Elsevier

Journal of Hepatology

Volume 24, Issue 2, February 1996, Pages 141-147
Journal of Hepatology

Alpha interferon treatment may prevent hepatocellular carcinoma in HCV-related liver cirrhosis

https://doi.org/10.1016/S0168-8278(96)80022-5Get rights and content

Abstract

Background/Aims: The aims of α-interferon treatment for chronic viral liver infections are clearance of the virus and healing of the disease. Hepatocellular carcinoma is a complication of viral cirrhosis; but it is not yet known whether treatment of viral cirrhosis with α-interferon prevents this complication.

Methods: The incidence and the risk (Cox regression analysis) of developing hepatocellular carcinoma were calculated in 347 patients with hepatic cirrhosis; 227 (34 hepatitis B virus and 193 hepatitis C virus related) were treated with α-interferon and 120 (28 hepatitis B virus and 92 hepatitis C virus) did not receive this treatment, in order to evaluate the efficacy of α-interferon in the prevention of hepatocellular carcinoma. In all patients, the cirrhosis was well compensated (Child A).

Results: Over mean follow-up periods of 49 months for hepatitis B virus and 32 months for hepatitis C virus, 20347 patients (662 hepatitis B virus and 14285 hepatitis C virus) developed hepatocellular carcinoma. The risk of developing this tumor was significantly greater in males (p<0.007) and in patients not treated with α-interferon (p<0.01). The Relative Risk of developing hepatocellular carcinoma increased significantly (p<0.0002) with each passing year. In patients with hepatic cirrhosis secondary to hepatitis B virus infections, the risk did not seem to be modified by α-interferon treatment, even though a greater, but not significant risk (Relative Risk=4.9; p=0.3) was calculated for untreated patients; in contrast, in hepatitis C virus-related cirrhosis, this risk was reduced by a factor of 4.0 (p=0.04). The tumor developed only in non-responder patients regardless of virus type. After adjustment for confounding factors (sex, age, alcohol consumption, cigarette smoking), a statistically significant (p<0.025) effect of interferon treatment in preventing hepatocellular carcinoma was still demonstrated when responders were matched with controls, but not when responders were compared with non-responders.

Conclusions: These results show that, in addition to its ability to halt the progression of viral-induced liver disease, α-interferon is also of benefit in patients with hepatitis C virus cirrhosis who respond to this treatment by lowering their risk of developing hepatocellular carcinoma.

References (46)

  • R.H Resnik et al.

    Primary hepatocellular carcinoma following non-A, non-B posttransfusion hepatitis

    Dig Dis Sci

    (1983)
  • J.H Gilliam et al.

    Primary hepatocellular carcinoma after chronic non-A, non-B, posttransfusion hepatitis

    Ann Intern Med

    (1984)
  • R.G Simonetti et al.

    Hepatitis C virus infection as a risk factor for hepatocellular carcinoma in patients with cirrhosis. A case-control study

    Ann Intern Med

    (1992)
  • W.L Chuang et al.

    The role of hepatitis B and C viruses in hepatocellular carcinoma in a hepatitis B endemic area. A case controlled study

    Cancer

    (1992)
  • J Ruiz et al.

    Hepatitis B and C viral infections in patients with hepatocellular carcinoma

    Hepatology

    (1992)
  • B Yoffe et al.

    Hepatitis B virus. New and evolving issues

    Dig Dis Sci

    (1992)
  • A Alberti et al.

    Hepatitis viruses as aetiological agents of hepatocellular carcinoma

    Ital J Gastroenterol

    (1991)
  • E Villa et al.

    Risk factors for hepatocellular carcinoma in Italy: male sex, hepatitis B virus, non-A, non-B infection and alcohol

    Cancer

    (1988)
  • C De Bac et al.

    Pathogenetic factors in cirrhosis with and without hepatocellular carcinoma: a multicenter Italian Study

    Hepatology

    (1994)
  • C La Vecchia et al.

    Risk factors for hepatocellular carcinoma in northern Italy

    Int J Cancer

    (1988)
  • M.G Filippazzo et al.

    Assessment of some risk factors for hepatocellular carcinoma: a case control study

    Stat Med

    (1985)
  • H Tsukuma et al.

    Risk factors for hepatocellular carcinoma among patients with chronic liver disease

    N Engl J Med

    (1993)
  • T Hirayama

    A large-scale cohort study on risk factors for primary liver cancer, with special reference to the role of cigarette smoking

    Cancer Chemother Pharmacol

    (1989)
  • Cited by (314)

    • Efficacy of pegylated interferon alpha-2b and ribavirin treatment on the risk of hepatocellular carcinoma in patients with chronic hepatitis C: A prospective, multicenter study

      2013, Journal of Hepatology
      Citation Excerpt :

      While recent advances in HCV have led to a markedly improved treatment, HCC is at present the sixth most common cancer and the third cause of cancer death worldwide [4]; moreover, its incidence is increasing due to HCV infection [5]. Previous studies have reported that patients who achieved a sustained virological response (SVR) after interferon (IFN) monotherapy demonstrated improvement in liver fibrosis and a reduction in the incidence of decompensated liver disease and HCC compared with non-SVR patients [6–9]. In the past 10 years, a combination of pegylated IFN (PegIFN) α and ribavirin (RBV) has become the standard treatment and has resulted in an increased SVR rate [10–12].

    View all citing articles on Scopus
    View full text