Decreased risk of hepatocellular carcinoma in patients with chronic hepatitis C whose serum alanine aminotransferase levels became less than twice the upper limit of normal following interferon therapy

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Abstract
Aim: The incidence of hepatocellular carcinoma (HCC) in C‐viral chronic hepatitis (CH) and liver cirrhosis (LC) patients after interferon (IFN) therapy was evaluated according to alanine aminotransferase (ALT) levels. Patients: Two hundred sixty‐nine patients with C‐viral CH and LC were treated with natural IFN‐α. The efficacy of IFN therapy was evaluated based on virologic response and ALT levels using the following groups: virologic‐sustained responders (VSR); biochemical‐sustained responders (BSR); partial responders (PR), which consisted of BSR patients whose serum ALT levels later relapsed; non‐responders (NR)1, which included patients with serum ALT levels that were usually less than 80 IU/l; and NR2, NR with ALT levels persistently more than 80 IU/l. Results: Of the 269 patients, 22 (8.2%) developed HCC after IFN therapy. The incidence of HCC (%/patient/year) was 0.78%, 0%, 0%, 0.17%, 4.68% in VSR, BR, PR, NR1, NR2, respectively. Multivariate analysis revealed that an increase in ALT levels to more than 80 IU/l is an important risk factor for the occurrence of HCC. Conclusions: We concluded that the patients with ALT levels less than twice the upper limit of normal after IFN therapy have a reduced risk of progression to HCC from C‐viral chronic liver disease.