Interferon Linked to Reduced Liver Cancer Risk in Patients With Chronic Hepatitis C

WESTPORT, Aug 03 (Reuters Health) - Interferon therapy reduces the risk of hepatocellular carcinoma in patients with stage F2 and F3 fibrosis due to chronic hepatitis C infection. Interferon appears to have little effect in patients with mild liver fibrosis, at least during short-term follow-up.

And, "[s]ustained virologic and biochemical responses [are] associated with a further reduction in risk," according to Dr. Haruhiko Yoshida, of the University of Tokyo, Japan, and other investigators with the Inhibition of Hepatocarcinogenesis by Interferon Therapy study.

The Japanese team examined the effects of interferon therapy on hepatocellular carcinoma risk in 2,890 patients with chronic hepatitis C who underwent liver biopsy at the start of the study. A subset of 2,400 patients received interferon therapy and close to 500 patients did not.

During a median 4.3 years of follow-up, 89 interferon-treated patients and 59 untreated patients developed hepatocellular carcinoma. Among the patients who did not receive interferon therapy, the risk of liver cancer increased with the degree of liver fibrosis at baseline, with a cumulative risk of 0.5% for patients with stage F0 or F1 fibrosis to 7.9% among those with stage F4 fibrosis. The data appear in the August 3rd issue of Annals of Internal Medicine.

Interferon therapy significantly reduced the risk of hepatocellular carcinoma, with an adjusted risk ratio of 0.516.

Patients with a sustained biochemical response to interferon "...in spite of viremia..." were at lower risk of progressing to liver cancer than patients with a sustained virologic response. "Moreover, the degree of risk differed between patients with mildly elevated ALT levels and those with highly elevated ALT levels. Thus, reduced risk seems to be associated not only with disappearance of viremia but [also] with amelioration of hepatic inflammation," the authors explain.

Alcohol consumption and HCV genotype did not significantly predict progression to hepatocellular carcinoma in this cohort, according to the report.

Ann Intern Med 1999;131:174-181.