Prevention of hepatocellular carcinoma and its recurrence in chronic hepatitis C patients by interferon therapy.
Chronic hepatitis C is a leading cause of hepatocellular carcinoma (HCC) worldwide. Prevention of chronic hepatitis C-related HCC is one of the most important issues in current hepatology. We conducted 2 cohort studies, one among patients with chronic hepatitis C mostly without cirrhosis and another among those with compensated cirrhosis, to confirm the prevention of HCC by interferon. We also conducted a randomized controlled study among patients with HCV-related HCC treated completely by ablation to examine the effect of interferon therapy on prognosis. With the chronic hepatitis C cohort, we showed that the risk of HCC development, which was strongly associated with the stage of liver fibrosis, age, and gender, was reduced by interferon therapy to one fifth among sustained virologic responders compared with untreated patients. Life expectancy was also significantly prolonged. The benefit of interferon therapy was greater among those with the higher risk of HCC. We confirmed efficacy in HCC-prevention in the second study among patients with compensated cirrhosis who received interferon therapy. The third study among HCC patients who had received complete tumor ablation showed that interferon therapy was associated with better survival, primarily as a result of the preservation of liver function and also probably prevention of recurrence. We have shown beneficial effects of interferon therapy on HCC prevention and liver function preservation. They were the strongest in sustained virologic responders. Further improvement in prognosis may be expected in the future because the current combination therapy of pegylated interferon and ribavirin shows higher efficiency than interferon alone.
Omata
Masao
M
Department of Gastroenterology, University of Tokyo Graduate School of Medicine, Tokyo, Japan. omata-2im@h.u-tokyo.ac.jp
Yoshida
Haruhiko
H
Shiratori
Yasushi
Y
D000998:Antiviral Agents / Q000627:therapeutic use*; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D008297:Male; D015337:Multicenter Studies as Topic; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D016896:Treatment Outcome
D000998:Antiviral Agents; D007372:Interferons