INTERFERON DECREASES HEPATOCELLULAR CARCINOGENESIS IN PATIENTS WITH CIRRHOSIS CAUSED BY THE HEPATITIS-B VIRUS - A PILOT-STUDY

BACKGROUND. To elucidate the influence of long term interferon adminis tration on the rate of occurrence of hepatocellular carcinoma (HCC) in patients with hepatitis B virus (HBV)-related cirrhosis, the authors analyzed 313 consecutive patients with cirrhosis. METHODS. Of the 313 patients, 94 underwent long term intermittent administration of interf eron for greater than or equal to 6 months, and the remaining 219 pati ents received no interferon or other antiviral drug. RESULTS. Cumulati ve occurrence rates of HCC in the group treated with interferon and th e untreated group were 4.5% and 13.3%, respectively, at the end of 3 y ears; 7.0% and 19.6%, respectively at the end of 5 years; and 17.0% an d 30.8%, respectively, at the end of 10 years. The rate of HCC develop ment in the treated group was significantly lower than that of the unt reated group (P = 0.0124). The Cox proportional hazard model revealed that interferon treatment was an independent contributing factor in lo wering the rate of carcinogenesis (odds ratio = 0.39; P = 0.031) even after correction by significant covariates in multivariate analysis. T he virologic study showed that the role of interferon therapy from the viewpoint of cancer prevention was much more significant in patients with a HBV DNA concentration of greater than or equal to 10 milliequiv alents. CONCLUSIONS. Interferon therapy for patients with HBV-related cirrhosis significantly decreased the HCC rate, especially in patients with a larger amount of serum HBV DNA. If interferon is administered properly for a selected group of patients, an effective strategy of ca ncer prevention can be achieved, even in patients with cirrhosis. (C) 1998 American Cancer Society.