Antiviral Therapy for Cirrhotic Hepatitis C: Association with Reduced Hepatocellular Carcinoma Development and Improved Survival

Abstract

Interferon therapy for cirrhotic patients with chronic hepatitis C, especially those in whom the infection had been cured, inhibited the development of hepatocellular carcinoma and improved survival.

Outcomes after successful direct-acting antiviral therapy for patients with chronic hepatitis C and decompensated cirrhosis

“…In the interferon era, antiviral therapy in patients with cirrhosis was associated with reduced hepatocellular carcinoma [9]. Large cohorts such as HALT-C have demonstrated that reduced cancer development may be an effect of interferon, which has anti-tumour properties, rather than viral clearance alone, although this was only observed after four years from treatment [15].…”

“…Previous studies of interferon-based therapies have demonstrated that HCV clearance improves liver fibrosis, even in cirrhosis [7]. Moreover, patients who achieved SVR had reduced mortality, complications of cirrhosis and hepatocellular carcinoma compared to untreated patients or those who failed to achieve SVR [8][9][10]. However such studies involved patients with relatively 'early' cirrhosis and it remains unclear whether these long term benefits will be seen in patients treated for more advanced disease.…”

Sustained virological response to interferon-α is associated with improved outcome in HCV-related cirrhosis: A retrospective study

“…9 A retrospective analysis and a prospective study of patients followed up for 6.8 years conducted in Japan showed that HCC risk was reduced, but not abolished, in patients with cirrhosis. 5,25 However, the overall reduction in HCC risk in SVR cirrhotic patients was limited as it did not exceed 20% with respect to untreated or non-responder patients. 14,15 A clear-cut relationship between SVR and drop of HCC risk in Caucasian patients with cirrhosis has not been established.…”

Does chemotherapy prevent HCV-related hepatocellular carcinoma? Cons

“…After the meta-analyses, 3 observational cohort studies, two prospective studies conducted in Japan [32] and in Taiwan [33] and one retrospective study conducted in Italy [34], have clearly confirmed that the efficacy of IFN in the chemoprevention of HCC is exclusively linked to the achievement of a sustained viral eradication, while no benefit in reducing HCC development was observed in non-responder patients.…”