According to results recently published in the journal Gut, patients with hepatitis C who have long-term responses to treatment with interferon have rates of liver cancer comparable to that of the general public.
Liver cancer is one of the most common types of cancer in the world. However, since its prevalence is much more common in the Eastern world compared to the Western world, most information regarding the disease has been established from studies conducted in that part of the world. The most common type of liver cancer, hepatocellular carcinoma, is characterized by cancer that starts in cells of the liver and can spread through blood and lymph vessels to different parts of the body. The liver is the largest organ in the body and is responsible for over 500 functions, including the secretion of glucose, proteins, vitamins and fats; the production of bile; the processing of hemoglobin; and the detoxification of numerous substances.
Infection with the hepatitis C virus increases a patient’s risk of developing hepatocellular cancer. Researchers continue to evaluate optimal management of hepatitis C, in order to reduce the risk of developing hepatocellular cancer, as well as diminish other damage to the liver that is caused by hepatitis C. Long-term treatment with the biologic agent interferon has demonstrated effective control of hepatitis C in patients infected with the virus. However, not all individuals respond to treatment with single-agent interferon. Research has focused not only on different options for treatment of hepatitis C, but also the long-term efficacy of chronic treatment with interferon in infected patients. Furthermore, researchers have begun to evaluate possible differences in treatment outcomes between patients in the Eastern and Western worlds.
A recent multi-institutional study including several countries from Europe evaluated the results of 8 clinical trials evaluating the effectiveness of long-term therapy with interferon in patients diagnosed with hepatitis C and its ability to help prevent hepatocellular cancer. This study included 336 patients who had been diagnosed with hepatitis C and were followed for over 4 years. Patients were treated with single-agent interferon; 286 patients had sustained anti-viral responses to treatment and 50 had detectable virus following treatment, but normal liver enzyme levels that are used to detect liver function (biochemical responders). Among patients who had sustained viral responses, none developed hepatocellular cancer. Among patients who had a biochemical response, the rate of hepatocellular cancer was 7.1%. Survival among patients who had sustained viral responses to interferon was comparable to that of the general population.
The researchers concluded that patients with hepatitis C who have viral responses to long-term therapy with interferon have low rates of hepatocellular cancer and have survival similar to that of the general public. Patients diagnosed with hepatitis C may wish to speak with their physician about their individual risks and benefits of treatment with long-term interferon.
Reference: Veldt B, Saracco G, Boyer N, et al. Long term clinical outcome of chronic hepatitis C patients with sustained virological response to interferon monotherapy. Gut. 2004; 53: 1504-1508.