcinoma was made on the basis of the appearance of local lesions at periodic ultrasound examination of the liver and confirmed with spiral computed tomography. Fine needle biopsy under sonographic guidance was effected. Fifty-nine patients (mean age: 55.3 +/- 7) received interferon (3MU three times a week for 12 months), 8 stopped therapy for side effects, 71 did not receive interferon (mean age: 56.8 +/- 8). Baseline characteristics were similar.
  
  
  RESULTS
  It emerges how interferon does not reduce the risk of hepatocellular carcinoma in compensated cirrhosis. In interferon treated patients an improvement in relation with worsening and death/orthotopic liver transplantation has been noted.
  
  
  CONCLUSIONS
  The use of the interferon seems to be scarcely useful when structural alterations of the cirrhotic kind show up, as cirrhosis represents by itself a risk factor for hepatocellular carcinoma. Nevertheless, in relation to the worsening of cirrhosis's stage the interferon therapy can be useful in compensated cirrhosis.
authors.affiliation: Unit of Hepato-Gastroenterology, S. Martino Hospital, Italy. testinogia@tiscalinet.it
authors.forename: Gianni
authors.initials: G
authors.lastname: Testino
authors.forename: Filippo
authors.initials: F
authors.lastname: Ansaldi
authors.forename: Enzo
authors.initials: E
authors.lastname: Andorno
authors.forename: Gian Luigi
authors.initials: GL
authors.lastname: Ravetti
authors.forename: Carlo
authors.initials: C
authors.lastname: Ferro
authors.forename: Fabio
authors.initials: F
authors.lastname: De Iaco
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Icardi
authors.forename: Umberto
authors.initials: U
authors.lastname: Valente
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D016009:Chi-Square Distribution; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D007372:Interferons / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000821:virology*; D008113:Liver Neoplasms / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents; D012367:RNA, Viral; D007372:Interferons; D000410:Alanine Transaminase