抄録
Interferon (IFN) has been widely used as an useful antiviral agent for HCV-related chronic hepatitis patients to block the development to cirrhosis which often complicates hepatocellular carcinoma (HCC). However, its efficacy for cirrhotic patients is still equivocal. In 63 patients with HCV-related cirrhotic patients, the effect of IFN therapy on the occurrence of HCC was evaluated. The patients were allocated into IFN-therapy group and control group according to patients’ will. IFN-α or IFN-β was basically administered for 6 months or 6 weeks at various doses. There was no difference in demographic and clinical features between both groups. HCC occurred in 6 of 39 patients (15%) in the IFN-therapy group during the observation period (IFN group; 44.0±5.3 months, Control group; 42.4±5.0 months) but in 9 of 24 patients (38%) in the control group (p<0.05). The survival rate was also significantly improved in the IFN-therapy group. There were 7 of the 39 IFN-therapy group patients who showed sustained normal levels of serum GPT activity and no detectable HCV-RNA, but none of the control group patients (p<0.05). In these patients of the IFN-therapy group, serum albumin levels and platelet and WBC counts were significantly higher at the end of the observation period than before the IFN therapy, but such increases were not seen in the IFN-therapy group patients who did not show normalization in serum GPT activity and HCV-RNA. Cox’s multi-variate regression analysis revealed that alcohol intake, serum HCV-RNA levels and IFN therapy were significant factors related to the HCC occurrence in both groups. There were two patients who developed complications associated with the IFN therapy, but completely reversed after its discontinuation. In conclusion, IFN therapy may be an advisable candidate for HCV-related cirrhotic patients whose serum HCV-RNA levels were rather low to block the occurrence of HCC.
