The anti-carcinogenic effect and mechanism of interferon (IFN) in patients with hepatitis B virus (HBV)-related cirrhosis have not been elucidated.
Dr Ikeda and colleagues from Tokyo, Japan performed a quantitative analysis of HBV-DNA concentration sequentially.
The researchers observed 57 patients out of 60 consecutive patients with cirrhosis who began IFN therapy between 1986 and 1990, for the appearance of hepatocellular carcinoma.
All patients underwent intermittent administration of IFN for a median period of 18 months.
The research team quantified HBV-DNA using transcription mediated amplification and hybridization protection assay.
The researchers took an HBV-DNA count <3.7 log-genome equivalent (LGE)/mL (equivalent to 103.7 or 5000 copies/mL) to be a negative value.
The research team noted that out of 25 patients who had HBV-DNA loss after IFN therapy, 9 lost HBV-DNA during the therapy and 16 lost HBV-DNA after cessation of the therapy.
|Carcinogenesis was found in 35% of 32 patients without HBV-DNA loss|
|Journal of Hepatology and Gastroenterology|
The other 9 patients showed a transient loss of HBV-DNA.
The remaining 23 retained persistently positive HBV-DNA during and after therapy.
Although the researchers found that hepatocellular carcinoma developed in 8.0% of the 25 patients with HBV-DNA loss, carcinogenesis was found in 35% of 32 patients without HBV-DNA loss.
In the 2 exceptional patients, hepatocellular carcinoma was detected at 1.2 and 3.6 years after loss of HBV-DNA, respectively.
Dr Ikeda concluded, "When the HBV-DNA concentration decreased by 2 LGE/mL at 6 months after initiation of interferon, HBV-DNA became negative eventually in 15 of 25 patients."
He added, "A significant decrease or loss of serum HBV-DNA prevents development of hepatocellular carcinoma, and sequential analysis of HBV-DNA could be very useful in both the prediction and the early detection of small hepatocellular carcinoma."