title: Development of hepatocellular carcinoma after interferon therapy in chronic hepatitis C. Is it possible to reduce the incidence by ribanirin and IFN combination therapy?
abstract: 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.
authors.affiliation: Division of Gastroenterology and Hepatology, Musashino Red-Cross Hospital, Tokyo, Japan. nizumi@musashino.jrc.or.jp
authors.forename: Namiki
authors.initials: N
authors.lastname: Izumi
authors.forename: Asahina
authors.initials: A
authors.lastname: Yasuhiro
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kurosaki
authors.forename: Yuko
authors.initials: Y
authors.lastname: Onuki
authors.forename: Yuki
authors.initials: Y
authors.lastname: Nishimura
authors.forename: Kazunari
authors.initials: K
authors.lastname: Inoue
authors.forename: Ken
authors.initials: K
authors.lastname: Ueda
authors.forename: Kaoru
authors.initials: K
authors.lastname: Tsuchiya
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakanishi
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Uchihara
authors.forename: Shozo
authors.initials: S
authors.lastname: Miyake
mesh_terms: 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
chemical_list: D012254:Ribavirin; D007372:Interferons