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Evidence summaries

Interferon and Prevention of Hepatocellular Carcinoma in Viral Cirrhosis

Interferon appears to have a slight preventive effect on hepatocellular carcinoma prevention in patients with HCV-related cirrhosis. Level of evidence: "B"

A systematic review 1 including 18 studies with a total of 4 614 subjects was abstracted in DARE. A difference in the incidence of HCC between the treated and untreated cirrhotic patients was observed. The pooled RD was 12.8 (95% CI: -8.3 to -17.2) when using a random-effects model.

Logistic regression analysis showed that cirrhotic patients treated with IFN have a lower likelihood of developing HCC (OR 0.28) after adjusting for covariates (IFN treatment, length of follow-up, cancer rate among untreated patients, design of study, type of publication and ethnic origin of patients).

When all studies except those demonstrating the highest and lowest therapeutic benefit were included in the meta-analysis, the RD was 12.5 (95% CI: -9.1 to-15.1). Compared with untreated patients, the rate of HCC development was lower in both sustained responders to IFN (pooled RD 19.1, 95% CI: - 13.1 to -25.2), and in non-responders (pooled RD 11.8, 95% CI: -6.4 to -17.1).

When only RCTs were pooled, there was a significant difference between the treated and untreated cirrhotic patients (RD 18.7, 95% CI: -3.9 to -33.5).

    References

    • Cammà C, Giunta M, Andreone P, Craxì A. Interferon and prevention of hepatocellular carcinoma in viral cirrhosis: an evidence-based approach. J Hepatol 2001 Apr;34(4):593-602. [PubMed] [DARE]

Primary/Secondary Keywords