Effect of the dose and duration of interferon-alpha therapy on the incidence of hepatocellular carcinoma in noncirrhotic patients with a nonsustainedresponse to interferon for chronic hepatitis C

Objective: We evaluated the effect of dose and duration of treatment with i nterferon (IFN)-alpha on the incidence of hepatocellular carcinoma (HCC) af ter IFN treatment in patients with chronic hepatitis C. Methods:A total of 291 noncirrhotic patients with chronic hepatitis C without hepatitis B viru s coinfection in whom hepatitis C virus (HCV) was not eradicated by IFN-a t herapy were retrospectively analyzed. The incidence of HCC after IFN therap y was compared according to the total dose or duration of treatment. Result s: Patients were followed up for 6-117 months after the end of IFN treatmen t, The duration of IFN treatment (less than or equal to 24 vs. >24 weeks) h ad no effect on the incidence of HCC. However, the incidence of HCC was sig nificantly lower in patients who received >500 million units of IFN as a to tal dose than in patients who received less than or equal to 500 million un its of IFN (p = 0.0480), and the total dose of IFN (>500 million units) was an independent factor affecting the incidence of HCC (p = 0.0405). In addi tion, when focusing on patients whose histology was F2 or F3 before IFN tre atment, the suppressive effect of the total dose of IFN (>500 million units ) was emphasized (p = 0.0049 in generalized Wilcoxon test and p = 0.0178 in multivariate analysis). Conclusions: Patients with chronic hepatitis C sho uld receive more than 500 million units of IFN when IFN is used to decrease the incidence of subsequent HCC. Copyright (C) 2001 S, Karger AG, Basel.