Effect of Pegylated Interferon Therapy After Curative Treatment of Hepatitis C Virus-Related Hepatocellular Carcinoma - A Case Report

The 5-year recurrence rate of hepatocellular carcinoma (HCC) isknown to be as high as 60-100% even if radically treated by radiofrequencyablation (RFA) or surgery. Accordingly it is required to treatbackground liver disease after radical treatment of HCC. A 50s malewith hepatitis C virus-related HCC (Genotype1b, 300KIU/mL) underwentRFA followed by pegylated interferon (PEG-IFN) α-2b and ribavirincombination therapy. Although the patient had an early virologicalresponse (EVR), he experienced a relapse. The patient was treated withlow-dose Peg-IFNα2a administration (90μg/2-4 weeks) for persistentlynormal alanine aminotransferase (ALT) and was followed up.Peg-IFN-α2a administration was initiated at doses of 90μg. HCVRNA test becomes negative after single dose, and then the patientremained negative HCV RNA result and normal ALT level. Afterthree months, recurrence of HCC 1.5 cm in size located at segment 2of the liver was observed and treated with RFA. After that, Peg-IFN-α2a administration was restarted and he had persistently negativeHCV RNA result, normal ALT level, and normal alpha-fetoprotein(AFP) level. Six months after the end of IFN treatment, his HCVRNAtest was negative, that is to say, he obtained a sustained virologicalresponse (SVR). Moreover, there has been no evidence ofHCC recurrence for 24 months after the second treatment of RFA.The HCC patient with genotype 1b and high viral load was treatedwith radical RFA followed by low-dose Peg-IFNα2a, and his HCVRNA level became negative, and he obtained an SVR, and ALT andAFP levels became normal. It was speculated that the Peg-IFN-α2alow-dose administration might contribute to preventing subsequentrecurrence of HCC.