Early Combination Therapy Prevents Liver Cancer
- "AASLD: Early Combination Therapy Prevents Liver Cancer in Hepatitis C Patients Who Fail on Interferon Monotherapy"
By Maria Bishop BOSTON, MA -- November 11, 2004 -- When patients with non-genotype 1 hepatitis C infection fail to achieve a sustained response on interferon monotherapy, they should be treated at an early stage with interferon plus ribavirin combination therapy -- especially older male patients with advanced fibrosis, who are at great risk of hepatocellular carcinoma (HCC). A 24-week course of combination therapy can prevent HCC has an 80% prevention rate in these patients, according to Japanese researchers speaking here on October 30[th at the 55th Annual Meeting of the American Society for Liver Diseases.
In this study, Naoki Hiramatsu, assistant professor, Department of Dendritic Cell Biology and Clinical Applications, Osaka University Graduate School of Medicine, Osaka, Japan, and colleagues enrolled 742 chronic hepatitis C patients who received interferon monotherapy. Two groups of patients were analyzed separately: 348 individuals with genotype 1 and a high viral load (called the 1H group) and 394 others.
Patients were categorized into 8 groups according to risk factors identified by multivariate analysis (age, gender, fibrosis). The risk ratio and incidence of HCC were calculated in comparison with the mean incidence of HCC in interferon nonresponders.
In the 1H group, the only significant risk factor for HCC was found to be age; with patients 55 years or older having a significantly higher risk ratio (RR = 3.77) than did those under 55 years (P =.0002).
Males over 55 years of age with fibrosis had the highest third-year rate of HCC appearance, which was 4.6% in sustained responders, 4.8% in transient responders and 8.0% in nonresponders.
In the non-1H group, the HCC incidence of transient responders and nonresponders was much higher than in the 1H group, although nearly the same values were obtained among sustained responders in both groups. Significant risk factors for HCC in this group were: age (RR = 4.37, P =.002), gender (RR = 5.59, P =.005), and degree of fibrosis (RR = 10.03, P =.002).
[Presentation title: "Necessity of Early Re-Treatment For Patients With Chronic Hepatitis C Who Do Not Achieve Sustained Response By Interferon Monotherapy." Abstract 383]
[Non-text portions of this message have been removed]