Although many studies have shown that interferon alfa inhibits hepatocarcinogenesis in chronic hepatitis C patients, a small number of hepatocellular carcinomas (HCCs) still occur even in patients experiencing a sustained virologic response (SVR).

In this study, investigators analyzed the frequency of HCC in sustained virologic responders over an extended period.

Seven hundred and ninety-two out of the 2,623 IFN-treated hepatitis C patients who had undergone liver biopsy showed a sustained virologic response. Screening for development of HCC was performed periodically during an average follow-up of 5.1 years.

Fibrosis of the pretreatment liver biopsy sample was graded. Risk factors for HCC were analyzed by using Cox proportional hazards regression.

Results

Of 792 patients, 23 developed HCC. Univariate analysis showed that stage of hepatic fibrosis, age, and alcohol consumption were significantly associated with a risk of HCC. There was a significant difference in the cumulative incidence between patients stratified according to these variables.

In conclusion, the authors write, “Pretreatment hepatic fibrosis score, age, and alcohol consumption may affect development of HCC even in sustained virologic responders. Thus, patients with these factors should be carefully followed even after eradication of the virus.”

Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.

02/23/05

Reference
Y Iwasaki and others. Risk factors for hepatocellular carcinoma in Hepatitis C patients with sustained virologic response to interferon therapy. Liver International 24(6): 603-10. December 2004.

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