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Interferon Therapy Reduces the Risk for Hepatocellular Carcinoma: National Surveillance Program of Cirrhotic and Noncirrhotic Patients with Chronic Hepatitis C in Japan

Haruhiko Yoshida, MD; Yasushi Shiratori, MD; Mitsuhiko Moriyama, MD; Yasuyuki Arakawa, MD; Tatsuya Ide, MD; Michio Sata, MD; Osami Inoue, MD; Michitami Yano, MD; Motohiko Tanaka, MD; Shigetoshi Fujiyama, MD; Shuhei Nishiguchi, MD; Tetsuo Kuroki, MD; Fumio Imazeki, MD; Osamu Yokosuka, MD; Shingo Kinoyama, MD; Gotaro Yamada, MD; Masao Omata, MD, IHIT Study Group
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From University of Tokyo and Nihon University, Tokyo, Japan; Kurume University, Fukuoka, Japan; Nagasaki Chuo Hospital, Nagasaki, Japan; Kumamoto University, Kumamoto, Japan; Osaka City University, Osaka, Japan; Chiba University, Chiba, Japan; and Kawasaki Medical School, Okayama, Japan.

Acknowledgments: The authors thank Tadao Kakizoe, MD, for general support and Yasuo Ohashi, PhD, for advice on biostatistics.

Grant Support: By the Ministry of Health and Welfare of Japan as one of the Comprehensive 10-Year Strategy for Cancer Control Projects (Field 4, Theme 2).

Requests for Reprints: Haruhiko Yoshida, MD, Department of Gastroenterology, University of Tokyo, Hongo 7-3-1,Bunkyo, Tokyo 113-8655, Japan; e-mail, yoshida-2im@h.u-tokyo.ac.jp.

Current Author Addresses: Drs.Yoshida, Shiratori, and Omata: Department of Gastroenterology, University of Tokyo, Hongo 7-3-1, Bunkyo, Tokyo 113, Japan.

Drs. Moriyama and Arakawa: Third Department of Internal Medicine, Nihon University, Oyaguchi-Kamicho 30-1, Itabashi, Tokyo173, Japan.

Drs. Ide and Sata: Second Department of Internal Medicine, Kurume University, Asahicho 67, Kurume, Fukuoka 830, Japan.

Drs. Inoue and Yano: Department of Clinical Research, Nagasaki Chuo Hospital, Kuhara 2-1001, Ohmura, Nagasaki 856,Japan.

Drs. Tanaka and Fujiyama: Third Department of Internal Medicine, Kumamoto University, Honjo 1-1-1, Kumamoto, Kumamoto 860,Japan.

Drs. Nishiguchi and Kuroki: Third Department of Internal Medicine, Osaka City University, Asahicho 1-5-7, Abeno, Osaka 545,Japan.

Drs. Imazeki and Yokosuka: First Department of Internal Medicine, Chiba University, Inohana 1-8-1, Chuo, Chiba 260, Japan.

Drs. Kinoyama and Yamada: Liver Center, Kawasaki Medical School, Nakayamashita 2-1-80, Okayama, Okayama 700, Japan.


Ann Intern Med. 1999;131(3):174-181. doi:10.7326/0003-4819-131-3-199908030-00003
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Hepatitis C virus (HCV) infection rarely resolves spontaneously once it becomes chronic (1). Most patients remain asymptomatic for a long period, with liver cirrhosis developing after approximately 30 years (23). Chronic hepatitis C with cirrhosis is a major risk factor for hepatocellular carcinoma (47). It has been previously shown that the risk increases with the degree of liver fibrosis (5).

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Figure 2.
Cumulative incidence of hepatocellular carcinoma (HCC) among patients treated with interferon (solid line) and untreated patients (dotted line).P

< 0.001 by the log-rank test. The number of hepatocellular carcinoma events and patients at risk at each time point are shown below the graph.

Grahic Jump Location
Grahic Jump Location
Figure 3.
Cumulative incidence of hepatocellular carcinoma (HCC) among patients treated with interferon (solid line) and untreated patients (dotted line), stratified by stage of liver fibrosis. Top left.PTop right.PBottom left.PBottom right.PP

Patients with stage F0 or F1 fibrosis. > 0.2. Patients with stage F2 fibrosis. = 0.0128. Patients with stage F3 fibrosis. = 0.0011. Patients with stage F4 fibrosis. = 0.0573. All values were obtained by using the log-rank test. The number of hepatocellular carcinoma events and patients at risk at each time point are shown below each graph.

Grahic Jump Location

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