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Efficacy of pegylated interferon and ribavirin combination therapy for patients with hepatitis C virus infection after curative resection or ablation for hepatocellular carcinoma—A retrospective multicenter study
Author(s) -
Harada Naoki,
Hiramatsu Naoki,
Oze Tsugiko,
Tatsumi Tomohide,
Hayashi Norio,
Takehara Tetsuo
Publication year - 2015
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.24173
Subject(s) - medicine , hepatocellular carcinoma , ribavirin , pegylated interferon , gastroenterology , hazard ratio , hepatitis c virus , hepatitis c , immunology , virus , confidence interval
The use of pegylated interferon (Peg‐IFN) plus ribavirin combination therapy for chronic hepatitis C patients who received curative treatment for hepatocellular carcinoma is controversial. This study tried to clarify this. Ninety‐nine chronic hepatitis C patients who received curative resection or radiofrequency ablation for primary hepatocellular carcinoma, met the Milan criteria and were treated with Peg‐IFN plus ribavirin therapy were enrolled (75 males, 24 females; mean age, 65.0 ± 5.9 years; 79 HCV genotype 1, 20 genotype 2). Among them, 40 patients who had received curative treatment for a single carcinoma were analyzed for recurrence (observation period: 27.6 ± 18.1 months). The factors associated with recurrence were examined using a log‐rank test and a Cox proportional‐hazards model. The discontinuation rate of the Peg‐IFN plus ribavirin combination therapy was 25% (25/99). Among the patients who completed the therapy, the sustained virologic response rates were 35% for the genotype 1 patients and 56% for the genotype 2 patients. The cumulative incidence rates of recurrence were 10.0% at 1 year and 40.8% at 3 years. On multivariate analysis, a virologic response and platelet counts served as independent factors of recurrence (sustained virologic response, hazard ratio = 0.190, P = 0.029; platelet counts <12 × 10 4 /mm 3 , hazard ratio = 3.19, P = 0.019). It is concluded that patients with chronic hepatitis C virus infection after curative treatment for hepatocellular carcinoma can be candidates for anti‐viral therapy to reduce the recurrence of hepatocellular carcinoma, especially patients with low platelet counts. J. Med. Virol. 87:1199–1206, 2015 . © 2015 Wiley Periodicals, Inc.