Effect of Prolonged Interferon Therapy on the Outcome of Hepatitis C Virus–Related Cirrhosis: A Randomized Trial

Effects of interferon treatment on development and progression of hepatocellular carcinoma in patients with chronic virus infection: A meta‐analysis of randomized controlled trials

“…After careful evaluation by applying the inclusion criteria, a total of 12 eligible RCTs were identified. 8,[17][18][19][20][21][22][23][24][25][26][27] Of the 12 studies, two were reported by the same study center, and the patients selected were also same in the two studies 17,18 ; but they reported data on IFN treatment versus no antiviral treatment in one report 18 and the data of HCC based on SVR in the other report 17 ; so both of the two studies were included in our analysis. Another two studies were also from the same research group 8,23 ; however, only the most recent one was included.…”

“…The male population varied from 45 to 100% in the IFN-treated group and 43 to 100% in the control group. In patients included for analysis of IFN's effect and HCC risk, [17][18][19][20][21][22][23][24][25] the mean/median duration of follow-up ranged from 2 to 9.2 years in the IFN-treated group and 2 to 8.2 years in the control group. Overall, eight studies were rated as good quality (scoring three for each study) based on Jadad scale evaluation.…”

“…[17][18][19][20][21][22][23][24][25][26][27] Among the selected studies, four assessed the incidence of HCC in HCV-infected patients initially treated with nonmaintenance IFN compared with no antiviral treated patients [18][19][20][21] ; two reported data on nonmaintenance IFN and HCC risk in HCV-infected patients based on SVR and nonresponse (NR, defined as detectable serum HCV RNA levels and no decrease of serum alanine aminotransferase levels into the normal range throughout the treatment period) 17,21 ; two assessed the retreatment effect of maintenance IFN in HCV-infected patients who were nonresponding to initial IFN-based antiviral therapy 22,23 ; two evaluated HCC incidence between nonmaintenance IFN treated and untreated patients with HBV infection 24,25 ; and the other two analyzed the therapeutic effect of IFN on advanced HCC patients. 26,27 Six studies were published from Western countries, 19,20,[22][23][24]27 and five were published from Asia. 17,18,21,25,26 Sample size in each study varied from 28 to 495 in the IFNtreated group and 23 to 510 in the control group, with mean age varying from 32 to 61 years in the IFN-treated group and 32 to 63 years in the control group.…”

Effect of sustained virological response on long-term clinical outcome in 113 patients with compensated hepatitis C-related cirrhosis treated by interferon alpha and ribavirin

“…Therefore, studies of the effect of antiviral therapy on clinical outcome of HCV-cirrhosis have largely been retrospective analyses of therapeutic trials using interferon-α alone, focusing on patients with cirrhosis [4][5][6][7][8][9][10][11] . Only three randomized trials have assessed this effect, giving conflicting results [12][13][14][15] . Recent metaanalysis suggested a slight, but significant preventive effect of standard interferon-α monotherapy on HCC occurrence in patients with HCV-cirrhosis, especially in those who achieve SVR, who intrinsically represent a small proportion of patients in these trials [16,17] .…”

“…Recent metaanalysis suggested a slight, but significant preventive effect of standard interferon-α monotherapy on HCC occurrence in patients with HCV-cirrhosis, especially in those who achieve SVR, who intrinsically represent a small proportion of patients in these trials [16,17] . The influence of interferon-α on the incidence of decompensation or death in patients with HCV-cirrhosis was less studied and more controversial [4,8,10,12,14,18] . At present, bitherapy with standard then pegylated interferon plus ribavirin has created a new perspective for patients with HCV because of the higher rate of SVR reported [19,20] .…”