Effect of interferon therapy on the development of hepatocellular carcinoma in patients with hepatitis C virus-related cirrhosis: a meta-analysis.

Background: The role of interferon in the prevention of hepatocellular carcinoma remains controversial. Aim: In this meta-analysis we evaluated the hepatocellular carcinoma incidence in interferon-treated and -untreated patients with hepatitis C virus-related cirrhosis. Methods: Eleven studies with 2178 patients were found to fulfil our inclusion criteria, The pooled odds ratio (OR) and 95% confidence intervals (CI) were calculated from the raw study data. Results: Hepatocellular carcinoma development was significantly more frequent in untreated (21.5%) than in interferon-treated patients (8.2%; OR: 3.0, 95% CI: 2.3-3.9). In the five studies reporting hepatocellular carcinoma incidence in patients with and without sustained response to interferon, hepatocellular carcinoma was detected at a much higher rate in patients without (9%) than with a sustained response (0.9%; OR: 3.7, 95% CI: 1.7-7.8). Moreover, hepatocellular carcinoma developed significantly more frequently in the untreated patients than in the non-sustained responders (OR: 2.7, 95% CI: 1.9-3.9). The benefit from interferon on hepatocellular carcinoma incidence was not influenced by the study type (prospective or retrospective), the follow-up duration, or the study origin. Conclusions: Interferon therapy significantly reduces the hepatocellular carcinoma risk in patients with hepatitis C virus cirrhosis. Hepatocellular carcinoma development becomes almost negligible among sustained responders, but a reduction in hepatocellular carcinoma incidence is also achieved even in the non-sustained responders.