Long-term outcome, with monitoring of platelet counts, in patients with chronic hepatitis C and liver cirrhosis after interferon therapy.
OBJECTIVE
Because the determination of the stage of fibrosis depends on rather subjective judgment, more objective parameters are needed. In this study, we followed the long-term outcome, with monitoring of platelet counts, in patients with chronic hepatitis C or liver cirrhosis (LC) who had undergone interferon (IFN) therapy.


METHODS
596 patients who were diagnosed at our institute from 1987 to 1998 with chronic hepatitis C and LC were treated with IFNs. A further 58 patients were not treated (NT). The annual rate of changes in platelet counts were calculated and compared for IFN-treated and NT patients.


RESULTS
The relationship between the efficacy of IFN therapy and the incidence of hepatocellular carcinoma (HCC) showed that the patients who were virologic sustained responders (VSR) had a significantly lower incidence of HCC than the nonresponders (NR) and NT patients. The change in platelet counts was +4,350/microl/year in the VSR, +1,010/microl/year in the biochemical sustained responders (BSR), -4,540/microl/year in the NR and -6,180/microl/year in the NT patients, indicating a significant platelet increase in the VSR, a decrease of the same magnitude in the NR and NT patients, and no change in the BSR. The cumulative probability of developing HCC and liver failure was significantly higher in groups with decreased platelet counts than in groups with increased platelet counts among patients who had undergone IFN therapy. Multivariate analyses revealed that a decrease in platelet counts was the cardinal risk factor for development of HCC and liver failure in chronic hepatitis C or LC patients.


CONCLUSIONS
Investigation of platelet counts was useful for determining the long-term outcome of patients who had undergone IFN therapy and for predicting the development of HCC.
Moriyama
Mitsuhiko
M
Third Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan. moriyama@med.nihon-u.ac.jp
Matsumura
Hiroshi
H
Aoki
Hiroshi
H
Shimizu
Toshihiro
T
Nakai
Kazuhiko
K
Saito
Takahide
T
Yamagami
Hiroaki
H
Shioda
Atsuo
A
Kaneko
Miki
M
Goto
Iori
I
Tanaka
Naohide
N
Arakawa
Yasuyuki
Y
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D015994:Incidence; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D007372:Interferons / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000097:blood* / Q000188:drug therapy* / Q000821:virology; D017093:Liver Failure / Q000453:epidemiology; D008113:Liver Neoplasms / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011994:Recombinant Proteins; D013997:Time Factors; D016896:Treatment Outcome
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D007372:Interferons