Shuhei Nishiguchi, MD, and colleagues of the Osaka City University Medical School in Japan, studied 90 patients with hepatitis C infection and cirrhosis, a scarring of the liver tissue that often accompanies the infection. Half the patients received treatment only for symptoms and half were given IFNa three times a week for 24 weeks. The researchers then followed the patients' health for an average of nine years and published their results in the Jan. 20 issue of the The Lancet.

Nishiguchi reports that patients receiving IFNa were less likely to develop liver cancer than the others -- only 27% of the patients getting IFNa developed the disease, compared with 75% of the other patients. The patients receiving IFNa also were less likely to die of liver cancer or worsening cirrhosis. About 89% of those given IFNa survived, compared to 42% of the other patients.

"With the exception of patients at particular risk for serious side effects, I would recommend this treatment to any patient with chronic hepatitis type C," Nishiguchi says. "It improves the chances of survival by preventing the worsening of liver damage."

However, the side effects of IFNa treatment can be harsh. "In recommending interferon treatment to patients, we explain possible side effects," Nishiguchi says. "These can include a decrease in platelet count, depression, and increased risk of infection." A lowered platelet count can lead to problems with bleeding and bruising.

The researchers also point out that the effects of IFNa on liver function, the development of liver cancer, and survival are still controversial. Not all of the patients in the study responded to IFNa. Out of 45 patients who took it, only 15 had a complete or partial response to the drug. The risk of developing liver cancer was decreased in the responders; of the 12 patients taking IFNa who developed liver cancer, two had shown a response to the treatment and 10 had not.

Another expert says the results of the Japanese study may not hold true in other countries. "Caution is required," when interpreting these results, says W. Thomas London, MD, a senior researcher with the Fox Chase Cancer Center. "Similar results have not been repeated in Western countries -- so it is possible that this good news only applies to Japan," he says.

"In general, the response rates to IFNa have been lower in the US and Europe than in Japan," London adds. "On the other hand, essentially all [hepatitis C] patients in the U.S. and Europe with significant liver disease, chronic hepatitis and/or cirrhosis, are being treated with IFNa with or without a second drug, ribavirin," he says. "Therefore, if Dr. Nishiguchi is right, these patients may be receiving an extra benefit from their treatment."

According to the Centers for Disease Control and Prevention, an estimated 3.9 million Americans have been infected with hepatitis C. The American Cancer Society estimates 16,200 new cases of liver and intrahepatic bile duct cancers will be diagnosed in the U.S. this year, and 14,100 people are expected to die of those cancers in 2001.