title: Effects of interferon therapy on development of hepatocellular carcinoma in patients with hepatitis C-related cirrhosis: A meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  The role of interferon (IFN) therapy on prevention of hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV)-related cirrhosis remains controversial. This meta-analysis aimed to determine whether IFN therapy reduced the incidence of HCC in HCV-related cirrhotic patients.
  
  
  METHODS
  We performed a meta-analysis including eight randomized controlled trials (RCT) (a total of 1505 patients) to assess the effect of IFN therapy on prevention of HCC in patients with HCV-related cirrhosis. The pooled odds ratios (OR) were calculated using a random or fixed effects model.
  
  
  RESULTS
  Our results showed that IFN therapy significantly decreased the overall HCC incidence in HCV-related cirrhotic patients (OR, 0.29; 95% confidence interval [CI], 0.10-0.80; P = 0.02). HCC risk in patients who failed to achieve sustained virological response (SVR) in the initial IFN-based treatment was also reduced by maintenance IFN therapy (OR, 0.54; 95% CI, 0.32-0.90; P = 0.02). Subgroup analysis indicated that IFN therapy decreased HCC incidence in HCV-related cirrhotic patients during long-term follow up (>48 months) evidently (OR, 0.25; 95% CI, 0.09-0.67; P = 0.006). However, subgroup analysis of four RCT with short-term follow up (≤48 months) did not demonstrate the significant difference in HCC incidence between IFN-treated cirrhotic patients and controls (OR, 0.78; 95% CI, 0.39-1.55; P = 0.48).
  
  
  CONCLUSIONS
  The present study suggested that IFN therapy could efficiently reduce HCC development in patients with HCV-related cirrhosis; this effect was more evident in the subgroup of patients with long-term follow up (>48 months). Patients who received maintenance IFN therapy had a lower risk of HCC than controls.
authors.affiliation: Department of Gastroenterology, Affiliated Hospital of Nantong University, Jiangsu             Department of Gastroenterology, Shanghai Xuhui Central Hospital, Shanghai, China.
authors.forename: Li-Shuai
authors.initials: LS
authors.lastname: Qu
authors.forename: Hong
authors.initials: H
authors.lastname: Chen
authors.forename: Xiao-Ling
authors.initials: XL
authors.lastname: Kuai
authors.forename: Zheng-Fu
authors.initials: ZF
authors.lastname: Xu
authors.forename: Fei
authors.initials: F
authors.lastname: Jin
authors.forename: Guo-Xiong
authors.initials: GX
authors.lastname: Zhou