Effect of response to interferon-α therapy on the occurrence of hepatocellular carcinoma in patients with chronic hepatitis B

Dig Dis. 2012;30(6):568-73. doi: 10.1159/000343068. Epub 2012 Dec 13.

Abstract

Objectives: The aim of this study was to examine whether interferon-α (IFN-α) therapy may reduce the occurrence of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) and to determine its effect based on responsiveness to IFN-α therapy.

Methods: A total of 641 biopsy-proven CHB patients were treated with IFN-α2b. 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-α.

Conclusion: The results suggest that the biochemical but not virologic response to IFN-α therapy reduces independently the occurrence of HCC in patients with CHB.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Antiviral Agents / therapeutic use*
  • Carcinoma, Hepatocellular / prevention & control*
  • Carcinoma, Hepatocellular / virology
  • DNA, Viral / blood*
  • Female
  • Follow-Up Studies
  • Hepatitis B, Chronic / blood
  • Hepatitis B, Chronic / complications
  • Hepatitis B, Chronic / drug therapy*
  • Humans
  • Interferon alpha-2
  • Interferon-alpha / therapeutic use*
  • Kaplan-Meier Estimate
  • Liver Neoplasms / prevention & control*
  • Liver Neoplasms / virology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Polyethylene Glycols / therapeutic use*
  • Proportional Hazards Models
  • Recombinant Proteins / therapeutic use
  • Treatment Outcome
  • Young Adult
  • alpha-Fetoproteins / metabolism*

Substances

  • Antiviral Agents
  • DNA, Viral
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins
  • alpha-Fetoproteins
  • Polyethylene Glycols
  • peginterferon alfa-2b