A sustained virological response to interferon or interferon/ribavirin reduces hepatocellular carcinoma and improves survival in chronic hepatitis C: A nationwide, multicentre study in Taiwan

Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Antiviral therapy (Impact Factor: 3.02). 02/2006; 11(8):985-94.
Source: PubMed


The long-term benefit for chronic hepatitis C (CHC) patients treated with interferon (IFN)/ribavirin (RBV) combination therapy remains unclear. We aimed to evaluate the long-term effects of IFN monotherapy and IFN/RBV combination therapy on reducing hepatocellular carcinoma (HCC) and mortality in patients with chronic hepatitis C virus (HCV) infection, adjusting for risk factors.
A total of 1,619 patients with biopsy-proven CHC, including 1,057 receiving IFN-based therapy (760 on IFN/RBV combination therapy) and 562 untreated controls from three medical centres and one regional core hospital in Taiwan were enrolled in this retrospective-prospective cohort study.
The incidence of HCC and survival during a follow-up period of 1.0-15.3 (mean 5.18) and 1-16 (mean 5.15) years in treated and untreated patients, respectively, was analysed using Cox proportional hazards regression. The cumulative incidence of HCC was 35.2% and 12.2% for untreated and treated groups, respectively (P=0.0013). The cumulative survival rate was 93.1% and 96.2% for untreated and treated groups, respectively (P=0.3928). Significantly lower incidences of HCC and mortality were observed in sustained virological responders (both for IFN monotherapy and IFN/RBV combination) but not in nonresponders when compared with untreated patients. HCV genotype 1 patients had significantly higher incidences of HCC than genotype non-1 patients. In multivariate analysis, pre-existing cirrhosis, non-response, HCV genotype-1 and age were associated with HCC; pre-existing cirrhosis and non-response correlated to mortality.
A sustained virological response secondary to IFN monotherapy or IFN/RBV combination therapy could reduce the risk for HCC and improve survival of CHC patients.

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Available from: Ming-Lung Yu, Oct 14, 2015
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    • "Notably, although HCC occurred in only a minority of non-cirrhotic patients, older noncirrhotic patients with high baseline cGT levels had as great a risk for HCC development as cirrhotic patients. Persistent viremia has been recognized as a strong indicator of HCC development among patients who have received anti-HCV antiviral therapy [7] [8] [9] "
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    ABSTRACT: Background& Aims Hepatitis C virus (HCV)-infected patients with cirrhosis remain at risk of hepatocellular carcinoma (HCC) even after achieving sustained virological response (SVR). The aim of the study was to explore the incidence and risk for HCC among non-cirrhotic patients with an SVR. Methods A total of 642 patients with an SVR after peginterferon/ribavirin therapy were enrolled with a median follow-up period of 53.0 months (range: 6–133 months). Results Thirty-three of the 642 (5.1%) patients developed HCC over 2324.8 person-years of follow-up. Cox regression analysis revealed that the strongest predictive factor of HCC occurrence was liver cirrhosis (HR 4.98, 95% CI. 2.32-10.71, P<0.001), followed by age (HR 1.06, 95% CI. 1.02-1.11, P=0.005) and r-GT levels (HR 1.008, 95% CI. 1.004-1.013, P<0.001). The incidence of HCC did not differ between patients with high and low baseline r-GT levels among patients with cirrhosis (P=0.53), but the incidence of HCC was significantly higher in non-cirrhotic patients with high r-GT levels compared with those with low r-GT levels (P=0.001). Cox regression analysis revealed that the strongest factors associated with HCC development in non-cirrhotic sustained responders were baseline r-GT levels (HR 6.44, 95% CI. 2.20-18.89, P=0.001) and age (HR 3.68, 95% CI. 1.33-10.17, P=0.012). The incidence of HCC was not different between older non-cirrhotic patients with high r-GT levels and cirrhotic patients (P=0.34). Conclusions HCC remains a threat in non-cirrhotic patients with an SVR. Serum r-GT levels helped to identify potential patients at high risk.
    Journal of Hepatology 07/2014; 61(1). DOI:10.1016/j.jhep.2014.02.022 · 11.34 Impact Factor
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    • "Therefore, we are unable to understand if the discrepancy between the serological and virological diagnostic tests of HBV/HCV would change over time. The present study cannot provide our own data of liver disease deterioration, ie, chronic liver disease to LC or HCC, and effect of anti-viral therapy on their outcome is not known 36. Another study is now underway and we might be able to answer some of the above-mentioned questions. "
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    • "Successful HCV treatment using antiviral therapy would prevent the consequences of HCV infection.[2], [3] Recently, the introduction of direct antiviral agents (DAA) has greatly improved the sustained virological response (SVR) rate in patients with HCV genotype 1 (HCV-1) infection.[4] On the other hand, pegylated interferon (peginterferon)/ribavirin, which is the standard-of-care for HCV-2 patients, has provided satisfactory results with an SVR rate of 80–93%.[5]–[7] "
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    PLoS ONE 03/2013; 8(3):e58882. DOI:10.1371/journal.pone.0058882 · 3.23 Impact Factor
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