Treatment with peginterferon-alpha2a and ribavirin may be individualized by genotype. Patients with HCV genotype 1 require treatment for 48 weeks and a standard dose of ribavirin; those with HCV genotypes 2 or 3 seem to be adequately treated with a low dose of ribavirin for 24 weeks.

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Background: The role of interferon in the prevention of hepatocellular carcinoma remains controversial. Aim: In this meta‐analysis we evaluated the hepatocellular carcinoma incidence in interferon‐treated and ‐untreated patients with hepatitis C virus‐related cirrhosis. Methods: Eleven studies with 2178 patients were found to fulfil our inclusion criteria. The pooled odds ratio (OR) and 95% confidence intervals (CI) were calculated from the raw study data. Results: Hepatocellular carcinoma development was significantly more frequent in untreated (21.5%) than in interferon‐treated patients (8.2%; OR: 3.0, 95% CI: 2.3–3.9). In the five studies reporting hepatocellular carcinoma incidence in patients with and without sustained response to interferon, hepatocellular carcinoma was detected at a much higher rate in patients without (9%) than with a sustained response (0.9%; OR: 3.7, 95% CI: 1.7–7.8). Moreover, hepatocellular carcinoma developed significantly more frequently in the untreated patients than in the non‐sustained responders (OR: 2.7, 95% CI: 1.9–3.9). The benefit from interferon on hepatocellular carcinoma incidence was not influenced by the study type (prospective or retrospective), the follow‐up duration, or the study origin. Conclusions: Interferon therapy significantly reduces the hepatocellular carcinoma risk in patients with hepatitis C virus cirrhosis. Hepatocellular carcinoma development becomes almost negligible among sustained responders, but a reduction in hepatocellular carcinoma incidence is also achieved even in the non‐sustained responders.

shimoto's disease, 1,2 as well as of thyroid autoantibodies and/ The prevalence of antithyroid peroxidase antibodies or thyroid dysfunction among patients with chronic hepatitis (ATPO) and/or of thyroid dysfunction was studied in 422 C. [3][4][5] However, the suggested link between hepatitis C and patients with chronic viral hepatitis C, B, and D. Baseline thyroid disease is still uncertain. Data in the literature are results were compared with those during and 6 months after few and differ widely among studies, depending on the charinterferon alfa (IFN-a) therapy. The overall prevalence of acteristics of the populations tested and the sensitivity of the ATPO among untreated patients was 14.1%, with no signifimethods used. [6][7][8] Moreover, in most reports, no comparison cant differences between chronic hepatitis C, B, or D, as well has been made between chronic hepatitis C and the other as between males and females. However, high ATPO titers known types of chronic viral hepatitis (B and D). (¢18 IU/mL) clustered significantly among females (8.7% vs.Therapy with interferon alfa (IFN-a), widely used in 3.4%; P Å .022), especially those with chronic hepatitis C chronic viral hepatitis B or C and in various malignant dis-(11.2% vs. 3.6%; P Å .036). Before treatment, 3.7% of the eases, has also been associated with a high prevalence of patients had thyroid dysfunction, mostly hypothyroidism autoantibodies, and rarely with the development of overt (3.5%), the latter increasing to 14.3% among patients with autoimmune diseases. Thyroid disease, with clinical manifes-ATPO titers ¢18 IU/mL. IFN-a treatment significantly intations of hypothyroidism or hyperthyroidism, has been recreased overall thyroid dysfunction (9.7%; P Å .001) and ported in 5% to 12% of patients who received IFN-a for hypothyroidism (7.8%; P Å .01), particularly among patients various diseases, 9-11 while antithyroid autoantibodies were with high baseline ATPO (38.5%; P Å .0002). Six months present in a high percentage. 11-14 Indeed, only a minority of after stopping IFN-a treatment, the prevalence of thyroid dyspatients with chronic viral hepatitis who are positive for function was 8.0%, still significantly higher than at baseline.antimicrosomal or antithyroid antibodies have thyroid dysBy multivariate analysis, the only predictor positively associfunction, which is usually subclinical. transcriptase polymerase chain reaction method (Amplicor, Roche