Effect of pegylated interferon therapy after curative treatment of hepatitis C virus-related hepatocellular carcinoma - A Case Report

Abstract

The 5-year recurrence rate of hepatocellular carcinoma (HCC) is known to be as high as 60-100% even if radically treated by radiofrequency ablation (RFA) or surgery. Accordingly it is required to treat background liver disease after radical treatment of HCC. A 50s male with hepatitis C virus-related HCC (Genotype1b, 300KIU/mL) underwent RFA followed by pegylated interferon (PEG-IFN) α-2b and ribavirin combination therapy. Although the patient had an early virological response (EVR), he experienced a relapse. The patient was treated with low-dose Peg-IFNα2a administration (90μg/2-4 weeks) for persistently normal alanine aminotransferase (ALT) and was followed up.

 Peg-IFN-α2a administration was initiated at doses of 90μg. HCV RNA test becomes negative after single dose, and then the patient remained negative HCV RNA result and normal ALT level. After three months, recurrence of HCC 1.5 cm in size located at segment 2 of the liver was observed and treated with RFA. After that, Peg-IFN-α2a administration was restarted and he had persistently negative HCV RNA result, normal ALT level, and normal alpha-fetoprotein (AFP) level. Six months after the end of IFN treatment, his HCV-RNA test was negative, that is to say, he obtained a sustained virological response (SVR). Moreover, there has been no evidence of HCC recurrence for 24 months after the second treatment of RFA.

 The HCC patient with genotype 1b and high viral load was treated with radical RFA followed by low-dose Peg-IFNα2a, and his HCV RNA level became negative, and he obtained an SVR, and ALT and AFP levels became normal. It was speculated that the Peg-IFN-α2a low-dose administration might contribute to preventing subsequent recurrence of HCC.