Does treatment of patients with chronic hepatitis C prevent hepatocellular carcinoma?

Patients with chronic hepatitis C virus (HCV) infection are at lifelong risk of developing hepatocellular carcinoma (HCC). Interferon-α (IFN) is widely used for the treatment of individuals with chronic HCV infection. There have been several retrospective studies analyzing the incidence of HCC in chronic HCV patients in correlation to their response to treatment. These studies showed that even in patients with only a partial response to therapy, the incidence of HCC was significantly lower than in the nonresponders. In cirrhotic patients, the cancer-suppressive activity of IFN was similar in patients with ALT normalization whether or not HCV RNA had been eradicated. Occult HBV infection (anti-HBc alone) and alcohol were procarcinogenic factors in HCV-associated-HCC patients, with chemoprevention having a lesser effect. Cumulative dose of more than 500 million units of IFN and retreatment of IFN were also associated with suppressing HCC. We believe that the greater effectiveness of new antiviral agents and combination therapy, as opposed to IFN alone for viral clearance, will translate into a superior means for preventing HCC.