Effect of Response to Interferon-alpha Therapy on the Occurrence of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B

초록

Objectives: The aim of this study was to examine whether interferon-alpha (IFN-alpha) therapy may reduce the occurrence of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) and to determine its effect based on responsiveness to IFN-alpha therapy. Methods: A total of 641 biopsy-proven CHB patients were treated with IFN-alpha 2b. They were followed by biochemistry and/or imaging studies at 3- to 6-month intervals for a median period of 113 months (range 6-222). Results: HCC was detected in 22 patients and 5- and 10-year cumulative occurrence rates were 0.4 and 3.2%, respectively. In univariate analysis, age (p < 0.001), serum AFP levels (p < 0.001), and serum HBV-DNA levels (p = 0.002) at baseline were associated with HCC development. HCC occurred less frequently in biochemical responders at the end of treatment than in non-responders (p = 0.001). However, virologic response was not associated with HCC development. Multivariate analysis showed that poor biochemical response (p = 0.007) as well as older age (p = 0.018) and a higher serum AFP level (p < 0.001) remained independent predisposing factors of HCC development in CHB patients treated with IFN-alpha. Conclusion: The results suggest that the biochemical but not virologic response to IFN-alpha therapy reduces independently the occurrence of HCC in patients with CHB. Copyright (C) 2012 S. Karger AG, Basel

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