title: Efficacy of low dose long-term interferon monotherapy in aged patients with chronic hepatitis C genotype 1 and its relation to alpha-fetoprotein: A pilot study.
abstract: OBJECTIVE
  The objective of this study was to examine the efficacy and safety of low dose long-term interferon (IFN) therapy in aged patients with chronic hepatitis C genotype 1.
  
  
  METHODS
  The IFN therapy was performed in Shin-Kokura Hospital on 44 patients aged 60 or older with chronic hepatitis C. All patients had high viral loads of genotype 1. Three million units of natural IFN-alpha was administered intramuscularly or intrasubcutaneously, three times a week for three years. A control group of 44 subjects not treated with IFN, matched for age, gender and hepatic histology, was formed.
  
  
  RESULTS
  Two of the 44 patients showed a sustained virological response. Alanine aminotransferase was below the upper limit of normal in 59% (23/39) of the patients and alpha-fetoprotein was less than 40 ng/mL in 97% (38/39) on the completion of treatment. Sustained biochemical response was observed in 53% (19/36) of the patients. In the liver cirrhosis group, serum albumin values and platelet counts increased in 38% (6/16) and 33% (6/18) of patients, respectively. Hepatocellular carcinoma (HCC) appeared in three patients by 13 months after the start of treatment, but no cases were reported thereafter. The cumulative non-carcinogenesis rate of HCC in the liver cirrhosis group was significantly higher in the IFN treatment group compared to the control group (log-rank test, P = 0.046).
  
  
  CONCLUSIONS
  Low dose long-term interferon monotherapy to prevent carcinogenesis of HCC was considered useful in aged patients for whom peg-interferon and ribavirin combination therapy is difficult.
authors.affiliation: The Center for Liver Diseases, Shin-Kokura Hospital, Kitakyushu City, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Nomura
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Kashiwagi
authors.forename: Ryouko
authors.initials: R
authors.lastname: Hirano
authors.forename: Hironori
authors.initials: H
authors.lastname: Tanimoto
authors.forename: Nobuo
authors.initials: N
authors.lastname: Tsutsumi
authors.forename: Masashi
authors.initials: M
authors.lastname: Higashi
authors.forename: Hiromi
authors.initials: H
authors.lastname: Ishibashi