[Hepatocarcinoma in HCV compensated correlated liver cirrhosis: role of treatment with interferon]

Abstract

The hepatocarcinoma (HCC) represents one of the major causes of morbidity and mortality in course of chronic HCV correlated hepatopathy. Up to today there are no reliable therapies which can delay or avoid the arising of HCC, nonetheless various Authors have noticed a decrease of such incidence in the subjects treated with interferon (IFN). Such encouraging results have not yet found univocal confirmation in course of compensated cirrhosis (Child-Pugh A). In our experience a cohort of 122 patients prospectively followed was analysed retrospectively to asses the effect of IFN therapy (mean follow-up 96 +/- 18.3 months). We conducted a randomized study in compensated cirrhosis with abnormal ALT and HCV-RNA positive serum (post-transfusional infection). Fifty-nine patients (mean age 55.3 +/- 7) received IFN (3 MU three times a week for 12 months) (8 stopped therapy for side effects), 71 did not receive IFN (mean age: 56.8 +/- 8). Baseline characteristics were similar. IFN therapy does not reduce the risk of HCC in compensated cirrhosis. In IFN treated patients it has been noted an improvement in relation with worsening and death/OLT. Moreover, in the non responder group, the number of negative events has been higher than in the sustained responder group and in subjects with relapse. On the contrary, no particular differences have been noticed in relation with the arising of HCC. It can be hypotized that the therapy with IFN does not reduce the risk of HCC in compensated cirrhosis. Such condition represents by itself a risk factor. It can be concluded that the therapy with IFN can be effective in reducing the possibility of clinical-laboratoristic worsening. However, even in case of substained response, the follow-up for the arising of HCC must always be done.