title: Decreased risk of hepatocellular carcinoma in patients with chronic hepatitis C whose serum alanine aminotransferase levels became less than twice the upper limit of normal following interferon therapy.
abstract: OBJECTIVE
  The incidence of hepatocellular carcinoma (HCC) in C-viral chronic hepatitis (CH) and liver cirrhosis (LC) patients after interferon (IFN) therapy was evaluated according to alanine aminotransferase (ALT) levels.
  
  
  METHODS
  Two hundred sixty-nine patients with C-viral CH and LC were treated with natural IFN-alpha. The efficacy of IFN therapy was evaluated based on virologic response and ALT levels using the following groups: virologic-sustained responders (VSR); biochemical-sustained responders (BSR); partial responders (PR), which consisted of BSR patients whose serum ALT levels later relapsed; non-responders (NR)1, which included patients with serum ALT levels that were usually less than 80 IU/l; and NR2, NR with ALT levels persistently more than 80 IU/l.
  
  
  RESULTS
  Of the 269 patients, 22 (8.2%) developed HCC after IFN therapy. The incidence of HCC (%/patient/year) was 0.78%, 0%, 0%, 0.17%, 4.68% in VSR, BR, PR, NR1, NR2, respectively. Multivariate analysis revealed that an increase in ALT levels to more than 80 IU/l is an important risk factor for the occurrence of HCC.
  
  
  CONCLUSIONS
  We concluded that the patients with ALT levels less than twice the upper limit of normal after IFN therapy have a reduced risk of progression to HCC from C-viral chronic liver disease.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo 173-8610, Japan. moriyama@med.nihon-u.ac.jp
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Moriyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsumura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aoki
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Shimizu
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yamagami
authors.forename: Atsuo
authors.initials: A
authors.lastname: Shioda
authors.forename: Miki
authors.initials: M
authors.lastname: Kaneko
authors.forename: Iori
authors.initials: I
authors.lastname: Goto
authors.forename: Naohide
authors.initials: N
authors.lastname: Tanaka
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Arakawa
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control*; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D007564:Japan / Q000453:epidemiology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012306:Risk; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D007372:Interferons; D000410:Alanine Transaminase