Effect of interferon alpha-2b plus ribavirin therapy on incidence of hepatocellular carcinoma in patients with chronic hepatitis.
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.
Kurokawa
Mika
M
Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan.
Hiramatsu
Naoki
N
Oze
Tsugiko
T
Mochizuki
Kiyoshi
K
Yakushijin
Takayuki
T
Kurashige
Nao
N
Inoue
Yuko
Y
Igura
Takumi
T
Imanaka
Kazuho
K
Yamada
Akira
A
Oshita
Masahide
M
Hagiwara
Hideki
H
Mita
Eiji
E
Ito
Toshifumi
T
Inui
Yoshiaki
Y
Hijioka
Taizo
T
Yoshihara
Harumasa
H
Inoue
Atsuo
A
Imai
Yasuharu
Y
Kato
Michio
M
Kiso
Shinichi
S
Kanto
Tatsuya
T
Takehara
Tetsuo
T
Kasahara
Akinori
A
Hayashi
Norio
N