Efficacy of low dose long‐term interferon monotherapy in aged patients with chronic hepatitis C genotype 1 and its relation to alpha‐fetoprotein: A pilot study

Abstract

Low dose long-term interferon monotherapy to prevent carcinogenesis of HCC was considered useful in aged patients for whom peg-interferon and ribavirin combination therapy is difficult.

Serum Alpha-Fetoprotein Levels During and After Interferon Therapy and the Development of Hepatocellular Carcinoma in Patients with Chronic Hepatitis C

“…Consistent with our results, Murashima et al [21] have already reported that IFN reduces the serum AFP level during treatment regardless of virologic response. Nomura et al [23] also showed a significant decrease in serum AFP level during low-dose and long-term IFN monotherapy in 44 aged patients with CHC; SVR status was achieved in only two. In contrast, Chen et al [22] demonstrated a significant decrease in serum AFP level during and after IFN therapy in an SVR group (n = 26), whereas no significant decrease in serum AFP level was observed in the non-SVR group (n = 9).…”

“…Several studies have revealed that elevation of serum AFP levels in CHC is associated with female gender, elevated serum ALT level, prolonged prothrombin time, decreased platelet count, low serum albumin level, hepatic necroinflammation and fibrosis in biopsy specimens, and genotype 1b HCV infection [18][19][20][21][22]. In addition, IFN therapy decreases serum AFP levels in patients with CHC [20][21][22][23][24]. However, there is little knowledge about the relationship between the changes in serum AFP level associated with IFN therapy and the development of HCC.…”

Severe Inflammation in the Background Liver Cirrhosis Correlates with the Development of Poorly Differentiated HCC in HCV-Associated Liver Cirrhosis

“…Such an effort would be important because it is accepted that the prognosis of cirrhotic patients with poorly differentiated HCC is worse than that of those with well differentiated or moderately differentiated HCC as mentioned above. The drugs which are proven nowadays to alleviate inflammation in HCVassociated liver disease by significantly decreasing the serum alanine aminotransferase level are interferon (25)(26)(27)(28)(29), ursodeoxycholic acid (30,31) and herbal medicine (Strongerneominophagen C (32, 33), Sho-saiko-to (34,35), and Juzen-taiho-to (36)). However, prospective trials using antiinflammatory agents including interferon therapy are necessary to confirm a positive impact of anti-inflammatory therapy on the prevention of HCC promotion.…”

Efficacy of low‐dose intermittent interferon‐alpha monotherapy in patients infected with hepatitis C virus genotype 1b who were predicted or failed to respond to pegylated interferon plus ribavirin combination therapy

“…The ALT normalization rates at 0, 4, 12, 24, and 48 weeks after commencement of IFN monotherapy, according to (A) substitutions of core aa 70 and aa 91, (B) sex, and (C) the levels of low-density lipoprotein cholesterol. monotherapy, which could reduce the risk of hepatocarcinogenesis [Arase et al, , 2007Akuta et al, 2005a,b;Donlin et al, 2007;Nomura et al, 2007;McHutchison et al, 2008].…”

“…They identified substitutions of amino acid (aa) 70 and/or 91 in the HCV core region, female sex, and low levels of low-density lipoprotein cholesterol as independent and significant pretreatment negative predictors associated with virological response. Furthermore, previous studies reported that low-dose intermittent IFN monotherapy, as a treatment strategy, induces biochemical response [i.e., normalization of alanine aminotransferase (ALT) and alphafetoprotein (AFP) levels] and reduces the risk of hepatocarcinogenesis, even if patients failed to achieve sustained virological response [Arase et al, , 2007Nomura et al, 2007;McHutchison et al, 2008]. Hence, low-dose intermittent IFN monotherapy might be beneficial therapeutically in reducing the risk of hepatocarcinogenesis in patients who are predicted to be non-responsive to PEG-IFN plus RBV.…”