Development of hepatocellular carcinoma after interferon therapy in chronic hepatitis C. Is it possible to reduce the incidence by ribanirin and IFN combination therapy?
OBJECTIVE
Although the incidence of hepatocellular carcinoma (HCC) has been shown to be reduced after interferon (IFN) monotherapy in chronic hepatitis C, the risk factors for the development of HCC have not been fully understood. The aim of this study is to investigate the risk factors for the development of HCC after IFN in chronic hepatitis C as well as whether the incidence of HCC will be reduced by ribavirin and IFN combination therapy or not.


METHODS
495 patients with chronic hepatitis C and which received IFN monotherapy were followed and the incidence and risk factors for the development of HCC were examined. On the other hand, in the patients which received ribavirin and IFN combination therapy, the sustained response rate was assessed and the reduction rate of HCC development was predicted.


RESULTS
Multivariate analysis by the Cox proportional hazard model revealed that the risk factors for HCC development were age, male gender, severe fibrosis and outcome of IFN therapy. On ribavirin and IFN combination therapy, the sustained response rate reached 17.3% in genotype 1b and 74% in genotypes 2a and 2b infection, thus reducing 20% of the estimated incidence of HCC.


CONCLUSIONS
To reduce the incidence of HCC in chronic hepatitis C, improvement of the sustained response rate is an essential issue, and ribavirin and IFN combination therapy shows to be promising.
Izumi
Namiki
N
Division of Gastroenterology and Hepatology, Musashino Red-Cross Hospital, Tokyo, Japan. nizumi@musashino.jrc.or.jp
Yasuhiro
Asahina
A
Kurosaki
Masayuki
M
Onuki
Yuko
Y
Nishimura
Yuki
Y
Inoue
Kazunari
K
Ueda
Ken
K
Tsuchiya
Kaoru
K
Nakanishi
Hiroyuki
H
Uchihara
Masakatsu
M
Miyake
Shozo
S
D000367:Age Factors; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000517:prevention & control*; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012254:Ribavirin / Q000627:therapeutic use; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome
D012254:Ribavirin; D007372:Interferons