EFFECTIVENESS OF INTERFERON-ALFA ON INCIDENCE OF HEPATOCELLULAR-CARCINOMA AND DECOMPENSATION IN CIRRHOSIS TYPE-C

Background/Aims: The role of interferon alfa treatment in improving mo rbidity endpoints in patients with chronic hepatitis C infection is cu rrently under debate, The aim of this study was to evaluate the effect iveness of interferon in preventing hepatocellular carcinoma and decom pensation in cirrhosis type C. Methods: A retrospective cohort study w as carried out on 329 consecutive Caucasian patients with cirrhosis fo llowed for a mean period of 5 years at seven tertiary care university hospitals, Inclusion criteria were biopsy-proven cirrhosis, anti-HCV p ositivity abnormal serum aminotransferase levels and absence of compli cations of cirrhosis. Results: The yearly incidence of hepatocellular carcinoma was 2.3% for 136 untreated patients and 1.0% for 193 patient s treated with interferon alfa, The yearly incidence of hepatic decomp ensation was 5.7 for untreated and 1.5 for the treated patients, Fourt een (7%) of 193 treated patients showed sustained aminotransferase nor malization and none of them developed complications of cirrhosis. At e nrollment, untreated patients were older and had more severe liver dis ease than patients treated with interferon. After adjustment for clini cal and serologic differences at entry between treated and untreated p atients, the 5-year estimated probability of the occurrence of hepatoc ellular carcinoma was 2.1% and 2.7% and of decompensation was 7% and 1 1% for treated and untreated cases, respectively. Conclusions: This an alysis did not detect any significant benefit of interferon alfa on mo rbidity in patients with compensated cirrhosis type C, although it sug gests a reduction in complications of cirrhosis for those with a susta ined response to therapy, and it indicates the need for better therapi es.