| [ Summary ] |
Recently we have come to realize that we are facing a disastrous increase in the number of deaths from liver cirrhosis(LC) and hepatocellular carcinoma (HCC) in Japan. Most of these cases are caused by the hepatitis C virus(HCV). To prevent LC and HCC caused by HCV, we must treat patients with chronic hepatitis C. The most effective treatment available now is interferon(IFN) therapy. Some studies suggest that only those patients who show a high probability of becoming sustained responders by IFN therapy should be treated. Past studies elucidated several predictors for sustained response, which include duration of disease, serotype, viral load, interferon sensitivity determining region (ISDR), and stage of fibrosis. In contrast, we recommend treating most patients with chronic hepatitis C. The long-term follow-up for patients treated with IFN therapy revealed that the occurrence rate for HCC was 0.2%/year in sustained responders, 0.9% / year in transient responders and 6.7% / year in nonresponders. Thus, hepatocarcinogenosis was inhibited not only in sustained responders but also in transient responders. These two kinds of responders constituted 78% of all patients treated with IFN therapy. Thus, we recommend that all patients with chronic hepatitis C, which are liable to progress to LC and HCC, should be treated with IFN. |