Interferon retreatment reduces or delays the incidence of hepatocellular carcinoma in patients with chronic hepatitis C

Abstract

Inhibition of hepatocarcinogenesis is a crucial issue in treating chronic hepatitis C patients, especially those who do not respond completely to interferon therapy. Interferon has been reported to reduce the incidence of hepatocellular carcinoma (HCC) not only in sustained virological responders but also in transient biochemical responders. However, the incidence of HCC increases in 5 years or more after interferon therapy in transient biochemical responders. The aim of this study is to assess whether interferon retreatment reduces the incidence of HCC in chronic hepatitis C patients in whom hepatitis C virus was not eradicated during initial interferon therapy. We enrolled 309 patients who were not sustained virological responders after initial interferon treatment consisting of a total dose of more than 250 megaunits of interferon and were followed for more than 2 years after treatment. Ninety-nine patients received interferon retreatment and 210 did not. Two courses of interferon therapy were administered in 84, three courses in 14 and five courses in one. The incidence of HCC was compared between patients with retreatment and those without. In the clinical characteristics, retreated patients were younger and followed up for a longer time period. The cumulative incidence of HCC was significantly lower in retreated patients. In multivariate analysis, patients' age (P=0.018) and the number of courses of interferon therapy (P=0.022) were independently associated with HCC incidence. These results suggest that interferon retreatment reduces or delays the incidence of HCC in chronic hepatitis C patients who did not completely respond to initial therapy.

Eradication of Hepatitis C Virus Reduces the Risk of Hepatocellular Carcinoma in Patients with Compensated Cirrhosis

“…These patients have lower SVR rates to peginterferon plus ribavirin [45] and, as we have already shown above, higher risk of HCC. Perhaps this explains the results of a study by Hino et al [46], who showed that retreatment reduces or delays the incidence of HCC in a population predominantly with early stage of liver fibrosis.…”

Efficacy and Anticarcinogenic Activity of Ribavirin Combination Therapy for Hepatitis C Virus-Related Compensated Cirrhosis

“…Previous studies have shown that gender, age, fibrosis stage, alanine aminotransferase, and interferon regimen are important pretreatment predictors of hepatocarcinogenesis [9,10,17]. In the present study 2 based on the patients with compensated cirrhosis, higher age and aspartate aminotransferase were associated with higher hepatocarcinogenesis rates in the whole population sample and in the sample which excluded patients who showed sustained virological response following additional treatment.…”

The Importance of a Prior Psychiatric Examination in Pegylated Interferon and Ribavirin Combination Treatment for Chronic Hepatitis C

“…Recently, the therapeutic effectiveness of interferon treatment, which is the only treatment that can completely cure chronic hepatitis C, has been shown to increase when used in combination with ribavirin [5][6][7][8]. As interferon treatment has also been proven to reduce the risk of HCC [9][10][11], interferon treatment has been actively administered for chronic hepatitis C. However, interferon treatment has various adverse events that may prevent completion of the full treatment regimen. These include psychiatric adverse events, especially depression, which often leads to a discontinuation of interferon treatment [12][13][14][15][16][17][18] pegylated interferon-α-2b and ribavirin combination treatment has been reported to range from 29 to 36% [5][6][7].…”