Although cirrhosis is a major risk factor for development of hepatocellular carcinoma, no definitive prospective analyses have assessed the long-term efficacy of antiviral therapy in cirrhotic patients.
Dr Shiratori and colleagues from Japan undertook a study in order to elucidate the role of antiviral therapy in the suppression of liver tumors and survival over a long-term follow-up period.
The researchers designed a prospective cohort study, including a total of 345 patients with chronic hepatitis C and cirrhosis from 25 clinical centers.
The investigators oversaw treatment for 271 patients who received 6 to 9 million U of interferon 3 times weekly for 26 to 88 weeks; 74 participants received no treatment.
The research team carried out regular blood tests and abdominal ultrasonography to detect hepatocellular carcinoma.
The researchers detected hepatocellular carcinoma in 119 patients during a 6.8-year follow-up: 84 (31%) in the interferon-treated group and 35 (47%) in the untreated group.
|69 patients died during follow-up: 17% in the treated group and 32% in the untreated group|
|Annals of Internal Medicine|
The research team found that the cumulative incidence of hepatocellular carcinoma among interferon-treated patients was significantly lower than in untreated patients, especially sustained virologic responders.
A total of 69 patients died during follow-up: 17% in the treated group and 32% in the untreated group.
The researchers found that interferon-treated patients had a better chance of survival than the untreated group.
The research team noted that this was especially evident in sustained virologic responders.
Patients enrolled in the control group had declined to receive interferon treatment even though they were eligible for treatment.
Dr Shiratori concluded, "Interferon therapy for cirrhotic patients with chronic hepatitis C, especially those in whom the infection had been cured, inhibited the development of hepatocellular carcinoma and improved survival."