AIM: To determine the role of interferon (IFN) with or without ribavirin in preventing or delaying hepatocellular carcinoma (HCC) development in patients with hepatitis C virus (HCV) related cirrhosis. Data on the preventive effect of IFN plus ribavirin treatment are lacking. METHODS: A total of 101 patients (62 males and 39 females, mean age 55.1+/-1.4 years) with histologically proven HCV related liver cirrhosis plus compatible biochemistry and ultrasonography were enrolled in the study. Biochemistry and ultrasonography were performed every 6 mo. Ultrasound guided liver biopsy was performed on all detected focal lesions. Follow-up lasted for 5 years. Cellular proliferation, evaluated by measuring Ag-NOR proteins in hepatocytes nuclei, was expressed as AgNOR-Proliferative index (AgNOR-PI) (cut-off = 2.5). Forty-one patients (27 males, 14 females) were only followed up after the end of an yearly treatment with IFN-alpha2b (old treatment control group = OTCG). Sixty naive patients were stratified according to sex and AgNOR-PI and then randomized in two groups: 30 were treated with IFN-alpha2b + ribavirin (treatment group = TG), the remaining were not treated (control group = CG). Nonresponders (NR) or relapsers in the TG received further IFN/ribavirin treatments after a 6 mo of withdrawal. RESULTS: AgNOR-PI was significantly lowered by IFN (P<0.001). HCC incidence was higher in patients with AgNOR-PI>2.5 (26% vs 3%, P<0.01). Two NR in the OTCG, none in the TG and 9 patients in the CG developed HCC during follow-up. The Kaplan-Mayer survival curves showed statistically significant differences both between OTCG and CG (P<0.004) and between TG and CG (P<0.003). CONCLUSION: IFN/ribavirin treatment associated with re-treatment courses of NR seems to produce the best results in terms of HCC prevention. AgNOR-PI is a useful marker of possible HCC development.

Interferon plus ribavirin and interferon alone in preventing hepatocellular carcinoma: a prospective study on patients with HCV related cirrhosis / AZZAROLI F; ACCOGLI E; NIGRO G; TRERE D; GIOVANELLI S; MIRACOLO A; LODATO F; MONTAGNANI M; TAME M; COLECCHIA A; MWANGEMI C; FESTI D; RODA E; DERENZINI M.; MAZZELLA G.. - In: WORLD JOURNAL OF GASTROENTEROLOGY. - ISSN 1007-9327. - STAMPA. - 10(21):(2004), pp. 3099-3102. [10.3748/wjg.v10.i21.3099]

Interferon plus ribavirin and interferon alone in preventing hepatocellular carcinoma: a prospective study on patients with HCV related cirrhosis.

AZZAROLI, FRANCESCO;TRERE', DAVIDE;LODATO, FRANCESCA;MONTAGNANI, MARCO;TAME', MARIAROSA;COLECCHIA, ANTONIO;FESTI, DAVIDE;RODA, ENRICO;DERENZINI, MASSIMO;MAZZELLA, GIUSEPPE
2004

Abstract

AIM: To determine the role of interferon (IFN) with or without ribavirin in preventing or delaying hepatocellular carcinoma (HCC) development in patients with hepatitis C virus (HCV) related cirrhosis. Data on the preventive effect of IFN plus ribavirin treatment are lacking. METHODS: A total of 101 patients (62 males and 39 females, mean age 55.1+/-1.4 years) with histologically proven HCV related liver cirrhosis plus compatible biochemistry and ultrasonography were enrolled in the study. Biochemistry and ultrasonography were performed every 6 mo. Ultrasound guided liver biopsy was performed on all detected focal lesions. Follow-up lasted for 5 years. Cellular proliferation, evaluated by measuring Ag-NOR proteins in hepatocytes nuclei, was expressed as AgNOR-Proliferative index (AgNOR-PI) (cut-off = 2.5). Forty-one patients (27 males, 14 females) were only followed up after the end of an yearly treatment with IFN-alpha2b (old treatment control group = OTCG). Sixty naive patients were stratified according to sex and AgNOR-PI and then randomized in two groups: 30 were treated with IFN-alpha2b + ribavirin (treatment group = TG), the remaining were not treated (control group = CG). Nonresponders (NR) or relapsers in the TG received further IFN/ribavirin treatments after a 6 mo of withdrawal. RESULTS: AgNOR-PI was significantly lowered by IFN (P<0.001). HCC incidence was higher in patients with AgNOR-PI>2.5 (26% vs 3%, P<0.01). Two NR in the OTCG, none in the TG and 9 patients in the CG developed HCC during follow-up. The Kaplan-Mayer survival curves showed statistically significant differences both between OTCG and CG (P<0.004) and between TG and CG (P<0.003). CONCLUSION: IFN/ribavirin treatment associated with re-treatment courses of NR seems to produce the best results in terms of HCC prevention. AgNOR-PI is a useful marker of possible HCC development.
2004
Interferon plus ribavirin and interferon alone in preventing hepatocellular carcinoma: a prospective study on patients with HCV related cirrhosis / AZZAROLI F; ACCOGLI E; NIGRO G; TRERE D; GIOVANELLI S; MIRACOLO A; LODATO F; MONTAGNANI M; TAME M; COLECCHIA A; MWANGEMI C; FESTI D; RODA E; DERENZINI M.; MAZZELLA G.. - In: WORLD JOURNAL OF GASTROENTEROLOGY. - ISSN 1007-9327. - STAMPA. - 10(21):(2004), pp. 3099-3102. [10.3748/wjg.v10.i21.3099]
AZZAROLI F; ACCOGLI E; NIGRO G; TRERE D; GIOVANELLI S; MIRACOLO A; LODATO F; MONTAGNANI M; TAME M; COLECCHIA A; MWANGEMI C; FESTI D; RODA E; DERENZINI M.; MAZZELLA G.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/1348
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