Interferon-Free Therapy Is Not a Trigger for Hepatocellular Carcinoma in Patients With Chronic Infection With Hepatitis C Virus

Abstract

The literature focused on data regarding the occurrence of hepatocellular carcinoma (HCC) after interferon (IFN)-free therapy is ambiguous. Researchers are preoccupied to find if the risk of developing liver cancer is related only to the therapy per se or it is influenced by a multitude of factors. We aimed to develop a local analysis of risk factors associated with HCC occurrence in patients with liver cirrhosis due to HCV (hepatitis C virus) infection treated with IFN-free therapy. We made an observational, retrospective study, between 2016 -2019, on 188 cirrhotic patients with HCV infection, diagnosed, treated and followed-up by screening for HCC occurrence, using the recordings from the patient's charts available in the archive of the Gastroenterology Lab, "Aquamed" Clinic, Constanța County, Romania. We noted the demographic, lab, imagistic data and treatment procedures applied, comparing two groups of patients: the IFN-free therapy group -89 patients and the standard IFN therapy group -99 patients. As statistic method, we used the SAS Cox proportional hazards regression procedure, in order to calculate the HR (hazard ratio) and CI (confidence interval) 95% for each parameter studied as risk factor involved in HCC occurrence. In the unadjusted model, there was estimated an increased risk in HCC occurrence in IFN-free therapy group compared to standard IFN therapy group (p = 0.0341). After adjustment for age, gender, severity of the disease, (Child-Pugh classification) or complications, there was not a statistically significant difference between IFN-free therapy group or IFN therapy group in order to develop HCC (hazard ratio = 0.05, p = 0.5038). Our observational study, even if made on a small number of patients, confirms that IFN-free therapy is safe, the benefits obtained covering the risks. Our study results did not find a link between IFN-free therapy and HCC occurrence over the known risk of liver cirrhosis, when taking into account multiple features of disease prior to treatment onset. RezumatLiteratura axată pe datele referitoare la apariția carcinomului hepatocelular după terapia fără interferon (IFN) este ambiguă în acest moment. Cercetătorii sunt preocupați să stabilească dacă riscul de a dezvolta hepatocarcinom este legat numai de terapia per se sau este influențat de o multitudine de factori. În acest context, ne-am propus să facem o analiză locală a factorilor de risc asociați cu apariția HCC la pacienții cu ciroză hepatică datorată infecției cu virus hepatitic C (VHC) tratată fără IFN. Am efectuat un studiu observațional, retrospectiv, între anii 2016 -2018 pe 188 de pacienți cu infecție cu VHC diagnosticați, tratați și urmăriți prin screening pentru apariția HCC, folosind înregistrările din diagramele pacientului, disponibile în arhiva Laboratorului de Gastroenterologie, Clinica "Aquamed", județul Constanța, România. Am analizat datele demografice, de laborator și imagistice, precum și procedurile de tratament aplicate, comparând două grupuri de pacienți: grupul de terapie fără IFN -89 pacienț...

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