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Effect of interferon α‐2b plus ribavirin therapy on incidence of hepatocellular carcinoma in patients with chronic hepatitis
Author(s) -
Kurokawa Mika,
Hiramatsu Naoki,
Oze Tsugiko,
Mochizuki Kiyoshi,
Yakushijin Takayuki,
Kurashige Nao,
Inoue Yuko,
Igura Takumi,
Imanaka Kazuho,
Yamada Akira,
Oshita Masahide,
Hagiwara Hideki,
Mita Eiji,
Ito Toshifumi,
Inui Yoshiaki,
Hijioka Taizo,
Yoshihara Harumasa,
Inoue Atsuo,
Imai Yasuharu,
Kato Michio,
Kiso Shinichi,
Kanto Tatsuya,
Takehara Tetsuo,
Kasahara Akinori,
Hayashi Norio
Publication year - 2009
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/j.1872-034x.2008.00477.x
Subject(s) - medicine , hepatocellular carcinoma , ribavirin , gastroenterology , cumulative incidence , incidence (geometry) , combination therapy , interferon , chronic hepatitis , oncology , immunology , virus , cohort , physics , optics
Aim: The objective of this study was to elucidate the long‐term effects of interferon (IFN)α‐2b plus ribavirin combination therapy and to clarify whether this therapy can reduce the incidence of hepatocellular carcinoma (HCC) in patients with chronic hepatitis C. Methods: A total of 403 patients infected with hepatitis C virus (HCV) were enrolled in a multicenter trial. All patients were treated with a combination of IFN‐α‐2b plus ribavirin therapy. We examined the incidence of HCC after combination therapy and analyzed the risk factors for liver carcinogenesis. Results: A sustained virological response (SVR) was achieved by 139 (34%) of the patients. The cumulative rate of incidence of HCC was significantly lower in SVR patients than in non‐SVR patients ( P = 0.03), while there was no difference in the cumulative incidence of HCC between the transient response (TR) group and the no response (NR) group. Cox's regression analysis indicated the following risk factors as independently significant in relation to the development of HCC: age being > 60 years ( P = 0.006), advanced histological staging ( P = 0.033), non‐SVR to IFN therapy ( P = 0.044). The cumulative incidence rate of HCC was significantly lower in patients who had average serum alanine aminotransferase (ALT) levels of < 40 IU/L than in those who showed average serum ALT levels of ≧ 40 IU/L after the combination therapy ( P = 0.021). Conclusions: These results suggest that the attainment of SVR or continuous normalization of ALT levels after IFN therapy can affect patients apart from HCC development.