Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan.
BACKGROUND AND AIMS:
The effects of pegylated interferon (PEG-IFN) α and ribavirin (RBV) treatment for chronic hepatitis C on the incidence of hepatocellular carcinoma (HCC) have not been well established. This study investigated the impact of treatment outcome on the development of HCC by chronic hepatitis C patients treated with PEG-IFNα2b and RBV.
This large-scale, prospective, multicenter study consisted of 1,013 Japanese chronic hepatitis C patients with no history of HCC (non-cirrhosis, n=863 and cirrhosis, n=150). All patients were treated with PEG-IFNα2b and RBV and the follow-up period started at the end of antiviral treatment (median observation period of 3.6 years). The cumulative incidence rate of HCC was estimated by the Kaplan-Meier method according to treatment outcome.
Forty-seven patients (4.6%) developed HCC during the observation period. In the non-cirrhosis group, the 5-year cumulative incidence rates of HCC for the sustained virological response (SVR) (1.7%) and transient virological response (3.2%) (TVR: defined as relapse or breakthrough) groups were significantly lower than that of the non-virological response (NVR) group (7.6%) (P=0.003 and P=0.03, respectively). A significantly low rate of incidence of HCC by TVR patients in comparison with NVR patients was found for patients with aged 60 and over, but not for those aged under 60. In the cirrhosis group, the 5-year cumulative incidence rates of HCC for the SVR (18.9%) and TVR groups (20.8%) were also significantly lower than that of the NVR group (39.4%) (P=0.03 and P=0.04, respectively).
SVR and complete viral suppression during treatment with relapse (TVR) were associated with a lower risk of the development of HCC when compared with NVR.