title: Effect of interferon alpha-2b plus ribavirin therapy on incidence of hepatocellular carcinoma in patients with chronic hepatitis.
abstract: OBJECTIVE
  The objective of this study was to elucidate the long-term effects of interferon (IFN)alpha-2b plus ribavirin combination therapy and to clarify whether this therapy can reduce the incidence of hepatocellular carcinoma (HCC) in patients with chronic hepatitis C.
  
  
  METHODS
  A total of 403 patients infected with hepatitis C virus (HCV) were enrolled in a multicenter trial. All patients were treated with a combination of IFN-alpha-2b plus ribavirin therapy. We examined the incidence of HCC after combination therapy and analyzed the risk factors for liver carcinogenesis.
  
  
  RESULTS
  A sustained virological response (SVR) was achieved by 139 (34%) of the patients. The cumulative rate of incidence of HCC was significantly lower in SVR patients than in non-SVR patients (P = 0.03), while there was no difference in the cumulative incidence of HCC between the transient response (TR) group and the no response (NR) group. Cox's regression analysis indicated the following risk factors as independently significant in relation to the development of HCC: age being > 60 years (P = 0.006), advanced histological staging (P = 0.033), non-SVR to IFN therapy (P = 0.044). The cumulative incidence rate of HCC was significantly lower in patients who had average serum alanine aminotransferase (ALT) levels of < 40 IU/L than in those who showed average serum ALT levels of >== 40 IU/L after the combination therapy (P = 0.021).
  
  
  CONCLUSIONS
  These results suggest that the attainment of SVR or continuous normalization of ALT levels after IFN therapy can affect patients apart from HCC development.
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Kurokawa
authors.forename: Naoki
authors.initials: N
authors.lastname: Hiramatsu
authors.forename: Tsugiko
authors.initials: T
authors.lastname: Oze
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Mochizuki
authors.forename: Takayuki
authors.initials: T
authors.lastname: Yakushijin
authors.forename: Nao
authors.initials: N
authors.lastname: Kurashige
authors.forename: Yuko
authors.initials: Y
authors.lastname: Inoue
authors.forename: Takumi
authors.initials: T
authors.lastname: Igura
authors.forename: Kazuho
authors.initials: K
authors.lastname: Imanaka
authors.forename: Akira
authors.initials: A
authors.lastname: Yamada
authors.forename: Masahide
authors.initials: M
authors.lastname: Oshita
authors.forename: Hideki
authors.initials: H
authors.lastname: Hagiwara
authors.forename: Eiji
authors.initials: E
authors.lastname: Mita
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Ito
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Inui
authors.forename: Taizo
authors.initials: T
authors.lastname: Hijioka
authors.forename: Harumasa
authors.initials: H
authors.lastname: Yoshihara
authors.forename: Atsuo
authors.initials: A
authors.lastname: Inoue
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Imai
authors.forename: Michio
authors.initials: M
authors.lastname: Kato
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kiso
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kanto
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Takehara
authors.forename: Akinori
authors.initials: A
authors.lastname: Kasahara
authors.forename: Norio
authors.initials: N
authors.lastname: Hayashi