Development of small hepatocellular carcinoma 80 months after clearance ofhepatitis C virus with interferon therapy

We describe a patient who had a complete and sustained response to interfer on (IFN) therapy for chronic hepatitis C but developed small hepatocellular carcinoma (HCC) 80 months later. A 55-year-old Japanese man with hepatitis C virus (HCV) infection and histological features of chronic active hepati tis was treated with recombinant IFN alpha-2a, 9 000 000 U daily for 2 week s followed by three times a week for 22 weeks, He successfully responded to IFN therapy with a normalization of serum alanine aminotransferase and con tinuous disappearance of serum HCV-RNA. However, 80 months after the cessat ion of IFN therapy, the patient's alpha-fetoprotein (AFP) level became elev ated for the first time and HCC, 12 mm in diameter, was detected by routine ultrasonographic screening, Laparotomy revealed a small HCC with no metast asis, and the nontumorous liver demonstrated chronic inactive hepatitis. Th is case indicates the need for careful follow-up using ultrasonography and AFP testing for at least 7 years after completing IFN therapy in all patien ts with chronic hepatitis C, even if the patients have a complete response to the therapy, (C) 2000 Lippincott Williams & Wilkins.