Clinical

Ongoing peginterferon for HCV does not reduce liver cancer risk

Last Updated: 2009-02-11 17:16:05 -0400 (Reuters Health)

NEW YORK (Reuters Health) - In patients infected with hepatitis C virus (HCV), maintenance therapy with peginterferon does not reduce the incidence of hepatocellular carcinoma (HCC), according to a report in the January issue of Gastroenterology.

"Our data (along with other results published earlier) showed that maintenance interferon does not reduce HCC or other clinical outcomes in patients who do not experience virus suppression," Dr. Anna S. Lok from the University of Michigan Medical Center, Ann Arbor, told Reuters Health. "Given the costs and side effects, maintenance interferon should not be used in clinical practice."

Dr. Lok and colleagues used data from the HALT-C (Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis) study to investigate whether long-term peginterferon treatment reduced the incidence of HCC and to identify risk factors associated with the development of HCC.

During a median follow-up of 4.6 years, 4.5% of peginterferon-treated patients and 4.9% of controls developed HCC, the authors report, for an estimated annual incidence of HCC of 1.1% in peginterferon-treated patients and 1.0% in controls.

The annual incidence of HCC was higher among patients with cirrhosis (1.4%) than among those with bridging fibrosis (0.8%).

Additional risk factors for developing HCC included older age, black race, higher alkaline phosphatase, the presence of esophageal varices, a history of smoking, and a lower platelet count.

Low platelet count and the presence of esophageal varices were the most significant contributors in the models tested, the researchers note.

"The HALT-C patients will be followed until October 2009," Dr. Lok explained. "This will allow us to evaluate the incidence of HCC over a longer period -- this is very important, as this is the first large prospective study of hepatitis C patients in the US to evaluate the incidence of HCC. Our data indicate that the rate of HCC seen in our patient population is lower than that reported in Japan and closer to that seen in European countries."

Gastroenterology 2009;136:138-148.