Department of Medicine, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea.
Gut Liver. 2011 Mar;5(1):77-81. doi: 10.5009/gnl.2011.5.1.77. Epub 2011 Mar 16.
BACKGROUND/AIMS: Despite great progress, antiviral treatment for chronic hepatitis C in patients with prior hepatocellular carcinoma (HCC) has been rarely investigated. We evaluated the efficacy and safety of antiviral therapy following treatment for hepatitis C-related HCC.
Thirteen patients (age 34 to 60 years) who were treated with peginterferon plus ribavirin after treatment for HCC were reviewed.
There were 6 patients with genotype 1 and 7 patients with genotype 2. All patients showed advanced fibrosis (≥F3) but belonged to the Child-Pugh class A. Treatment was stopped in 2 patients because of recurrent HCC and in 1 patient due to a lack of early virologic response. Seven patients achieved sustained virologic response and three patients relapsed. The sustained virologic response rate was 54% overall, 17% in genotype 1, and 86% in genotype 2. No significant adverse events were reported.
Antiviral therapy should not be excluded in patients who were previously treated with HCC with genotype 2 chronic hepatitis C, in which an efficacious antiviral treatment for chronic hepatitis C was feasible. Additional study is needed to prove the validity of antiviral therapy in patients with genotype 1 hepatitis C-related HCC.
背景/目的：尽管取得了巨大进展，但对于先前患有肝细胞癌（HCC）的慢性丙型肝炎患者的抗病毒治疗仍鲜有研究。我们评估了治疗丙型肝炎相关 HCC 后抗病毒治疗的疗效和安全性。
回顾了 13 名接受聚乙二醇干扰素加利巴韦林治疗 HCC 后的患者。
6 例患者为基因型 1，7 例患者为基因型 2。所有患者均显示出晚期纤维化（≥F3），但均属于 Child-Pugh 分级 A。由于 HCC 复发，2 例患者停止治疗，1 例患者因早期病毒学应答不足而停止治疗。7 例患者达到持续病毒学应答，3 例患者复发。持续病毒学应答率总体为 54%，基因型 1 为 17%，基因型 2 为 86%。未报告明显的不良事件。
对于先前患有基因型 2 慢性丙型肝炎相关 HCC 的患者，不应排除抗病毒治疗，因为对于慢性丙型肝炎的有效抗病毒治疗是可行的。需要进一步研究来证明基因型 1 丙型肝炎相关 HCC 患者抗病毒治疗的有效性。
