Review
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World J Hepatol. Oct 27, 2013; 5(10): 521-527
Published online Oct 27, 2013. doi: 10.4254/wjh.v5.i10.521
Chemoprevention of hepatocellular carcinoma in patients with hepatitis C virus related cirrhosis
Gianni Testino, Paolo Borro
Gianni Testino, Paolo Borro, Department of Internal e Specialistic Medicine, Centro Alcologico Regionale-Regione Liguria, UO Alcologia e Patologie Correlate, 16132 Genova, Italy
Gianni Testino, Paolo Borro, IRCCS AOU San Martino-IST-National Institute for Cancer Research, 16100 Genova, Italy
Author contributions: Testino G and Borro P designed and performed the research, contributed new reagents and analytical tools and analyzed data; Testino G wrote the paper.
Correspondence to: Gianni Testino, MD, Department of Internal e Specialistic Medicine, Centro Alcologico Regionale–Regione Liguria, UO Alcologia e Patologie Correlate, Padiglione 10 (piano Terra), Piazzale R. Benzi 10, 16132 Genova, Italy. gianni.testino@hsanmartino.it
Telephone: +39-10-5552769 Fax: +39-10-5556741
Received: May 13, 2013
Revised: August 23, 2013
Accepted: September 18, 2013
Published online: October 27, 2013
Abstract

Interferon (IFN) therapy has been reported to decrease the risk of hepatocellular carcinoma (HCC) and improve survival by preventing liver-related deaths in patients with chronic hepatitis C virus (HCV) infection, while the role of IFN therapy on the natural history of hepatitis C related cirrhosis is still under debate. The ideal goal of therapy is to prevent the progression into end-stage disease. The use of IFN in patients with HCV compensated cirrhosis reduces the negative clinical evolution independently of the type of laboratoristic and virological response. In our experience, IFN therapy in HCV compensated cirrhosis is barely useful in prevention of HCC, as cirrhosis itself represents a risk of cancer. Some authors noted that IFN treatment reduces the risk of HCC independently of the virological response. It would probably be interesting to evaluate the efficacy of weekly low-dose pegylated (PEG)-IFN therapy in patients with HCV cirrhosis and to assess potential benefits of long-term PEG-IFN plus Ribavirin treatment.

Keywords: Chemoprevention, Cirrhosis, Hepatitis C virus, Hepatocellular carcinoma

Core tip: Interferon (IFN) therapy has been reported to decrease the risk of hepatocellular carcinoma (HCC) and improve survival. The use of IFN in patients with hepatitis C virus (HCV) compensated cirrhosis reduces the negative clinical evolution independently of the type of the laboratoristic and virological response. In our experience, IFN therapy in HCV compensated cirrhosis is barely useful in the prevention of HCC, as cirrhosis itself represents a risk of cancer. It would probably be interesting to evaluate the efficacy of weekly low-dose pegylated (PEG)-IFN therapy in patients with HCV cirrhosis and to assess potential benefits of long-term PEG-IFN plus Ribavirin treatment.