Impact of interferon therapy on the natural history of hepatitis C virus related cirrhosis

Gramenzi, Annagiulia; Andreone, Pietro; Fiorino, Sirio; Cammà, Calogero; Giunta, Marco; Magalotti, Donatella; Cursaro, Carmela; Calabrese, Carlo; Arienti, Vincenzo; Rossi, Cristina; Febo, Giulio Di; Zoli, Marco; Craxı̀, Antonio; Gasbarrini, Giovanni; Bernardi, Mauro

doi:10.1136/gut.48.6.843

Cited by 80 publications

(72 citation statements)

References 29 publications

(22 reference statements)

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“…61 The rest of the studies, mostly retrospective and nonrandomized, suggested a moderate decrease in the risk for HCC among HCVinfected patients treated with interferon. 54,8,[62][63][64][65][66][67][68][69] In general, the reported preventive effect of interferon alfa therapy was less marked in European studies than in studies from Japan. The benefit was better appreciated in patients with sustained response than nonresponders.…”

Section: Hcc In Hcv-related Cirrhosismentioning

confidence: 99%

Hepatocellular carcinoma and hepatitis C in the United States

M.D.

2002

Hepatology

196

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Chronic infection with hepatitis C virus (HCV) is a major risk factor for development of hepatocellular carcinoma (HCC). In general, HCC develops only after 2 or more decades of HCV infection and the increased risk is restricted largely to patients with cirrhosis or advanced fibrosis. Factors that predispose to HCC among HCV-infected persons include male sex, older age, hepatitis B virus (HBV) coinfection, heavy alcohol intake, and possibly diabetes and a transfusion-related source of HCV infection. Viral factors play a minor role. The likelihood of development of HCC among HCV-infected persons is difficult to determine because of the paucity of adequate long-term cohort studies; the best estimate is 1% to 3% after 30 years. Once cirrhosis is established, however, HCC develops at an annual rate of 1% to 4%. Successful antiviral therapy of patients with HCV-related cirrhosis may reduce the future risk for HCC. The incidence of and mortality caused by all HCC has doubled in the United States over the past 25 years, an increase that has affected all ethnic groups, both sexes, and younger age groups. Given the current prevalence of HCV infection among persons 30 to 50 years of age, the incidence and mortality rates H epatocellular carcinoma (HCC) affects approximately half a million persons each year worldwide making it the fifth most common malignancy in men and the ninth most common in women. HCC is a rapidly fatal cancer that mostly affects persons in developing countries where hepatitis B virus (HBV) is endemic. Recently, however, a trend of increasing rates of HCC has been reported from several developed countries in North America, Europe, and Asia. Hepatitis C virus (HCV) infection appears to play an important role in these new trends. Hepatitis C and HCCSeveral lines of evidence indicate a strong causal association between HCV and HCC. HCV RNA can be found in the serum, liver, and tumor tissues of patients with HCC, but unlike HBV it does not integrate into the host genome. 1 Markers of HCV infection are found in a variable proportion of HCC cases in Europe with an increasing gradient from North to South 2 ; for example, 44% to 66% in Italy, 3-5 27% to 58% in France, 6 60% to 75% in Spain, 7 and in 80% to 90% of HCC cases in Japan. 8,9 Moreover, the age-standardized death rates owing to HCC in several European countries are significantly correlated with the seroprevalence of HCV in the general population. 10 The frequency of HCV seropositivity among persons with HCC compiled from a summary of published studies of HCC in the United States is shown in Fig. 1. Of 1,429 patients assumed to have been tested, 384 (27%) were positive for HCV. 11-15 However, a higher but undefined proportion of patients with HCC might have had HCV detected by polymerase chain reaction testing of liver tissue and/or serum, even if antibody to HCV (anti-HCV) was not detectable, 16 particularly if first-generation tests were used. On the other hand, 240 of 1,670 (14%) patients with HCC in the United States tested positive for hepatitis ...

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Section: Hcc In Hcv-related Cirrhosismentioning

confidence: 99%

Hepatocellular carcinoma and hepatitis C in the United States

M.D.

2002

Hepatology

196

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“…3 One prospective randomized trial 4 showed reduced HCC incidence in IFN-treated patients with chronic HCV irrespective of virological response, but these results have not been reproduced. A retrospective analysis of a large database in Japan 5 and other small studies [6][7][8] designed to assess the rate of SVR following IFN therapy have not provided conclusive evidence that the progression of liver disease underling HCV infection was halted in nonresponder patients.…”

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confidence: 99%

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

et al. 2007

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“…1,2 Other than liver transplantation, which treats patients with end-stage liver failure, no available therapy can effectively interfere with the progression of cirrhosis. [3][4][5][6][7][8][9] Under various disease-related conditions, persistence of recurrent hepatocellular injury leads to a wound-healing process in which oxidative stress, inflammatory response mediated by immune cells and/or cytokines, and activation of hepatic stellate cells (HSCs) contribute to the cascade of fibrogenesis. 1,10 Heme oxygenase-1 (HO-1) is an inducible protein that responds to a wide range of stimuli.…”

mentioning

confidence: 99%