Impact of Interferon Therapy on the Natural History of Hepatitis C Virus Related Cirrhosis

Overview

Journal Gut

Specialty Gastroenterology

Date 2001 May 19

PMID 11358906

Citations 19

Authors

A Gramenzi

P Andreone

S Fiorino

C Camma

M Giunta

D Magalotti

C Cursaro

C Calabrese

V Arienti

C Rossi

G Di Febo

M Zoli

A Craxi

G Gasbarrini

M Bernardi

Affiliations

Soon will be listed here.

Abstract

Background: The role of interferon treatment on the natural history of hepatitis C virus related cirrhosis is under debate.

Aim: To evaluate the effect of interferon on the clinical course of compensated hepatitis C virus related cirrhosis.

Patients And Methods: Seventy two cirrhotic patients treated with interferon and 72 untreated controls matched treated patients with for quinquennia of age, sex, and Child-Pugh's score were enrolled in a prospective non-randomised controlled trial. Treated patients received leucocytic interferon alfa, with an escalating schedule for 12 months. The incidence and risk (Cox regression analysis) of clinical complications (hepatocellular carcinoma, ascites, jaundice, variceal bleeding, and encephalopathy) and death were calculated.

Results: Over median follow up periods of 55 months for treated and 58 for untreated subjects, seven and nine patients, respectively, died, and 20 and 32, respectively, developed at least one clinical complication (ns). Hepatocellular carcinoma developed in six treated and 19 untreated patients (p=0.018). Seven treated patients showed sustained aminotranferase normalisation and none died or developed complications. Clinical complications were significantly associated with low albumin, bilirubin, and prothrombin activity while hepatocellular carcinoma was significantly related to no treatment with interferon, oesophageal varices, and high alpha fetoprotein levels. By stratified analysis, the beneficial effect of interferon was statistically evident only in patients with baseline alpha fetoprotein levels > or =20 ng/ml.

Conclusions: Interferon does not seem to affect overall or event free survival of patients with hepatitis C virus related cirrhosis while it seems to prevent the development of hepatocellular carcinoma. Patients who achieved sustained aminotransferase normalisation survived and did not develop any complications during follow up.

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References

Peto R, Pike M, Armitage P, Breslow N, Cox D, Howard S . Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples. Br J Cancer. 1977; 35(1):1-39. PMC: 2025310. DOI: 10.1038/bjc.1977.1. View

Baffis V, Shrier I, Sherker A, Szilagyi A . Use of interferon for prevention of hepatocellular carcinoma in cirrhotic patients with hepatitis B or hepatitis C virus infection. Ann Intern Med. 1999; 131(9):696-701. DOI: 10.7326/0003-4819-131-9-199911020-00011. View

Chiaramonte M, Stroffolini T, Caporaso N, Coppola R, Craxi A, Gaeta G . Hepatitis-C virus infection in Italy: a multicentric sero-epidemiological study (a report from the HCV study group of the Italian Association for the Study of the Liver). Ital J Gastroenterol. 1991; 23(9):555-8. View

Tsukuma H, Hiyama T, Tanaka S, Nakao M, Yabuuchi T, Kitamura T . Risk factors for hepatocellular carcinoma among patients with chronic liver disease. N Engl J Med. 1993; 328(25):1797-801. DOI: 10.1056/NEJM199306243282501. View

Oka H, Tamori A, Kuroki T, Kobayashi K, Yamamoto S . Prospective study of alpha-fetoprotein in cirrhotic patients monitored for development of hepatocellular carcinoma. Hepatology. 1994; 19(1):61-6. View

Bellentani S, Tiribelli C, Saccoccio G, Sodde M, Fratti N, De Martin C . Prevalence of chronic liver disease in the general population of northern Italy: the Dionysos Study. Hepatology. 1994; 20(6):1442-9. DOI: 10.1002/hep.1840200611. View

Nishiguchi S, Kuroki T, Nakatani S, Morimoto H, Takeda T, Nakajima S . Randomised trial of effects of interferon-alpha on incidence of hepatocellular carcinoma in chronic active hepatitis C with cirrhosis. Lancet. 1995; 346(8982):1051-5. DOI: 10.1016/s0140-6736(95)91739-x. View

Koretz R . Interferon and hepatocellular carcinoma. Lancet. 1996; 347(8995):194-5. DOI: 10.1016/s0140-6736(96)90379-7. View

Andreone P, Cursaro C, Gramenzi A, Trevisani F, Gasbarrini G, Bernardi M . Interferon and hepatocellular carcinoma. Lancet. 1996; 347(8995):195. View

10.

Zoli M, Magalotti D, Bianchi G, Gueli C, Marchesini G, Pisi E . Efficacy of a surveillance program for early detection of hepatocellular carcinoma. Cancer. 1996; 78(5):977-85. DOI: 10.1002/(SICI)1097-0142(19960901)78:5<977::AID-CNCR6>3.0.CO;2-9. View

11.

Mazzella G, Accogli E, Sottili S, Festi D, Orsini M, Salzetta A . Alpha interferon treatment may prevent hepatocellular carcinoma in HCV-related liver cirrhosis. J Hepatol. 1996; 24(2):141-7. DOI: 10.1016/s0168-8278(96)80022-5. View

12.

Fattovich G, GIUSTINA G, Degos F, Tremolada F, Diodati G, Almasio P . Morbidity and mortality in compensated cirrhosis type C: a retrospective follow-up study of 384 patients. Gastroenterology. 1997; 112(2):463-72. DOI: 10.1053/gast.1997.v112.pm9024300. View

13.

Bruno S, Silini E, Crosignani A, Borzio F, Leandro G, Bono F . Hepatitis C virus genotypes and risk of hepatocellular carcinoma in cirrhosis: a prospective study. Hepatology. 1997; 25(3):754-8. DOI: 10.1002/hep.510250344. View

14.

Idilman R, de Maria N, Colantoni A, Dokmeci A, Van Thiel D . Interferon treatment of cirrhotic patients with chronic hepatitis C. J Viral Hepat. 1997; 4(2):81-91. DOI: 10.1111/j.1365-2893.1997.tb00209.x. View

15.

Fattovich G, GIUSTINA G, Degos F, Diodati G, Tremolada F, Nevens F . Effectiveness of interferon alfa on incidence of hepatocellular carcinoma and decompensation in cirrhosis type C. European Concerted Action on Viral Hepatitis (EUROHEP). J Hepatol. 1997; 27(1):201-5. DOI: 10.1016/s0168-8278(97)80302-9. View

16.

Camma C, Di Marco V, Lo Iacono O, Almasio P, Giunta M, Fuschi P . Long-term course of interferon-treated chronic hepatitis C. J Hepatol. 1998; 28(4):531-7. DOI: 10.1016/s0168-8278(98)80274-2. View

17.

Serfaty L, Aumaitre H, Chazouilleres O, Bonnand A, Rosmorduc O, Poupon R . Determinants of outcome of compensated hepatitis C virus-related cirrhosis. Hepatology. 1998; 27(5):1435-40. DOI: 10.1002/hep.510270535. View

18.

Poynard T, Opolon P . Hepatitis C: somber views of natural history and optimistic views of interferon treatment?. Hepatology. 1998; 27(5):1443-4. DOI: 10.1002/hep.510270537. View

19.

Imai Y, Kawata S, Tamura S, Yabuuchi I, Noda S, Inada M . Relation of interferon therapy and hepatocellular carcinoma in patients with chronic hepatitis C. Osaka Hepatocellular Carcinoma Prevention Study Group. Ann Intern Med. 1998; 129(2):94-9. DOI: 10.7326/0003-4819-129-2-199807150-00005. View

20.

Benvegnu L, Chemello L, Noventa F, Fattovich G, Pontisso P, Alberti A . Retrospective analysis of the effect of interferon therapy on the clinical outcome of patients with viral cirrhosis. Cancer. 1998; 83(5):901-9. DOI: 10.1002/(sici)1097-0142(19980901)83:5<901::aid-cncr15>3.0.co;2-z. View