title: Clinical features of hepatocellular carcinoma that occur after sustained virological response to interferon for chronic hepatitis C.
abstract: OBJECTIVE
  This study investigated the clinical features of hepatocellular carcinoma in patients with sustained virological response to interferon for hepatitis C viral (HCV) infection.
  
  
  METHODS
  A total of 7,715 patients with HCV infection were treated with interferon and followed up for more than 1 year after withdrawal of interferon in 64 Japanese hospitals and clinics between July 1988 and August 2001. Sustained virological response was obtained in 2,515 (32.6%) patients. Of these 2,515 patients, clinical data were collected for 38 patients in whom hepatocellular carcinoma developed. Sustained virological response was defined as HCV RNA negativity more than 6 months after the termination of interferon.
  
  
  RESULTS
  All patients were HCV RNA negative at the time of diagnosis of hepatocellular carcinoma. The median period until the detection of hepatocellular carcinoma was 4.7 years (range 1.4-9.0 years). There were significant improvements in hepatic function including serum albumin, aspartate aminotransferase, alanine aminotransferase, indocyanine green test, platelet count and histological activity grade in comparison with those before interferon therapy and at the onset of hepatocellular carcinoma. The maximum tumor size in patients without medical follow-up for 1 year or more (median: 60 mm) was significantly larger than in patients who were periodically followed up for 6 months or less (median: 25 mm) (P=0.002).
  
  
  CONCLUSIONS
  The present findings emphasize the importance of regular medical follow up of patients with HCV infection, as even patients showing a sustained virological response to interferon and in whom hepatic function has improved have the potential to develop hepatocellular carcinoma.
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. masikeda@cc.go.jp
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ikeda
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Fujiyama
authors.forename: Motohiko
authors.initials: M
authors.lastname: Tanaka
authors.forename: Michio
authors.initials: M
authors.lastname: Sata
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ide
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yatsuhashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000209:etiology / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D007564:Japan; D008113:Liver Neoplasms / Q000097:blood / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood*; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D012367:RNA, Viral; D007372:Interferons